The Effects of Trigger Events on Changes in Children's Health Insurance Coverage. What Potential Trigger Events Precede Changes in Coverage?


Events representing changes in the parents' employment status, jobs, or hours worked; family income; family headship or size; and participation in AFDC were shown to have occurred with greater frequency among children who experienced transitions in health insurance coverage than among children who did not. Depending on the type of transition, between 29 and 50 percent of transitions were accompanied by trigger events in the preceding month, and between 53 and 75 percent had trigger events in the preceding six months. The strongest association between potential trigger events and transitions appeared among children who lost ESI and became uninsured. Children who moved from ESI to Medicaid showed weaker evidence of employment or income-related events, which is consistent with the finding that two-thirds of their parents retained ESI, but we find no suggestion of what else may have helped to produce these changes in coverage. Parents' gains in employment and changes in family income appeared important in moving children out of other insurance, but this was as true of children who lost all coverage as it was of children who obtained ESI. Other than the loss of AFDC, possible trigger events were generally weakest in their influence and perhaps the most inconsistent among children who left Medicaid.

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