Analysis of Children's Health Insurance Patterns: Findings from the SIPP. 1. Medicaid Eligibility among Uninsured Children

05/12/1999

Table 8 looks at Medicaid eligibility among uninsured children by demographic characteristics, and Table 9 does so by socioeconomic characteristics. Each table presents the number uninsured and the percent of these who are Medicaid-eligible for each demographic or socioeconomic group.

TABLE 8: MEDICAID ELIGIBILITY AMONG UNINSURED CHILDREN UNDER 19, BY DEMOGRAPHIC CHARACTERISTICS: SEPTEMBER 1994
Demographic Characteristic Number Uninsured Percent Medicaid- Eligible Share of Medicaid- Eligible Share of Medicaid- Ineligible
All Children 8,911,000 32.9 100 100
Age of Child     100 100
    Infant (0) 275,000 68.3 6.4 1.5
    1 to 5 1,986,000 47.5 32.2 17.4
    6 to 8 1,360,000 42 19.5 13.2
    9 to 10 1,014,000 43.3 15 9.6
    11 to 15 2,559,000 19 16.6 34.7
    16 to 18 1,719,000 17.8 10.4 23.6
Race/Ethnicity of Child     100 100
    White Non-Hispanic 4,741,000 27 43.7 57.9
    Black Non-Hispanic 1,305,000 44.8 19.9 12
    Hispanic 2,338,000 36.7 29.2 24.8
    Other 527,000 39.8 7.1 5.3
    Family Composition     100 100
    Both Parents Present 5,783,000 26.6 52.4 71
    Mother Only Present 2,444,000 50.3 41.9 20.3
    Father Only Present 324,000 32.5 3.6 3.7
    No Parent Present 360,000 16.9 2.1 5
Metropolitan Residence     100 100
    Metro 6,284,000 34.5 74 68.8
    Non-Metro 2,504,000 28.4 24.3 30
    Not Applicable 123,000 42.2 1.8 1.2
Region     100 100
    New England 211,000 48.2 3.5 1.8
    Middle Atlantic 920,000 33.2 10.4 10.3
    East North Central 1,334,000 38.4 17.5 13.7
    West North Central 482,000 38.1 6.3 5
    South Atlantic 1,422,000 30.4 14.8 16.6
    East South Central 763,000 35.7 9.3 8.2
    West South Central 1,652,000 27.3 15.3 20.1
    Mountain 393,000 34.4 4.6 4.3
    Pacific 1,735,000 31.1 18.4 20
SOURCE: Survey of Income and Program Participation, 1992 Panel.

 

TABLE 9: MEDICAID ELIGIBILITY AMONG UNINSURED CHILDREN UNDER 19, BY SOCIOECONOMIC CHARACTERISTICS: SEPTEMBER 1994
Socioeconomic Characteristic Number Uninsured Percent Medicaid- Eligible Share of Medicaid- Eligible Share of Medicaid- Ineligible
Poverty Level     100 100
    Less than 50% FPL 1,049,000 78.3 28 3.8
    50% to < 100% FPL 1,889,000 54.8 35.3 14.3
    100% to < 200% FPL 3,447,000 28.2 33.1 41.4
    200% to < 300% FPL 1,590,000 4.7 2.6 25.3
    300% FPL or Greater 936,000 3.4 1.1 15.1
Parents' Employment     100 100
    1 or More Full Time 6,118,000 24.1 50.2 77.7
    Part Time Only 814,000 44.4 12.3 7.6
    No Working Parent 1,619,000 64.2 35.4 9.7
    No Parent Present 360,000 16.9 2.1 5
Parents' Education     100 100
    No Parent Present 360,000 16.9 2.1 5
    6 Years or Less 690,000 38.7 9.1 7.1
    7 to 11 Years 1,549,000 43.1 22.7 14.8
    12 Years 3,716,000 34.1 43.1 41
    Attended College 1,614,000 26.7 14.7 19.8
    4-Year College Degree 618,000 24.4 5.1 7.8
    Graduate Work 363,000 25 3.1 4.6
SOURCE: Survey of Income and Program Participation, 1992 Panel.

