Analysis of Children's Health Insurance Patterns: Findings from the SIPP. 1. Change in Coverage between Years

05/12/1999

Table 7 provides a cross-tabulation of health insurance coverage in October 1992 by health insurance coverage in September 1993 and in September 1994. The top row reports the number of children who were in each coverage group in October 1992. Below that is reported, for each October 1992 coverage group, the percentage distribution of children in September 1993 and, in the lower panel, September 1994.

Of the 12.6 million children who were reported as enrolled in Medicaid in October 1992, about 80 percent were still enrolled in September 1993 and 74 percent in September 1994. These figures do not reflect continuous enrollment, necessarily. A child who left Medicaid during 1993 but returned by September would be included in the 80 percent. Nevertheless, they indicate a very high degree of continuity in the reliance on Medicaid. Most of those who were not enrolled in Medicaid one or two years later were uninsured: 11 percent in September 1993 and nearly 14 percent in September 1994. Most of the remainder--7 percent in September 1993 and close to 10 percent in September 1994--acquired employer-sponsored coverage.

Of the 9.5 million children who were uninsured in October 1992, 62 percent were still uninsured in September 1993 and 52 percent in September 1994. Those who became insured were more likely to find such coverage in employer-sponsored plans than in Medicaid but at nowhere near the four to one rate that characterizes the dominance of employer-sponsored coverage over Medicaid among all insured children. In September 1993, 20 percent of the children who were uninsured 11 months earlier had employer-sponsored coverage while 14 percent were enrolled in Medicaid. One year later, 25 percent had employer-sponsored coverage, and 17 percent were covered by Medicaid. Other coverage accounted for 2.5 percent of these children in September 1993 and 3.7 percent in September 1994 while 2.1 percent had left the SIPP population by the first date and 3.2 percent by the second. In September 1993 we also find that 4.4 percent of those with employer-sponsored coverage in October 1992 had become uninsured compared to 8.6 percent of those with other coverage. By September 1994 the percentage uninsured among those with employer-sponsored coverage in October 1992 had risen modestly to 6.1 percent while the percentage uninsured among those with other coverage initially had actually fallen slightly.

TABLE 7: DISTRIBUTION OF CHILDREN BY HEALTH INSURANCE COVERAGE IN OCTOBER 1992 AND COVERAGE IN SEPTEMBER 1993 AND SEPTEMBER 1994
    Health Insurance Coverage in October 1992
Calendar Month and Coverage Medicaid Employer- Sponsored Coverage Other Coverage Uninsured Total
October 1992--Total Children 12,614,000 46,439,000 3,007,000 9,489,000 71,549,000
    Coverage in September 1993          
Medicaid 79.8 2.5 3.3 13.9 17.7
Employer-sponsored Coverage 7.1 90.8 29.9 19.7 64
Other Coverage 0.9 1.7 57.8 2.5 4
Uninsured 11.4 4.4 8.6 61.8 13.4
Not in Population 0.8 0.5 0.4 2.1 0.8
    Total 100 100 100 100 100
    Coverage in September 1994          
Medicaid 74.1 2.7 2.9 16.8 17.2
Employer-sponsored Coverage 9.6 88 36.9 24.8 63.6
Other Coverage 1 2.3 52.6 3.7 4.3
Uninsured 13.6 6.1 7.1 51.5 13.4
Not in Population 1.7 1.1 0.5 3.2 1.4
Total 100 100 100 100 100
SOURCE: Survey of Income and Program Participation, 1992 Panel.

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