One in three children aged 18 and under in the United States now has public health insurance coverage, according to a new report funded by the Robert Wood Johnson Foundation.
Some of the greatest coverage gains have occurred in children from low-income households and among nonwhite and Hispanic children, who have the highest rates of being uninsured.
Nationwide, the proportion of children with private insurance fell from 64.5% in 2008 to 59% in 2012. The declines in private coverage for children were statistically significant in 45 states, but Medicaid and the Children’s Health Insurance Program (CHIP) have more than offset the reductions by covering 33.6% of children in 2012, up from 25.8% in 2008, according to the report.
In 2012, 7.5% of children in the were without health insurance, down from 9.7 percent in 2008. The report, by the University of Minnesota’s State Health Access Data Assistance Center, uses U.S. Census Bureau data from 2008 through 2012, the most recent data available.
Dr. Mary Tierney, a Washington-based pediatrician and nationally recognized expert on Medicaid and CHIP, described the findings as encouraging. "We have in this country done a really good job of getting our children insured," she said in an interview.
Overall, 35 states experienced statistically significant declines in rates of uninsured children and no states showed an increase over the 5 years, according to the report’s state-by-state analysis. Rates of uninsured children ranged from 1.4% in Massachusetts to 17% in Nevada. Oregon had the largest drop in uninsured children, followed by Florida, Delaware, Mississippi, and South Dakota.
While there remains substantial variation in children’s coverage based on income, the report cites a narrowing of the gap between low- and higher-income children. Compared to children with family incomes that were at 400% of poverty level or higher, children with family incomes at or below 138% of the federal poverty level were 4.5 times more likely to be uninsured in 2012 – down from 5.3 times likelier to be uninsured in 2008.
The report cites a reduction in coverage disparities linked to race and ethnicity. In 2012, nonwhite children were 1.3 times more likely to be uninsured than were white children; in 2008, they were 1.5 times likelier to be uninsured. Similarly, the gap has narrowed between uninsured Hispanic and white children, dropping from a rate 2.8 times higher for Hispanic children in 2008 to a rate 2.3 times higher in 2012.