State-Level Trends in Childrens’ Health Insurance Coverage
Reducing the number of children without health insurance coverage has long been a focus of national and state health policy. This report documents recent coverage trends at the state level using data from 2008 through 2012, the most recent year available.
The report is accompanied by state-level summary tables for each state.
Several encouraging trends emerge from the data:
- Despite the Great Recession and slow recovery, the percentage of children without health insurance coverage declined from 9.7 percent in 2008 to 7.5 percent in 2012, the most recent year of data available.
- The decline in uninsurance was widespread across the nation, with 35 states experiencing statistically significant declines in uninsurance and no states showing an increase. State Medicaid and CHIP programs have played an increasingly important role in ensuring that children have health insurance coverage.
- Although there is substantial variation in health insurance coverage by income, disparities in coverage between low-income and higher-income children have narrowed over time. In 2008, children with family incomes at or below 138% of the poverty level were 5.3 times more likely to be uninsured than those with incomes above 400% of poverty; by 2012, this gap had narrowed to 4.5.
- Disparities in coverage by race and ethnicity have also been reduced. In 2012, non-white children were 1.3 times more likely to be uninsured than white children, down from a gap of 1.5 in 2008. The gap between Hispanic and white children declined by an even larger amount, from an uninsurance rate that was 2.8 times higher for Hispanic children than white children in 2008 to a ratio of 2.3 in 2012.
Some of the largest coverage gains in the past several years have been made by groups of children that have historically had the highest rates of uninsurance – low-income children and non-white and Hispanic children. However, the remaining variation across states and within states suggests the potential for further substantial gains.
Although the health insurance coverage provisions of the Affordable Act are likely to have larger impacts for adults than for children, it is likely that children will be affected as well, through a variety of pathways. For example, children who were eligible but not enrolled in Medicaid/CHIP could gain coverage if their parents become eligible and sign up for public coverage. It will be important to monitor these impacts over time, and this report provides a baseline from which these changes can begin to be measured over time and across states.