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The proportion of children with health insurance coverage for any part of the year has increased modestly, from 89 percent in 2000 to 94 percent in 2014. However, during this period, the share of children with private insurance decreased from 71 to 61 percent, while the proportion of children covered under Medicaid[1] increased from 21 to 40 percent.

Importance

Children not covered at all by health insurance, or who experience gaps in coverage, are less likely than those with continuous insurance coverage to have a regular source of health care, and are more likely than children continuously insured to have medical care delayed or unmet, and to have prescriptions unfilled.[2],[3]
Gaps in coverage can be particularly detrimental for children with chronic health conditions, such as asthma, that require frequent, consistent preventive monitoring by health care providers.[4] In 2015, eight percent of children were uninsured at least part of the previous 12 months, and two percent were uninsured for more than a year.[5]

Because children without health insurance are also more likely than others to receive late or no care for health problems, they are at greater risk for hospitalization.[6] In addition to resulting in reduced access to health care, a lack of health insurance can also negatively influence children’s school attendance and participation in extracurricular activities, and increase parental financial and emotional stress.[7],[8] There is preliminary evidence that enrolling children in more comprehensive health insurance plans has a beneficial effect, not only on access to services, but on health outcomes, as reported by parents.[9]

Trends

26_fig1Federal and state rules (including the introduction of Children’s Health Insurance Program [CHIP]) led to major expansions in Medicaid coverage for children over the past 15 years. Simultaneously, fewer children have been enrolled in private insurance plans. Between 1990 and 1998, the proportion of children who were covered by any type of health insurance decreased, from 87 to 85 percent. Between 1998 and 2000, the proportion of children who were covered increased to 89 percent, and continued to rise slowly up to 2012. Between 2012 and 2014, the proportion increased from 91 to 94 percent; however, there was a redesign of the questions in 2013, so the data are not strictly comparable. (Figure 1). Nevertheless, data from other sources also show large increases over that time: from 93 to 95 percent, and increasing further in 2015, to 96 percent.[10]

The proportion of children covered under private health insurance plans decreased between 1987 and 1995, from 74 to 66 percent, then increased to 71 percent by 2000. Between 2000 and 2009, the share of children who were privately insured decreased again, from 71 to 61 percent. Since then, however, the rate has remained steady or increased slightly, and was at 61 percent in 2014. The proportion of children covered by public insurance increased fairly consistently between 1987 and 2014, from 19 to 43 percent of all children, except for a small decrease between 1995 and 1997, from 26 to 23 percent. (Figure 1) Although Medicaid and CHIP are administered by the states, which have wide latitude in setting eligibility and benefits policies, much of the funding comes from the federal government.[11]

Differences by Race and Hispanic Origin[12]

26_fig2Hispanic children are less likely than other children to be covered by health insurance. In 2014, only 91 percent of Hispanic children had health insurance coverage for some part of the year, compared with 95 percent of white and Black children, and 94 percent of Asian children. (Figure 2) However, this gap has been narrowing over time. (Appendix 1)

The type of coverage also varies greatly by race and Hispanic origin. More than three-quarters of insured white and Asian children have private coverage (73 percent, each), compared with less than half of black and Hispanic children (46 and 42 percent, respectively). (Figure 2)

There are several explanations as to why many Hispanic children are uninsured, including a lack of awareness of eligibility, language barriers and other access difficulties, and fears that using publicly funded insurance may lead to reprisals from immigration or other law enforcement officials.[13] Additional barriers may include ineligibility due to non-citizenship status, and the fact that Hispanics are less likely to work for employers who offer health insurance.[14]

Differences by Family Type

Children in married-couple families, or in families headed by a single woman, are more likely to have health insurance coverage for at least some portion of the year than are children in families headed by an unmarried man. In 2014, 95 percent of children in married-couple families had health insurance coverage, and 93 percent of children in families headed by a single woman, compared with 90 percent of children in families headed by a single man. (Appendix 1) However, children in families headed by a single man were more likely than those in families headed by a single woman to be covered by private health insurance, though both were much less likely to be covered by private health insurance than children in married-couple families (51, 38, and 71 percent, respectively). (Appendix 2)

