The Effects of Trigger Events on Changes in Children's Health Insurance Coverage. How Do Trigger Events Affect the Likelihood of Changes in Coverage?

04/18/2000

Regression analysis of the effects of particular events on the likelihood that children who have a given type of insurance coverage (or none at all) will experience a transition to a specific other type of coverage indicates the following.

Children with ESI. Loss of employment, reduction in hours, and changes in jobs by either parent had a significant effect on children moving from ESI to uninsured--as did a marked drop in family income and a decline in family size. Only the parents' loss of employment or a parent leaving the family affected moves from ESI to Medicaid, however, while the father's reduction in hours and either a marked rise or fall in family income contributed to children leaving ESI for other insurance.

Children without Insurance. Events with a significant effect on the likelihood of uninsured children becoming covered by ESI were limited to an increase in the hours worked by either parent, a marked rise in family income, and a parent joining or rejoining the family. The mother's change in jobs or loss of employment and a parent joining or leaving the family had significant effects on the likelihood of an uninsured child gaining coverage through Medicaid. The mother's changing jobs also contributed to children becoming reinsured through other insurance, as did a marked rise or fall in family income. An increase in family size significantly reduced the likelihood of a child obtaining coverage through other insurance, however.

Children with Medicaid. The family's loss of AFDC, the father's gaining employment, and the mother increasing her hours of work to 30 or more had significant effects on the likelihood that a child would leave Medicaid either by obtaining ESI or becoming uninsured. The loss of AFDC had a stronger effect on the odds of a child becoming uninsured than obtaining ESI. The mother's changing jobs also contributed to the likelihood that a child became reinsured by obtaining ESI while the father's loss of employment and either a marked rise or fall in family income contributed significantly to children leaving Medicaid and becoming uninsured, although the mechanisms behind the effects of job loss and falling income are not obvious.

Children with Other Insurance. The mother's changing jobs or the father's increasing his hours worked had significant effects on children changing their coverage from other insurance to ESI while the father's losing employment or the family's income falling markedly contributed to children moving from other insurance to uninsured. Either parent's gaining employment also increased the odds of children moving from other insurance to uninsured, which is difficult to understand unless it represents parents dropping expensive private coverage in anticipation of ESI that will be available following a brief waiting period.

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