State Estimates of Uninsured Children, January 1998. Final Report.. A. Introduction


State estimates of not only the number of uninsured children but their characteristics have attracted growing interest with the passage of legislation establishing the State Children's Health Insurance Program (SCHIP). The Current Population Survey (CPS), the most widely cited source of data on the uninsured, has been criticized because its state samples are inadequate to provide state estimates of uninsured children with sufficient statistical precision to serve policy needs. To produce detailed breakdowns of uninsured children goes well beyond what most of the state samples can support. But while it may be inappropriate to rely on "direct sample" estimation to produce the tabulations that policymakers require, there exist innovative but well-grounded techniques for developing state and substate estimates by the application of statistical procedures that "borrow strength" from other data sources. This report employs statistical procedures that allow us to (1) make use of the entire CPS sample in developing estimates for each state and (2) incorporate data from a wide variety of other sources. We apply these procedures to the March 1998 CPS to develop state estimates of the number of uninsured children in January 1998 by poverty level and age. The report also includes illustrative estimates of the number of children simulated to be eligible for Medicaid and the number who would be eligible for coverage under the SCHIP if the September 1999 rules had been in effect in 1997.

Part I of this report is organized as follows. Section B discusses the purpose of the tables in this report, and Section C provides a brief description of the methodology. Section D presents estimates of uninsured rates among children for the 50 states and the District of Columbia (DC), and Section E presents illustrative estimates of the number of children who are eligible for Medicaid and SCHIP, by state. These estimates are based on a simulation model that incorporates state program detail. Finally, Section F discusses some caveats regarding these estimates.

Part II of the report consists primarily of the state tables--10 per state. Three of the tables are based entirely on the March 1998 CPS data without any of the enhancements that we have introduced. They are included to demonstrate, first, how limiting they are for most states and, second, to show how closely (or not) our enhanced estimates match in broad terms certain state characteristics that can be estimated directly from the CPS sample data. A Technical Appendix follows the state tables and outlines the procedures that we employed to develop the estimates.