Many Children Lack Health Insurance

By Caroline Wilbert
WebMD Health News Reviewed by Louise Chang, MD

Oct. 21, 2008 -- Many children don't have health insurance, even if their parents do, according to a new study published in The 聽Journal of the American Medical Association. This phenomenon -- uninsured children with at least one insured parent -- is particularly prevalent in low-income and middle-income families.

Jennifer DeVoe, MD, DPhil, from Oregon Health and Science University, and colleagues looked at records of 39,588 children and teenagers and found that 3.3% fell into the category of being uninsured (for part or all of the year) with at least one insured parent.

The data came from the Medical Expenditure Panel Survey, which is nationally representative. Researchers pooled data from 2002 to 2005.

The characteristics most commonly associated with uninsured children with an insured parent: low-income and middle-income households, parents with less than a high school education, Hispanic ethnicity, single-parent households, geographic residence in the south or west, and having a parent with private insurance coverage.

Children with parents who had public health coverage were 36% less likely to be uninsured than children whose parents had private insurance.

More than 9 million children in the United States lack health insurance. That number doubles if you include, as this study does, children who have gaps in coverage during the year. Gaps in coverage result in poorer health long-term, the authors write.

"When entire families have access to health insurance, children and adolescents not only benefit from more consistent insurance coverage but also have improved access to a regular source of care and higher rates of preventive services," the authors write.

The authors estimate that more than 1 million children had no coverage for the entire year, and 3 million children had some lack of coverage despite having one parent with full coverage. The authors assert that many adults may be able to afford employer-sponsored health insurance for themselves but not for their children. Because the cost of insurance relative to income is projected to rise, this could be an even larger problem in the future.

The authors write, "The question of whether the employer-based model is sustainable may need to be revisited. In this study, the private system did not do a good job of providing coverage for entire families."

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