Trade-offs between public and private coverage for low-income children have implications for future policy debates

Health Affairs

Volumn 33, Issue 8, 2014, Pages 1367-1374

  McMorrow, Stacey ^a   Kenney, Genevieve M ^a   Anderson, Nathaniel ^a   Clemans Cope, Lisa ^a   Dubay, Lisa ^a   Long, Sharon K ^a   Wissoker, Douglas ^a  

^a URBAN INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ARTICLE; CHILD; CHILD CARE; EMPLOYER; HEALTH CARE ACCESS; HEALTH CARE COST; HEALTH CARE NEED; HEALTH CARE POLICY; HEALTH INSURANCE; HEALTH SURVEY; HUMAN; LOWEST INCOME GROUP; MAJOR CLINICAL STUDY; MEDICAID; PARENT; PATIENT SATISFACTION; ADULT; ECONOMICS; FEMALE; INSURANCE; MALE; MEDICALLY UNINSURED; ORGANIZATION AND MANAGEMENT; POVERTY; RISK FACTOR; SOCIOECONOMICS; UNITED STATES; YOUNG ADULT;

ADULT; FEMALE; HEALTH EXPENDITURES; HEALTH POLICY; HUMANS; INSURANCE COVERAGE; INSURANCE, HEALTH; MALE; MEDICALLY UNINSURED; PATIENT PROTECTION AND AFFORDABLE CARE ACT; POVERTY; PRIVATE SECTOR; PUBLIC SECTOR; RISK FACTORS; SOCIOECONOMIC FACTORS; UNITED STATES; YOUNG ADULT;

EID: 84905990821     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2014.0264     Document Type: Article

References (30)

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12. For more information and products based on the HRMS, see Health Reform Monitoring Survey [home page on the Internet]. Washington (DC): Urban Institute; [cited 2014 Jun 25]. Available from: http://hrms.urban .org/
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14. To access the Appendix, click on the Appendix link in the box to the right of the article online
15. We also include some estimates using data from the HRMS for the first quarter of 2014
16. Long SK, Kenney GM, Zuckerman S, Goin DE,Wissoker D, Blavin F, et al. The Health Reform Monitoring Survey: addressing data gaps to provide timely insights into the Affordable Care Act. Health Aff (Millwood). 2014;33(1):161-7.
17. ACS estimates are subject to more extensive editing than those of the HRMS to reflect underreporting of Medicaid or CHIP coverage and other issues
18. Our findings were consistent when we included data from the first quarter of 2014
19. Where applicable, we used statespecific program names to identify Medicaid or CHIP coverage and to assign coverage types based on write-in responses
20. We defined low income as less than 250 percent of poverty because the HRMS includes income breaks only at 138 percent, 250 percent, and 400 percent of poverty.We also excluded fifty-four observations with missing values for key analytic variables.
21. We knew only the respondent's coverage and individual offer status. However, respondents with children reported whether either parent had employer-sponsored insurance that could cover the child.
22. Pascale J. Measurement error in health insurance reporting. Inquiry. 2008-09;45(4):422-37.
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24. Estimates were based on four quarters of HRMS-Kids data, with 2,606 observations for children whose family incomes were less than 138 percent of poverty
25. This estimate is inconsistent with employer-level data, which suggests that when employers offer any coverage they generally offer dependent coverage. See Vistnes J, Zawacki A, Simon K, Taylor A. Declines in employer-sponsored insurance between 2000 and 2008: examining the components of coverage by firm size. Health Serv Res. 2012;47(3 Pt 1): 919-38. The discrepancy could be because low-income families are more likely to work in jobs without dependent coverage and may report no offer of coverage if the employer does not contribute, or it could reflect measurement error.
26. These estimates are similar to those in Medicaid and CHIP Payment and Access Commission, Report to Congress on Medicaid and CHIP (Note 4), p. 8, which are based on data from the Medical Expenditure Panel Survey.
27. Jacobs K, Graham-Squire D, Roby DH, Kominski GF, Kinane CM, Needleman J, et al. Proposed regulations could limit access to affordable health coverage for workers' children and family members [Internet]. Berkeley (CA): Center for Labor Research and Education, University of California, Berkeley, and Center for Health Policy Research, University of California, Los Angeles; 2011 Dec [cited 2014 Jun 25]. (Policy Brief). Available from: http://laborcenter.berkeley.edu/healthcare/Proposed_Regulations11 .pdf
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