Children's Health Insurance Patterns: A Review of the Literature. Chapter I. Introduction


Policymakers are currently considering proposals aimed at reducing the number of children without health insurance. The debate over various proposals could benefit from better information about the uninsured child population. To start, there is a lack of consensus about the number of uninsured children and the extent to which some of the uninsured are eligible for Medicaid but not participating. This study reviews the literature on children's health insurance pattens and Medicaid program participation. Specifically, this literature review focuses on (1) uninsured children -- how many are there, what are their characteristics, how long are they uninsured, and why are they uninsured; and (2) Medicaid eligibility, enrollment, participation rates, program dynamics, and measurement issues.

This literature review is the first task in an eight month research contract awarded by the Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE), to Mathematica Policy Research, Inc. (MPR). The overall study objective is to improve understanding of the issues involved in analysis of children's health insurance patterns. This literature review was designed to identify key analytic questions that are not fully answered from current research. Subsequent tasks will include the design and implementation of further analyses of uninsured children using the Survey of Income and Program Participation (SIPP) and possibly other data as well. These analyses will benefit from the literature review, particularly with regard to the identification of methodological issues in measuring children's health insurance patterns. This review also provides a basis of comparison for key estimates produced in the additional tasks of this effort.