Analysis of Children's Health Insurance Patterns: Findings from the SIPP. Technical Appendix B: The Dynamics of Uninsurance, Medicaid Eligibility and Participation among Children: 1993-1994

05/12/1999

This report uses data from the Survey of Income Program Participation (SIPP) to investigate dynamic aspects of the lack of health insurance, eligibility for Medicaid, and Medicaid participation among children in 1993 and 1994. After describing our data source we present findings on the duration of spells of uninsurance based on an analysis of new spells as well as spells active at a point in time. We explain why these alternative approaches to measuring the duration of uninsurance yield such different distributions of spell length. We also present estimates of the amount of time that uninsured children are eligible for Medicaid. From there we turn to an examination of the patterns of health insurance coverage preceding and following completed spells of uninsurance, and we compare spells of different lengths. We do this for spells of Medicaid-eligible uninsurance as well. Next we examine the frequency of transitions in coverage, beginning with changes in coverage between one year and the next and then turning our attention to monthly transitions in uninsurance and Medicaid enrollment, culminating in the presentation of estimates of cumulative monthly exit rates from uninsurance, Medicaid-eligible uninsurance, non-Medicaid-eligible uninsurance, and Medicaid enrollment. In the closing sections we discuss churning versus turnover as phenomena in the dynamics of uninsurance and Medicaid enrollment and then summarize our principal findings.

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