Abstract
Objective
To examine trends in health insurance type among US children and their parents.
Methods
Using the Medical Expenditure Panel Survey (1998–2011), we linked each child (n =
120,521; weighted n ≈ 70 million) with his or her parent or parents and assessed patterns
of full-year health insurance type, stratified by income. We examined longitudinal
insurance trends using joinpoint regression and further explored these trends with
adjusted regression models.
Results
When comparing 1998 to 2011, the percentage of low-income families with both child
and parent or parents privately insured decreased from 29.2% to 19.1%, with an estimated
decline of −0.86 (95% confidence interval, −1.10, −0.63) unadjusted percentage points
per year; middle-income families experienced a drop from 74.5% to 66.3%, a yearly
unadjusted percentage point decrease of −0.73 (95% confidence interval, −0.98, −0.48).
The discordant pattern of publicly insured children with uninsured parents increased
from 10.4% to 27.2% among low-income families and from 1.4% to 6.7% among middle-income
families. Results from adjusted models were similar to joinpoint regression findings.
Conclusions
During the past decade, low- and middle-income US families experienced a decrease
in the percentage of child–parent pairs with private health insurance and pairs without
insurance. Concurrently, there was a rise in discordant coverage patterns—mainly publicly
insured children with uninsured parents.
Keywords
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Article info
Publication history
Published online: August 18, 2015
Accepted:
June 15,
2015
Received:
January 7,
2015
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
