title: Low-Income Working Families With Employer-Sponsored Insurance Turn To Public Insurance For Their Children.
abstract: Many families rely on employer-sponsored health insurance for their children. However, the rise in the cost of such insurance has outpaced growth in family income, potentially making public insurance (Medicaid or the Children's Health Insurance Plan) an attractive alternative for affordable dependent coverage. Using data for 2008-13 from the Medical Expenditure Panel Survey, we quantified the coverage rates for children from low- or moderate-income households in which a parent was offered employer-sponsored insurance. Among families in which parents were covered by such insurance, the proportion of children without employer-sponsored coverage increased from 22.5 percent in 2008 to 25.0 percent in 2013. The percentage of children with public insurance when a parent was covered by employer-sponsored insurance increased from 12.1 percent in 2008 to 15.2 percent in 2013. This trend was most pronounced for families with incomes of 100-199 percent of the federal poverty level, for whom the share of children with public insurance increased from 22.8 percent to 29.9 percent. Among families with incomes of 200-299 percent of poverty, uninsurance rates for children increased from 6.0 percent to 9.2 percent. These findings suggest a movement away from employer-sponsored insurance and toward public insurance for children in low-income families, and growth in uninsurance among children in moderate-income families.
authors.affiliation: Douglas Strane (straned@email.chop.edu) is a clinical research associate at PolicyLab at the Children's Hospital of Philadelphia (CHOP), in Pennsylvania.
authors.forename: Douglas
authors.initials: D
authors.lastname: Strane
authors.affiliation: Benjamin French is an associate professor in the Department of Biostatistics and Epidemiology, Perelman School of Medicine, at the University of Pennsylvania, in Philadelphia.
authors.forename: Benjamin
authors.initials: B
authors.lastname: French
authors.affiliation: Jennifer Eder is a consultant at Manatt Phelps & Phillips in New York City. At the time of this research, she was chief policy officer at PolicyLab at CHOP.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Eder
authors.affiliation: Charlene A. Wong is a pediatrician in the Department of Adolescent Medicine at CHOP and the University of Pennsylvania.
authors.forename: Charlene A
authors.initials: CA
authors.lastname: Wong
authors.affiliation: Kathleen G. Noonan is a senior legal adviser at PolicyLab at CHOP.
authors.forename: Kathleen G
authors.initials: KG
authors.lastname: Noonan
authors.affiliation: David M. Rubin is director of PolicyLab and medical director of population health, both at CHOP, and a professor of pediatrics at the Perelman School of Medicine, University of Pennsylvania.
authors.forename: David M
authors.initials: DM
authors.lastname: Rubin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D065326:Children's Health Insurance Program / Q000191:economics*; D004608:Eligibility Determination; D005260:Female; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data*; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States
keywords: Children < Insurance; Children’s Health; Employer- Based System < Insurance; Financing Health Care; Health Economics