Longitudinal patterns of health insurance coverage among a national sample of children in the child welfare system.
OBJECTIVE
We sought to describe health insurance coverage over time among a national sample of children who came into contact with child welfare or child protective services agencies.


METHODS
We used data from 4 waves of the National Survey of Child and Adolescent Well-Being to examine insurance coverage among 2501 youths. Longitudinal insurance trajectories were identified using latent class analyses, a technique used to classify individuals into groupings of observed variables, and survey-weighted logistic regression was used to identify variables associated with class membership.


RESULTS
We identified 2 latent insurance classes--1 contained children who gained health insurance, and the other contained children who stably maintained coverage over time. History of sexual abuse, and race/ethnicity other than White, Black, and Hispanic, were associated with membership in the "gainer" class. Foster care placement and poorer health status were associated with membership in the "maintainer" class. Caregiver characteristics were not associated with class membership.


CONCLUSIONS
The majority of children in child welfare had stable health insurance coverage over time. Given this vulnerable population's dependence upon Medicaid, protection of existing entitlements to Medicaid is essential to preserve their stable insurance coverage.
Raghavan
Ramesh
R
Washington University in St Louis, Campus Box 1196, One Brookings Dr, St Louis, MO 63130, USA. raghavan@wustl.edu
Aarons
Gregory A
GA
Roesch
Scott C
SC
Leslie
Laurel K
LK
D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage; D007348:Insurance, Health; D007361:Intelligence Tests; D008297:Male; D011581:Psychological Tests; D011594:Psychometrics; D013997:Time Factors; D014481:United States