In 2008, an estimated 26 million American children 18 and under had at least one parent living outside the household. Children in such situations are potentially eligible to receive child support from the parent living elsewhere. Almost 70 percent of these child support (CS) eligible children live in low-income families with incomes less than 200 percent of the federal poverty level (FPL) and an additional 21 percent have incomes between 200 and 399 percent of the FPL. As a result of their generally low incomes and unique family structures, these children represent a particularly vulnerable population that may face numerous challenges in obtaining private health insurance coverage. Many of these children are likely to be eligible for Medicaid or the Children’s Health Insurance Program (CHIP), however.
The most recent estimates of health insurance coverage and Medicaid/CHIP eligibility for the child support eligible population come from the Urban Institute’s 1999 National Survey of America’s Families (NSAF). In 1999, 14.5 percent of CS eligible children living with their mothers were found to be uninsured. The uninsurance rate was 18 percent for those with incomes under 200 percent of the FPL. The same data indicate that 72.9 percent of all CS eligible children were eligible for Medicaid or CHIP and, of those that were uninsured, 81.3 percent were Medicaid or CHIP eligible., While these statistics are now outdated, they do suggest that Medicaid and CHIP could play an important role in extending coverage to uninsured CS eligible children.
Over the past decade, state child support enforcement (CSE) agencies have been increasingly focused on improving the functioning of medical support and encouraging better collaboration with Medicaid. The passage of CHIPRA in February 2009 also placed a strong emphasis on enrolling and retaining all uninsured children who are eligible for Medicaid or CHIP. Along with the impending implementation of national health reforms, these developments have sparked a renewed interest in the current health insurance landscape for child support eligible children and the need for updated estimates of public program eligibility and health insurance coverage for this population. This brief focuses on identifying the coverage patterns of CS eligible children, with a special emphasis on the uninsured, and their eligibility for Medicaid/CHIP.