CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings. Finding 1 (Chapter III)

08/01/2014

Finding 1 (Chapter III): CHIP contributed greatly to the decline in uninsured rates among low-income children, which fell from 25 percent in 1997 to 13 percent in 2012. Since CHIP was enacted, coverage rates improved for all ethnic and income groups and coverage disparities narrowed significantly for Hispanic children.

The percentage of all children who were uninsured has dropped from 15 to 9 percent since CHIP was enacted in 1997, and the decline for low-income children was even greater, falling from 25 percent in 1997 to 13 percent in 2012 (Figure ES.1). These declines occurred despite recession conditions that separated many families from their connection to employer-sponsored coverage and left them with fewer resources to purchase coverage on their own. The increase in Medicaid and CHIP coverage was the primary reason uninsured rates among children declined. Public coverage rates increased 15 percentage points among all children (from 20 to 35 percent) and by 26 percentage points for children in families with incomes in the primary CHIP target range of between 100 and 200 percent of the FPL.

Figure ES.1. Percentage of Low-Income Children with Medicaid/CHIP, Employer-Sponsored Insurance, and Uninsured, 1997–2012

Figure ES.1. Percentage of Low-Income Children with Medicaid/CHIP, Employer-Sponsored Insurance, and Uninsured, 1997–2012

Source: CPS-ASEC.
Notes: Children are ages 0 to 18. Low income is below 200 percent of the FPL.


The coverage gains for low-income children were not matched by similar gains for low-income adults, pointing to the importance of public coverage in driving the decline in uninsurance among children. Throughout the 15-year period, uninsured rates were substantially higher among low-income adults than among children (Figure ES.2). Uninsured rates were consistently highest among adults without children, who were less likely to be eligible for public coverage. In contrast, rates for children declined steadily, falling from 25 to 13 percent over the 15-year period.

Figure ES.2. Percentage Uninsured: Low-Income Children and Adults, 1997–2012

Figure ES.2. Percentage Uninsured: Low-Income Children and Adults, 1997–2012

Source: CPS-ASEC.
Notes: Children are ages 0 to 18. Low income is below 200 percent of the FPL.


Uninsured rates fell for all groups defined by race/ethnicity and language but the decline was greatest among Hispanic children, where the uninsured rate dropped from 34 to 17 percent and the coverage disparity between non-Hispanic white and Hispanic children narrowed from 13 percentage points in 1997 to 5 percentage points in 2012.

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