Differences by Income

26_fig3The likelihood of being covered by health insurance for at least part of the year increases with income. In 2014, 96 percent of children living in families with incomes of $75,000 or more had coverage. In contrast, only 92 percent of children in families with incomes under $50,000 were covered. As family income goes up, coverage by public insurance goes down, and coverage by private insurance goes up. However, 20 percent of children in families with incomes over $75,000 a year had public insurance in 2014. (Figure 3)

In the past fourteen years, the rate of insurance coverage has increased most among children in families making less than $25,000 a year, from 81 to 92 percent. For children in families making between $25,000 and $49,999 a year, the rate of insurance coverage has been increasing since 2007, going from 84 to 92 percent. For children in families with higher incomes, coverage rates were similar in 2014 as in 2000, after a sharp decline between 2006 and 2007. (Appendix 1)

Rates of coverage under private insurance have fallen for children at all family income levels in the past decade, but declines have been greater for children in lower-income families. For instance, the proportion of children in families making less than $25,000 a year who were covered by private insurance in 2014 was a third of what it was in 2000 (21 and 33 percent, respectively), while for children in families that made more than $75,000 the private-coverage proportion was only slightly lower (86 and 94 percent, respectively). (Appendix 2)

Differences by Nativity and Citizenship

26_fig4Children who are U.S. citizens, whether native-born or naturalized, are more likely than children who are non-citizens to have health insurance coverage. Among children, the health insurance coverage rates in 2014 for U.S. citizens were 94 percent for native-born citizens, and 92 percent for naturalized citizens, compared with only 80 percent for non-citizens under age 18. Noncitizens had lower rates of private insurance, but public insurance rates were only slightly lower than among native-born citizens. (Figure 4)

Differences by Type of Health Insurance Coverage

In general, children belonging to economically advantaged groups are the most likely to have private health insurance, which is largely employment-based, while children in economically disadvantaged groups are the most likely to have government health insurance, most often Medicaid, a means-tested program. (Figure 3)

Although Medicaid (as of 2014) covers 40 percent of children overall, it covers 77 percent of poor children. Among poor children, Medicaid coverage is highest for black children (82 percent), followed by Hispanic children (79 percent), white children (72 percent), and Asian children (70 percent). Younger children are more likely to be covered by Medicaid, with 81 percent of poor children ages 0 to 5, 78 percent of children ages six to 11, and 71 percent of children ages 12 to 17 covered by Medicaid in 2013. (Appendix 3)

Government health insurance, which consists primarily of Medicaid but also includes several other sources of coverage (see Definition section below), covered 43 percent of all children in 2014. (Appendix 3)

Differences by Region

Children living in the Northeast and Midwest are more likely than children living in the South and the West to have health insurance coverage at least part of the year (95 and 95 percent, each, for the Northeast and the Midwest, versus 94 and 93 percent, respectively for the West and South in 2014). (Appendix 1) There is wide variation in rates of uninsurance across the states, with children in Nevada nearly five times more likely than children in Hawaii to be without health insurance in 2013.[15]

State and Local Estimates

State estimates of health insurance coverage for children (under age 18) and coverage for low-income children (under age 19, below 200 percent of poverty) are available from the Census Bureau (tables HI05 and HI10).

2013-2014 state estimates of health care coverage by type of coverage are available at the Kaiser Family Foundation’s State Health Facts Online.

2011-2012 state estimates for the consistency of health care coverage (continuous coverage for the past 12 months) are available through the National Survey of Children’s Health at the Data Center for Child & Adolescent Health.

County-level and state-level estimates of health insurance coverage for the total population and children under age 18 are available from the U.S. Census Bureau for 2008-2014.

International Estimates

None available.

National Goals

While there is no national goal specifically for child health insurance coverage, the federal government has set a goal through the Healthy
People 2020
initiative goal to increase the percentage of children who have access to a medical home from 57.5 percent in 2007 to 63.3 percent by 2020, as well as a goal to increase the proportion of all people with health insurance, from 83.2 percent in 2008 to 100 percent in 2020.

More information available here (goal MCH-30.1) and here (goal AHS-1).

Related Indicators

Definition

These estimates reflect coverage for any portion of the year by private or public health insurance. Public health insurance consists primarily of Medicaid, but also includes Medicare, State Children’s Health Insurance Programs (SCHIP/CHIP), and the Medical Care Program of the Uniformed Services (CHAMPUS/Tricare).

