ANALYSIS OF CHILDREN'S HEALTH INSURANCE PATTERNS:
FINDINGS FROM THE SIPP
INTRODUCTION
Purpose of This Report
The passage of the legislation establishing the Children's Health Insurance
Program (CHIP) has turned the policy spotlight on the number and characteristics
of children without health insurance. In fact, many more children go without
health insurance than the number who are uninsured at any one time. The
research reported here was conducted to explore the dynamics of health
insurance coverage among children and to tell us more about the relationship
between Medicaid eligibility and insurance coverage. The unique contribution
of this research is that it provides the most detailed picture yet of the
dynamics of health insurance coverage among children by addressing five
broad questions:
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How many children lack insurance?
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How long do children remain uninsured?
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What are the patterns of movement between spells with and without insurance?
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What are the characteristics of children by type of health insurance coverage?
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How many fewer uninsured children would there be if participation in Medicaid
were more complete?
This report summarizes the key findings in each of these areas and interprets
them against the backdrop of current policy discussions.
Source of Data
This analysis is based on the 1992 panel of the Survey of Income and
Program Participation (SIPP), a longitudinal survey that provides extensive
monthly data on a large sample of children (and adults) from 1992 through
1994. These are the latest data with which we could construct the multi-year
longitudinal measures presented in this report. The 1993 SIPP panel would
have given us data through 1995, but our work with these data raised concerns
that the number of poor children was overstated. The Census Bureau started
another SIPP panel in 1996, but until recently, only the first wave of
data, covering a four-month reference period, had been released.
Given that readers will want to apply the findings presented here to
the present, an important caveat is that the data on which this analysis
is based precede welfare reform. Clearly, point estimates of uninsured
children and Medicaid participants in 1994 will differ from today's figures,
but the underlying dynamics on which this report focuses remain relevant
even though some of the particulars may have changed.