Each table also indicates what share of the Medicaid-eligible uninsured and the Medicaid-ineligible uninsured each demographic or socioeconomic group represents.

Overall, 33 percent of the uninsured were estimated to be eligible for Medicaid in September 1994.6 The sharpest differentials in this percentage are by age of child. The eligibility rate is 68 percent among infants, then drops to between 42 percent and 48 percent among children age 1 to 10, then drops further to 18 or 19 percent among older children. Children 1 to 5 represent 32 percent of Medicaid-eligible uninsured children while children 6 to 10 combine to represent 34.5 percent of this population. Infants represent 6 percent of the Medicaid-eligible uninsured. Children 11 to 15 represent less than 17 percent of the Medicaid-eligible uninsured but 35 percent--the largest share--of children who are uninsured but not Medicaid-eligible. Similarly, children 16 to 18 account for 24 percent of the Medicaid-ineligible uninsured but only 10 percent of the Medicaid-eligible uninsured.

Racial and ethnic differences in the proportion of uninsured children who are eligible for Medicaid reflect differences in family composition and income level. Non-Hispanic blacks have the highest eligibility rate at 45 percent despite the fact that blacks also have the highest rate of Medicaid coverage by far (Table 3). Hispanic children and those of races other than white or black have eligibility rates between 37 and 40 percent while non-Hispanic whites have a 27 percent eligibility rate. Because of their overall numbers, non-Hispanic whites account for the largest shares of both the Medicaid-eligible and Medicaid-ineligible uninsured at 44 percent and 58 percent, respectively. Hispanic children account for the next largest shares of both groups: 29 percent of the Medicaid-eligible and 25 percent of the ineligible uninsured.

Nearly 51 percent of uninsured children in mother-only families are eligible for Medicaid compared to 33 percent in father-only families, 27 percent in two-parent families and 17 percent among children living without their parents. Again, because of size, two-parent families account for the largest shares of both the Medicaid-eligible and ineligible uninsured at 52 percent and 71 percent respectively. Children in mother-only families represent 42 percent of the Medicaid-eligible uninsured and 20 percent of the Medicaid-ineligible. Children in father-only or no parent families account for 5 percent or less of either group.

Uninsured children living in metropolitan areas are somewhat more likely to be eligible for Medicaid than those living in non-metropolitan areas (35 versus 28 percent), and they account for 74 percent of the Medicaid-eligible uninsured and 69 percent of the Medicaid-ineligible uninsured.

Except for New England, the regions vary by only 11 percentage points in the proportion of their uninsured children who are Medicaid-eligible. Children in the West South Central region have the lowest eligibility rate at 27 percent while uninsured children in the two North Central regions have a 38 percent Medicaid eligibility rate, which is 10 percentage points below that of New England. Consistent with this fairly limited variation in Medicaid eligibility, each region's share of all Medicaid-eligible uninsured children is fairly comparable to its share of Medicaid-ineligible uninsured children.

Medicaid eligibility among uninsured children is highly related to family income level, as we would expect. We see in Table 9 that uninsured children below 50 percent of poverty have a 78 percent Medicaid eligibility rate. Family composition, family resources, and low eligibility thresholds in some states account for why this eligibility rate is not even higher. The Medicaid eligibility rate among children between 50 and 100 percent of poverty is 55 percent while the rate among children between 100 and 200 percent of poverty is about half that level. Children in each of the three lowest poverty classes account for similar shares of all the Medicaid-eligible uninsured: between 28 and 35 percent. Children in families between 100 and 200 percent of poverty account for the largest share of uninsured children who are not eligible for Medicaid--41 percent--while children in families between 200 and 300 percent of poverty represent 25 percent of the Medicaid-ineligible uninsured.

Parents' employment is inversely related to uninsured children's Medicaid eligibility. Uninsured children with at least one parent working full time have a 24 percent Medicaid eligibility rate compared to 44 percent for children with parents working only part time. Children with no working parent have a 64 percent Medicaid eligibility rate, and they account for 35 percent of all Medicaid-eligible uninsured children. Children with at least one parent working full time, who represent more than two-thirds of all uninsured children, account for 50 percent of the Medicaid-eligible uninsured and 78 percent of the ineligible uninsured. Children with no parent present have the lowest Medicaid eligibility rate at 17 percent and account for only 2 percent of the Medicaid-eligible uninsured and 5 percent of the ineligible uninsured.