In 2013, there was a redesign in the way questions about health insurance were asked. These changes were meant to enhance reporting for earlier time periods, information about other people in the household, and the type of coverage. More details on the changes and their effects are available here.

Data Sources

Data for 2002-2014: U.S. Census Bureau. CPS Table Creator (online tool).

Data for 2001: Mills, Robert J. (2002). Health Insurance Coverage: 2001, Detailed Tables. Current Population Reports, P60-220. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032002/health/toc.htm

Data for 2000: Mills, Robert J. (2001). Health Insurance Coverage: 2000, Detailed Tables. Current Population Reports, P60-215. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032001/health/toc.htm

Data for 1987, 1990, and 1995-1999: U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. (2003). Trends in the well-being of America’s children and youth, 2003. Tables HC 1.1.A and HC 1.1.B. Available at: https://aspe.hhs.gov/pdf-report/trends-well-being-americas-children-and-youth-2003

Data for 1988-1989, and 1991-1994: U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. (2000). Trends in the well-being of America’s children & youth, 2000. Tables HC 1.1.A and HC 1.1.B. Available at: https://aspe.hhs.gov/pdf-report/trends-well-being-americas-children-and-youth-2000

Raw Data Source

Bureau of Labor Statistics and U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement

http://www.census.gov/cps/.

 

Appendix 1 – Percentage of Children Under 18 Covered By Health Insurance,1 All Plans (Private and Public): Selected Years, 1987-20142

1987 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Total 87 87 86 89.3 89.3 89.7 89.6 90.1 89.7 88.8 89.4 90.5 90.3 90.2 90.6 91.1 92.7 94
Age
Ages 0-5 88 89 87 89.6 90 90.5 90.6 91.4 90.2 89.2 89.9 91.5 91 91 91.5 91.6 92.8 93.4
Ages 6-11 87 87 87 89.5 89.8 90.3 89.9 90.1 90.5 89.2 89.9 91.1 90.7 90.7 90.9 91.5 93.2 94.7
Ages 12-17 86 85 85 88.8 88.3 88.4 88.5 88.8 88.5 88 88.5 88.9 89 89 89.4 90.3 92.1 93.8
Race and Hispanic Origin3
White, non-Hispanic 90 90 90 93.5 93.5 93.4 93.5 93.4 93.4 93 93 93.5 93.3 93.1 93.2 93.5 94.6 95.3
Black 83 85 85 88.1 87.9 88 87.2 88.8 89.1 86.5 88.7 89.8 88.8 88.9 89.8 90.7 93.2 95.1
Hispanic 72 72 73 76 77 79.2 79.4 80.5 79.2 78.7 80.2 83.3 83.6 83.7 84.9 85.9 88.7 90.7
Asian or Pacific Islander 90 86 86 88.9 90.1 88.3 88.6 91.3 89.1 88.6 88.6 89 90.1 90.9 90.8 91.9 91.9 93.2
Asian alone 88.4 88.2 91.8 89.1 88.8 88.7 89 90.2 90.8 90.9 92 92 93.8
Family Type
Married couple families 90.9 91.2 91.2 91.2 91.6 91.1 90.7 91.1 91.7 91.7 91.6 92 92.2 93.3 94.6
Male householder, no spouse present 81.7 81.9 81.2 83.1 82.1 82.9 79 82.9 83.4 83.8 83.3 86.1 86.7 89.3 90.4
Female householder, no spouse present 86.6 86.2 87.3 86.5 87.6 87.2 85.7 86.4 88.9 88.1 88.3 88.3 89.6 92 93.1
Family Income4
Less than $25,000 80.7 81.2 82.2 82.1 82.8 82.7 81.8 83.5 84.8 85.1 85 86.1 87.5 90.5 91.9
$25,000-49,999 87 86.9 86.5 87.1 87.2 85.4 84.6 84.1 86.5 86.8 86.4 86.9 87.1 90.8 91.9
$50,000-74,999 93.4 93.4 93.3 92.3 92.6 92 90.4 90.2 91.4 90.9 90.6 90.5 91 91.9 93.6
$75,000 or more 96.3 95.9 96.3 96 96.1 96.2 94.8 95.6 95.5 95.3 95.8 95.6 95.6 96 96.2
Nativity and citizenship
Native 90.2 90.4 90.8 90.7 91.1 90.7 89.7 90.2 91.3 90.9 90.9 91.2 91.6 93.3 94.3
Foreign-born 67.2 65.1 64.7 63.7 67.6 66.2 67.6 69.3 68 72.3 70.5 74.8 77.5 77.8 83.2
Naturalized citizen 85.8 85.2 83 86.5 85.8 83.2 85.5 85.1 89.2 89.8 88.1 87.5 91.3 91.9 91.6
Not a citizen 64.3 61.9 61.1 59.8 64.2 63.1 64 65.8 62.8 68 65.5 70.8 72.7 71.9 80.1
Region
Northeast 93.1 92.7 92.4 92 93.3 93.2 91.8 92.4 93.3 93.5 92.5 93.3 94.3 94.1 95.3
Midwest 92.8 93.5 93.2 93 92.7 92.9 93 93.2 94 92.6 93 93 93.3 94.8 95.2
South 86.7 87.1 87.4 87.4 87.8 87.6 85.7 85.8 88.1 87.7 88.2 89.1 88.9 91.5 92.9
West 87.1 86.9 87.8 88.1 88.7 87.4 87.4 89.4 89.1 89.8 89.3 89.1 90.5 91.8 93.7
1 Children are considered to be covered by health insurance if they had public or private coverage at any time during the year.2 Starting in 2004, the Current Population Survey revised the evaluation process of Health Care Coverage data to more accurately reflect respondents’ coverage status. More information available at: http://www.census.gov/hhes/www/hlthins/usernote/usernote3-21rev.html. Questions were revised again in 2013. More detail on this change are available at: https://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/redesign.html

