Final Synthesis Report of Findings from ASPE "Leavers" Grants. Child Health and Insurance Coverage


One set of measures of child well-being center on child health and health insurance coverage. Ten of the studies with survey data report the percentage of children without any type of health insurance coverage (Table VII.1). This number ranges from less than 10 percent in Missouri, Massachusetts, and the Bay Area, to over 20 percent in Arizona and Illinois. Not surprisingly, some of the states with low percentages of uninsured children, like Massachusetts, are also the states with the highest rates of Medicaid coverage. However, Missouri and the Bay Area also have low percentages of uninsured children but only moderate rates of Medicaid coverage. Higher than average private insurance coverage among children of leavers in these two studies accounts for this discrepancy.

Table VII.1:
Measures of Child Health and Uninsurance for Single-Parent Leaver Families' Children


AZ DC1 GA IL1 IA MO MA1 SC1,2 WA Bay Area

Health Insurance3


26 16 11 29 20 4 8 8 10 13 9


51 60 83 53 62 68 83 85 67 64


12 12 5 23 5 11 20 10 7 9  


8 11 4   18 3   4 10 28 6

Child health


    64       50 42    

Very good

    14       24 25    


    13       18 24    


    4   6 7   6 8    


    1       1 1    

Child's health better/worse since exit


Child lacks access to routine health care


1Results are for all cases, not just single-parents.
2Results are for families that remain off of welfare at the time of the survey.
3Numbers may not sum to 100% because multiple coverage is possible.
4In 20 percent of families, none of the children are covered. In 40 percent of families, children are uninsured at some point over the year.
5Includes all private coverage.
6Includes all private or other government insurance.
7Iowa reports child's health is fair or poor combined.
Source: See Appendix B for a complete listing of the leavers studies referenced.

 Child health is also a measure of child well-being. In the four states reporting child health, the percentage of leaver families with children in poor or fair health as reported by the parent in response to the grantee survey is relatively low, ranging from 5 to 9 percent. Only South Carolina shows how child health changes between the time families receive TANF and after they exit. This study reports that 39 percent of leaver families say their child is in better health since exit, compared with only 3 percent who feel their child is in worse health. South Carolina also reports results for childrens access to health care. The study reports that 7 percent of leaver families have a child that lacks access to routine health care since TANF exit.