Analysis of Children's Health Insurance Patterns: Findings from the SIPP. How Does a Child's Age Influence the Chances of Being Uninsured or on Medicaid?

05/12/1999

It is important to measure the relationship between age and health insurance coverage because age differences in coverage reflect experiences over the life cycle. Both the probability of being uninsured and the average time without insurance increase with age--a finding established by longitudinal analysis. To generate findings like this, we followed children over the entire year at a given age. Between infancy and late adolescence, the probability of being uninsured during a year rose from 16 percent to 27 percent. Among those who were uninsured for any length of time, only 10 percent of infants versus 38 percent of 18-year-olds were uninsured for the entire year.

The likelihood of being both uninsured and ineligible for Medicaid increases even more sharply with age than does being uninsured alone. Only 6 percent of infants compared with a full 24 percent of 18-year-olds were ever uninsured and ineligible for Medicaid during the year. Furthermore, while only 5 percent of those infants who were ever uninsured and Medicaid-ineligible remained so for the entire year, nearly one-third of the 18-year-olds in the same situation remained so for the entire year.

Medicaid coverage declines sharply with age. Age differences in Medicaid participation are to a large degree a reflection of eligibility criteria that progressively favor younger children.1 Our findings highlight the very prominent role of Medicaid among infants and how that role diminishes as children grow older. Nearly 40 percent of all infants were covered by Medicaid for some part of their infancy, and nearly two-thirds of them, or 25 percent of all infants, were covered for the entire year. With increasing age, the probability that a child was ever covered by Medicaid during the year declined gradually to about 15 percent or less, while the proportion of Medicaid children who were covered for the entire year fell to about one-third. In contrast to the 25 percent of all infants who were covered by Medicaid for the entire year, only 10 percent of 10-year-olds and less than 5 percent of 18-year-olds were enrolled for the entire year. This latter differential is likely to diminish over time as Medicaid eligibility under the poverty-related criteria is phased in and Medicaid expansions are introduced under CHIP.

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