3 The 2002 and later surveys allowed respondents to mark more than one race, so comparisons across years are problematic. White, black, and Asian alone only include respondents who only marked one racial box. Estimates for Blacks include Hispanics of that race. Persons of Hispanic origin may be of any race.

4 Questions to determine income were changed in 2014. More detail on this change are available at: https://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/redesign.html

Sources: Data for 1987, 1990, and 1995-1999: U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. (2003). Trends in the well-being of America’s children and youth, 2003. Tables HC 1.1.A and HC 1.1.B. Available at: https://aspe.hhs.gov/pdf-report/trends-well-being-americas-children-and-youth-2003 Data for 2000: Mills, Robert J. (2001). Health Insurance Coverage: 2000, Detailed Tables. Current Population Reports, P60-215. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032001/health/toc.htm. Data for 2001: Mills, Robert J. (2002). Health Insurance Coverage: 2001, Detailed Tables. Current Population Reports, P60-220. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032002/health/toc.htm. Data for 2002-2014: U.S. Census Bureau. CPS Table Creator (online tool), available at: http://www.census.gov/cps/data/cpstablecreator.html

 

Appendix 2 – Percentage of Children Under 18 Covered By Private Health Insurance Plans:1 Selected Years, 1987-20142

1987 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Total 74 71 66 71.2 69.6 69 67 67.1 66.3 65.2 64.6 63.6 60.5 59.6 59.4 60.1 59.8 60.8
Age
Ages 0-5 72 68 60 67.5 65.5 64.9 62.9 63.2 62 61 59.7 58.7 55.4 54.4 54.4 55.5 54.3 55.5
Ages 6-11 74 73 67 71.3 69.6 69.4 67.4 67.7 66.9 65.7 65.6 64.5 61.4 60 59.6 60.1 60 60.7
Ages 12-17 75 73 71 74.7 73.5 72.2 70.4 70.2 69.9 68.6 68.3 67.7 64.8 64.1 64.1 64.4 64.8 66
Race and Hispanic Origin3
White, non-Hispanic 83 81 78 82 80.7 80.4 79 78.4 78.4 77.2 77.1 76.5 74.1 73.2 72.9 73.5 73.2 72.6
Black 49 48 44 55.7 54 52.6 49.9 50.3 49.4 49.7 48.6 46.9 43.1 41.5 43.2 43.6 42.5 45.5
Hispanic 48 45 38 46.8 45.2 44.9 42.8 44.8 42.9 41.8 40.9 40.9 37.3 38 38.1 38.9 39.7 42.3
Asian or Pacific Islander 70 72 67 74.5 73.3 71.8 72.7 76.6 74.6 72.6 70.9 69.9 69.7 66.9 68.1 71.5 69.3 69.6
Asian alone 72.7 72.5 77.6 75.1 73.3 71.6 71.6 71 68 69.5 73.6 70.9 72.6
Family Type
Married couple families 79.5 78.3 77.7 76.4 76.6 75.7 74.7 74.4 73.3 70.6 70.1 70.3 71.1 70.3 70.7
Male householder, no spouse present 60.4 58.3 55.2 52 53.5 55.1 51.5 52.9 50 46.2 44 47 47 49.5 51
Female householder, no spouse present 49.4 46.8 46.8 43.7 43.5 42.6 41.6 40.6 39.9 37 36.9 36 35.9 35.9 37.9
Family Income4
Less than $25,000 33 30 29.2 26.5 25.6 24.9 23.4 21.4 20.4 17.8 17.7 18.1 17.9 19.9 21.3
