Health insurance is critical to children’s well-being. Children who have health insurance are more likely than those without coverage to use preventative health services,1,2,3 experience fewer emergency room visits and hospitalizations,4 have better overall health,5,6,7 and have better educational and labor force outcomes.8,9 Over the last decade, increased federal and state funding of the Child Health Insurance Program (CHIP)10 and the implementation of the Affordable Care and Patient Protection Act (or ACA)11,12 helped improve health insurance coverage among children.10 Now, though, for the first time in close to a decade, the percentage of children under age 19 who did not have health insurance has increased, rising from 5.0 percent in 2017 to 5.5 percent in 2018, according to a recent Census report.13 This amounts to roughly 425,000 more children who were uninsured in 2018 than in 2017.
Historically, rates of children without health insurance in the United States have varied across racial/ethnic groups, with Hispanic and non-Hispanic Black children more likely to be uninsured than their non-Hispanic White counterparts.13,14,15,16 Children’s access to services— including health insurance and health care—is shaped by the immigrant experiences of their parents.a,17 For example, prior research has found that having even just one U.S.-born parent is associated with a greater likelihood of having a regular health care provider18 and better child health outcomes.19
In this brief, we examine whether the recent increase in the health uninsured rate has been experienced similarly by children across racial/ethnic groups. We used data from the 2011-2019 Current Population Survey (CPS), covering the time period from 2010 to 2018, to examine patterns of uninsured rates over time for children from the three largest racial/ethnic groups: Hispanic, non-Hispanic White, and non-Hispanic Black children.b We also compared the uninsured rates of Hispanic children with at least one U.S.-born parent with those of Hispanic children with only foreign-born parents (including foreign-born single parents). Methods of data collection and processing for the CPS have changed over time. Therefore, while we report overall trends in uninsured rates from 2010 to 2018, we were only able to statistically compare changes in children’s uninsured rates within the three time periods for which direct comparisons can be made: 2010-2012, 2013-2015, and 2016-2018.c For clarity, we explicitly note in the text where direct comparisons can or cannot be made.
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