Medicaid eligibility varies unevenly by parents' education. Children whose parents have at most 7 to 11 years of schooling have the highest Medicaid eligibility rate at 43 percent while children whose parents are college graduates have the lowest eligibility rate at 24 to 25 percent. Children whose parents have exactly 12 years of schooling have a Medicaid eligibility rate matching the national average but because of their numbers account for 43 percent of all Medicaid-eligible uninsured children and 41 percent of Medicaid-ineligible uninsured children. Shares of both populations decline as parents' education rises or falls from this median level.

Interpretation of these very high rates of Medicaid eligibility that we see among subgroups of the uninsured must be tempered by some of our findings from the examination of eligibility over time, which suggest that spells of Medicaid-eligible uninsurance frequently end with children enrolling or re-enrolling in Medicaid or by losing their eligibility, and that spells of Medicaid-eligible uninsurance typically last just a few months. Furthermore, it is important to recognize that Medicaid enrollment of children may be underreported by more than 2 million children at a point in time (see Technical Appendix D), which is about the number of uninsured children that we estimate to be eligible for Medicaid. Now, not all of the children whose Medicaid enrollment is unreported will have been reported as uninsured, and our simulations underestimate the number of children who are eligible for Medicaid. Nevertheless, it is undoubtedly correct to infer that the Medicaid eligibility rate among uninsured children is overstated in Tables 8 and 9. What implications this has for the observed differentials is not clear, however. It is plausible that Medicaid underreporting is greatest for subgroups with the highest percentages of Medicaid eligibles among their uninsured. If so, the differentials themselves may be overstated. On the other hand, if the underreporting of Medicaid coverage is due in large part to a stigma that respondents associate with participation, then respondents who belong to subgroups with low participation could feel this stigma most strongly, with the result that Medicaid participation is more likely to be unreported in subgroups with low participation than in subgroups with high participation.

View full report

Preview
Download

"sippchip.pdf" (pdf, 56.23Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table1.PDF" (pdf, 3.96Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table2.PDF" (pdf, 4Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table3.PDF" (pdf, 3.76Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table4.PDF" (pdf, 3.88Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table5.PDF" (pdf, 3.99Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table6.PDF" (pdf, 5.13Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table7.PDF" (pdf, 4.34Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table8.PDF" (pdf, 4.91Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenB_table9.PDF" (pdf, 5Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table10.PDF" (pdf, 4.96Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table11.PDF" (pdf, 4.98Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table12.PDF" (pdf, 4.19Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table13.PDF" (pdf, 5.08Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table14.PDF" (pdf, 5.15Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table15.PDF" (pdf, 4.63Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table16.PDF" (pdf, 4.18Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendB_table17.PDF" (pdf, 4.19Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table1.PDF" (pdf, 4.5Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table2.PDF" (pdf, 3.96Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table3.PDF" (pdf, 4.2Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table4.PDF" (pdf, 4.22Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table5.PDF" (pdf, 3.67Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table6.PDF" (pdf, 3.85Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table7.PDF" (pdf, 3.87Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table8.PDF" (pdf, 4.33Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppenC_table9.PDF" (pdf, 3.94Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table10.PDF" (pdf, 4.34Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table11.PDF" (pdf, 3.69Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table12.PDF" (pdf, 4.63Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table13.PDF" (pdf, 3.89Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table14.PDF" (pdf, 4.6Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table15.PDF" (pdf, 4.21Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table16.PDF" (pdf, 3.86Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table17.PDF" (pdf, 3.88Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table18.PDF" (pdf, 4.61Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table19.PDF" (pdf, 4.22Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table20.PDF" (pdf, 3.89Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table21.PDF" (pdf, 3.9Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table22.PDF" (pdf, 4.21Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table23.PDF" (pdf, 4.74Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table24.PDF" (pdf, 3.98Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table25.PDF" (pdf, 4.04Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table26.PDF" (pdf, 4.7Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"AppendC_table27.PDF" (pdf, 4.46Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®