$25,000-49,999 70.1 66.7 65.5 62.8 61.3 57.8 53.7 51.7 49.4 47.4 45.8 42.8 44.3 42.9 43.5
$50,000-74,999 87.5 86.4 86.1 83 83.8 80.7 78.6 77.6 77.1 74 72.9 71.3 71 68.1 68
$75,000 or more 93.7 93.2 93.1 92.5 92.1 92.4 90.7 90.9 90.1 89 89.2 89.8 89.2 87.2 86.3
Nativity and citizenship
Native 72.2 70.6 70 68.1 68.1 67.2 66 65.4 64.4 61.2 60.2 60 60.5 60.4 61.2
Foreign-born 50.3 46.8 43.7 40.9 44.7 45.1 45.1 44.7 42.2 41.6 41.5 44.2 47.7 45.2 49.5
Naturalized citizen 75.7 64.9 64.5 70.1 67.4 65.7 65.2 64.5 70.6 66.3 61.6 60.7 58.1 56.3 61.3
Not a citizen 46.2 43.8 39.5 35.9 40.4 41.4 41.1 40.2 35.4 35.6 35.9 39 44.1 40.5 45.1
Region
Northeast 75.3 73.5 72 72.6 73.1 72 70.9 70.1 68.4 66.5 66 66.7 65.8 66.6 66.2
Midwest 79.2 78.2 77.3 74.6 73.6 72.8 71.8 70.7 69.7 65.9 65.5 63.5 65.8 67 66.2
South 67.5 65.4 64.1 62.2 62.7 61.9 60.3 58.9 59.2 56.4 54.6 55.4 55.1 54 55.9
West 66.4 65.6 66 63.1 63.4 63.2 62.5 64 61.5 58 57.5 57.2 59 58.2 60.2
1 Children are considered to be covered by health insurance if they had public or private coverage at any time during the year.2 Starting in 2004, the Current Population Survey revised the evaluation process of Health Care Coverage data to more accurately reflect respondents’ coverage status. More information available at: http://www.census.gov/hhes/www/hlthins/usernote/usernote3-21rev.html. Questions were revised again in 2013. More detail on this change are available at: https://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/redesign.html

3 The 2002 and later surveys allowed respondents to mark more than one race, so comparisons across years are problematic. White, black, and Asian alone only include respondents who only marked one racial box. Estimates for Blacks include Hispanics of that race. Persons of Hispanic origin may be of any race.

4 Questions to determine income were changed in 2014. More detail on this change are available at: https://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/redesign.html

Sources: Data for 1987, 1990, and 1995-1999: U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. (2003). Trends in the well-being of America’s children and youth, 2003. Tables HC 1.1.A and HC 1.1.B. Available at: https://aspe.hhs.gov/pdf-report/trends-well-being-americas-children-and-youth-2003 Data for 2000: Mills, Robert J. (2001). Health Insurance Coverage: 2000, Detailed Tables. Current Population Reports, P60-215. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032001/health/toc.htm. Data for 2001: Mills, Robert J. (2002). Health Insurance Coverage: 2001, Detailed Tables. Current Population Reports, P60-220. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032002/health/toc.htm. Data for 2002-2014: U.S. Census Bureau. CPS Table Creator (online tool), available at: http://www.census.gov/cps/data/cpstablecreator.html

