Marriage and Health Care Coverage Among Families with Children. Coverage Rates for Low-Income Families

08/01/2008

Among low-income families, married-parent families are less likely than single-parent families to have full family health care coverage.

In 2003, 61 percent of low-income married-parent families had health care coverage for all family members for at least part of the year, compared with 78 percent of low-income single-parent families (Table 2). The number of low-income families with full health care coverage was also lower for married-parent than single-parent families (4.0 million versus 4.3 million). Low-income is defined in these analyses as having a family income below 200 percent of the federal poverty level.

Table 2
Health Care Coverage Among Low-Income Families with Children,
by Marital Status and Coverage Type, 2003
Marital Status and Coverage Type Percentage of Families Covered Number of Families Covered
(in millions)
Fully Covered
Married-parent families 61 4.0
Single-parent families 78 4.3
Partially Covered
Married-parent families 33 2.2
Single-parent families 19 1.0
Source: Annual Social and Economic Supplement (ASEC) to the Current Population Survey (CPS), 2004.
Notes: Limited to families with incomes below 200 percent of the federal poverty level. Fully covered means that everyone in the family had coverage for at least part of the year. Partially covered means that only some family members were covered.

There are several possible reasons why low-income married-parent families might be less likely to have full family health care coverage. Although married-parent families are more likely to have at least one full-time worker, many workers in low-wage employment are not offered family health care coverage (DiJulio and Jacobs 2007). Additionally, compared to low-income families with married parents, those with single parents are more likely to have incomes below poverty, so more single-parent families may be eligible for public health care coverage that includes all family members.

When not fully covered, low-income married parent families are more likely than single-parent families to have health care coverage for at least some family members.

In 2003, 33 percent of low-income married-parent families (2.2 million) and 19 percent of low-income single-parent families (1.0 million) had partial health care coverage (Table 2). In many of these families, it is possible that the children were covered by SCHIP while the parents lacked coverage. If so, the gap in health care coverage rates between low-income single-parent and married-parent families may be smaller for children than for parents. The information needed to determine which family members lacked health care coverage was not available for this analysis.

Higher rates of public health care coverage for single-parent families account for almost all of the difference in coverage rates between low-income single-parent and married-parent families.

In 2003, 58 percent of low-income single-parent families were fully covered by some type of public health care program, compared with 28 percent of low-income families with married parents (Figure 2). Rates of employment-based coverage were higher for married-parent families (32 percent versus 20 percent), but the difference in employment-based coverage was smaller than the difference in rates of public health care coverage. Regardless of marital status, few low-income families received coverage through either direct-purchased or mixed health care plans.

Figure 2
Source of Full Health Care Coverage Among Low-Income Families with Children,
by Marital Status, 2003

Figure 2: Source of Full Health Care Coverage Among Low-Income Families with Children, by Marital Status, 2003. See text for explanation of chart.

Source: Annual Social and Economic Supplement (ASEC)
to the Current Population Survey (CPS), 2004.
Notes: Limited to families with health care coverage for all family members.
Rates for source of coverage do not sum to overall coverage rates (Table 2)
because some families have more than one coverage source.

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