 

Appendix 3 – Percentage of Children Under 18 Covered By Public Health Insurance Plans:1 Selected Years, 1987-20142

1987 1990 1995 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
All Government Insurance1 19 22 26 24.2 25.8 26.7 29.1 29.7 29.7 29.9 31 33.3 36.8 37.9 38.8 39.2 41.4 42.9
Age
Ages 0-5 22 28 33 28.7 31.1 32.1 34.6 35.4 34.8 34.8 36.4 39.5 42.6 43.8 44.7 44.6 46.7 47.7
Ages 6-11 19 20 26 24.3 26.4 26.7 28.8 29.5 29.9 29.5 30.5 33 36.4 38 38.9 39.1 42 43.6
Ages 12-17 16 19 21 19.6 20.1 21.6 24.2 24.7 24.8 25.5 26.3 27.4 31.1 32.1 33 34.1 35.8 37.8
Race and Hispanic Origin3
White, non-Hispanic 12 15 18 17.1 18.8 18.5 20.8 21.3 21.2 22.1 22 23.1 26.2 27.4 28.2 28.4 30.2 32.5
Black 42 45 49 41.1 41.5 43.4 45.1 47.3 48.3 44.1 47.9 51.1 53.8 56 55.1 56.3 59.6 59.7
Hispanic 28 32 39 33.8 36.5 39.3 42.2 41.9 41.4 42.3 44.2 47.9 52 51.5 53.4 53.8 57 57.6
Asian or Pacific Islander 21.8 21.4 22.2 21.3 22.7 19.8 21 22.1 24.2 27.2 29.5 29.4 26.7 30.5 33.8
Asian alone 21.1 20.7 22 19 20.5 21.1 21.9 25.4 27.7 27.7 24.6 29.3 31.5
Family Type
Married couple families 17.1 18.5 19.1 21 21.4 21.4 21.9 22.4 24.6 28.1 28.9 29.4 29.2 31.6 33.9
Male householder, no spouse present 28.1 29.2 31.7 36.8 35.7 35 33.7 37.5 40.1 44.5 45.4 46.6 47.6 48.1 50.4
Female householder, no spouse present 44.3 46.5 47.6 50 52 52 51.3 53.1 55.9 58.1 58.9 59.7 61.9 64.5 64.3
Family Income4
Less than $25,000 54.7 58.2 59.8 62.3 64.4 64.3 64.9 68.1 69.9 73.1 73 74.5 76 78.5 78.2
$25,000-49,999 24.6 27.5 28.8 32.6 34.6 36 38.7 40.1 45.3 48.5 49.4 53.1 52.6 58.4 59.3
$50,000-74,999 11.1 13.2 13 15.7 15.2 17.6 18.8 19.8 21.6 24.8 27.1 28.2 29.7 32.7 36.8
$75,000 or more 7 6.5 6.9 8.1 9.3 8.6 8.9 9.6 10.9 12.4 13 12.8 13.9 17.3 19.6
Nativity and citizenship
Native 24.2 26 26.8 29.1 29.9 29.9 30 31.1 33.5 36.8 38.1 38.9 39.3 41.4 43
Foreign-born 23.1 21.8 25.2 27.8 26.9 25.7 27.3 28.4 28 35.4 33.2 35.4 36.3 40.1 40.7
Naturalized citizen 21.9 24.1 24.7 22.9 21.2 21.9 25.7 24.7 22.5 28.8 31.6 31.6 42.1 43.1 36.6
Not a citizen 23.3 21.4 25.3 28.6 28 26.3 27.6 29.3 29.3 37 33.6 36.6 34.4 38.8 42.2
Region
Northeast 24.3 24.9 25.2 25.4 26.2 27.3 27 27.9 30.9 33.8 33.4 34.7 37.1 37.1 40.1
Midwest 19.1 21.2 22.1 25.2 25.9 25.9 27.5 29.3 31 33.9 35.5 36.9 36.4 36.8 38.7
South 25.3 28.1 29.7 31.8 32 32.8 32 33.5 35.5 38.5 40.8 41.8 41.6 45.2 45.8
West 26.9 26.9 27.7 31.2 32.4 30.1 30.8 30.9 33.6 38.8 38.6 38.5 39.2 42.4 44.1
Medicaid: All Children 15 19 23 20.6 22.6 23.8 26.3 26.9 26.7 27.1 28.2 30.3 33.8 34.8 35.5 35.9 38.1 39.6
Age
Ages 0-5 18 24 30 24.9 27.7 29.1 31.7 32.5 31.6 32.2 33.6 36.3 39.5 40.3 40.8 41 43.1 44.1
Ages 6-11 15 17 23 20.9 23.2 24 26.2 26.8 27.1 26.9 27.8 30.3 33.7 35.3 36.1 36.2 38.9 40.5
Ages 12-17 12 14 17 16.2 17.1 18.8 21.4 21.9 21.8 22.5 23.2 24.4 27.9 29.1 30 30.7 32.5 34.4
Race and Hispanic Origin3
White, non-Hispanic 8 11 14 13.6 15.3 15.7 17.8 18.5 18 19.1 19 20 23 23.9 24.4 24.9 26.4 28.7
Black 38 42 45 36.6 38.3 40.4 42.2 43.9 45.1 41.2 44.6 47.4 50.2 53 52.3 53.1 57.1 56.7
Hispanic 26 30 37 31.9 34.2 36.9 40.5 40 39.4 40.4 42.6 46.2 49.9 49.2 51.4 51.2 54.5 55.2
Asian or Pacific Islander 29 16 22 16.4 17.3 19 19.3 20.1 16.7 18.6 19.7 21.4 25.4 26.9 25.9 24.6 28.2 31.1
Asian alone 18.1 18.9 19.8 15.9 18.2 18.8 19.2 23.8 25.6 24.5 23 27.2 29.1
Medicaid: Poor children4 56 62 65 58.1 61.2 62.2 65.4 65.4 66 65.6 68.4 69.8 72.9 71.7 74.1 75.1 77.5 77
Age
Ages 0-5 61 71 73 63.1 67.7 69.1 71.9 72.2 70.5 69.9 73.6 76.2 77.9 77.1 78.4 79 80.9 80.6
Ages 6-11 56 59 65 58.7 61.7 61.3 65.5 64.2 67.1 66 68.8 69.5 73.9 71.4 76.1 75.7 79.1 78.3
Ages 12-17 48 52 53 51.2 52.4 54.6 57.3 58.1 59.1 59.7 61.3 61.7 64.8 64.9 66.3 69.5 71.4 71
Race and Hispanic Origin3
White, non-Hispanic 47 56 55 54.9 57.2 58.4 60.3 62.7 61.2 63.6 65.3 62.6 69.7 67.1 68.8 73 68.6 71.6
Black 67 73 76 65.9 70.5 68.5 71.2 70.7 75.4 71.1 74.5 75.7 76.9 77.1 79.9 79.1 86.1 82
Hispanic 53 58 64 53.9 57.9 60.7 67.1 63.7 63 63.1 66.5 71.8 73 71.9 75.7 74.7 82.8 79.4
Asian or Pacific Islander 69 53 63 53.6 57.7 54.7 48.1 56.6 47.5 58 63.1 60.5 62.6 65.8 63.9 62.5 65.7 67.9
Asian alone 51.9 47.2 56.1 46.1 58.8 63.5 57.3 61.9 66.7 62.2 60.7 65.7 67.9
1 Children are considered to be covered by health insurance if they had public or private coverage at any time during the year.2 Starting in 2004, the Current Population Survey revised the evaluation process of Health Care Coverage data to more accurately reflect respondents’ coverage status. More information available at: http://www.census.gov/hhes/www/hlthins/usernote/usernote3-21rev.html. Questions were revised again in 2013. More detail on this change are available at: https://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/redesign.html

3 The 2002 and later surveys allowed respondents to mark more than one race, so comparisons across years are problematic. White, black, and Asian alone only include respondents who only marked one racial box. Estimates for Blacks include Hispanics of that race. Persons of Hispanic origin may be of any race.

4 Questions to determine income were changed in 2014. More detail on this change are available at: https://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/redesign.html

Sources: Data for 1987, 1990, and 1995-1999: U.S. Department of Health and Human Services. Office of the Assistant Secretary for Planning and Evaluation. (2003). Trends in the well-being of America’s children and youth, 2003. Tables HC 1.1.A and HC 1.1.B. Available at: https://aspe.hhs.gov/pdf-report/trends-well-being-americas-children-and-youth-2003 Data for 2000: Mills, Robert J. (2001). Health Insurance Coverage: 2000, Detailed Tables. Current Population Reports, P60-215. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032001/health/toc.htm. Data for 2001: Mills, Robert J. (2002). Health Insurance Coverage: 2001, Detailed Tables. Current Population Reports, P60-220. U.S. Census Bureau, Washington, DC. Tables HI03 and HI08. Available at: http://www.census.gov/hhes/www/cpstables/macro/032002/health/toc.htm. Data for 2002-2014: U.S. Census Bureau. CPS Table Creator (online tool), available at: http://www.census.gov/cps/data/cpstablecreator.html

 

 

Endnotes


[1]Throughout this document, “Medicaid” refers to both coverage under the traditional Medicaid and the CHIP program, but not other forms of public coverage, such as CHAMPUS. The term “government health insurance” is used to refer to all types of public coverage, including Medicaid, Medicare and several other smaller programs.

[2]For a review of the literature, see Hadley, J.
(2002). Sicker and Poorer: The Consequences of Being Uninsured. Chapter
6 – “Insurance, Medical Care Use, and Birth, Child, and Maternal Health
Outcomes.” Prepared for the Kaiser Commission on Medicaid and the Uninsured. Available at: http://www.kff.org/uninsured/20020510-index.cfm (See Chapter 6, pp 53-71)

[3]Olson, L. M., Tang, S. S., & Newacheck, P. W.
(2005). Children in the Unted States with discontinuous health insurance
coverage. New England Journal of Medicine, 353(4), 382-391.

[4]Halterman, J. S., Montes, G., Shone, L. P., &
Szilagyi, P. G. (2008). The impact of health insurance gaps on access to care
among children with asthma in the United States. Ambulatory Pediatrics, 8(1),
43-49.

[5]Cohen, R. A., Martinez, M. E., & Zammitti, E. P. (2016). Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2015. National Center for Health Statistics. Available from: http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201605.pdf

[6]The Uninsured: Key Facts About Americans without
Health Insurance
. 7451-03 (2007) Prepared for
the Kaiser Commission on Medicaid and the Uninsured.

[7]Ross, D. C., & Hill, I. T. (2003). Enrolling
eligible children and keeping them enrolled. The Future of Children,13(1), 80-97. Available at: http://www.jstor.org/stable/10.2307/1602640.

[8]Hughes, D. C., & Ng, S. (2003). Reducing health
disparities among children. The Future of Children,13(1),
152-167. Available at: http://www.jstor.org/stable/10.2307/1602645

[9]Miller, S. (2012). The impact of the Massachusetts
health care reform on health care use among children. American Economic
Review, 102
(3),502-507.

[10] Cohen, R. A., Martinez, M. E., & Zammitti, E. P. (2016). Op cit.

[12] Beginning in 2002, the Census allowed respondents to select more than one racial category. White, black and Asian refer only to those who selected only one race. Hispanics may be any race, while whites in this report do not include Hispanics.

[13]Flores, G., Lin, H., Walker, C., Lee, M., Portillo, A., Henry, M., Fierro, M. * Massey, K. (2016). A cross-sectional study of parental awareness of and reasons for lack of health insurance among minority children, and the impact on health, access to care, and unmet needs. International Journal for Equity in Heatlh, 15(4). Published online, March 22, 2016. Available at: http://equityhealthj.biomedcentral.com/articles/10.1186/s12939-016-0331-y; Holahan, J., Dubay, L., & Kenney, G. (2003). Which children are still uninsured and why. The Future of Children, 13(1): 68-70.

[14]Pérez, S. (2004). Shaping new policies for Latino children and the nation’s future. The Future of Children, 14(2), 122-126. Available at: http://www.jstor.org/stable/10.2307/1602798

[15]Additional health insurance tables using the American Community Survey (ACS), Table HI05: Health insurance coverage status and type of coverage by state and age for all people: 2013. Available at: http://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/acs-tables.html

 

Suggested Citation:

Child Trends Databank. (2016). Health care coverage. Available at: https://www.childtrends.org/?indicators=health-care-coverage

 

Last updated: May 2016
 

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