Uninsured Children

Who are They and Where Do They Live?

The number of uninsured children has declined since the late 1990s, reaching the lowest level reported in more than 20 years in 2008. Notwithstanding that progress, an estimated 7.3 million children lack health insurance coverage, most of whom are eligible for public health insurance under either Medicaid or the Children’s Health Insurance Program (CHIP). While prior studies have examined the characteristics of uninsured children and variation in uninsured rates across different subgroups of children, those analyses have either focused on national statistics or examined estimates for a particular state. This chart book uses data from the 2008 American Community Survey (ACS) to provide detailed state estimates that include:

  • The number of uninsured children and the proportion of children who are uninsured across and within each state;
  • Uninsured rates for children with different demographic, socioeconomic and family characteristics in each state; and
  • The composition of insured and uninsured children in each state.

The estimates in this chart book highlight the types of uninsured children who need to be targeted with outreach, enrollment and retention efforts in order to reduce uninsurance and move toward universal coverage among children. They also indicate that the nature of the uninsured problem varies across states and that a “one size fits all” approach to outreach, enrollment and retention may not work.

The data used to construct these estimates are from 2008. As such, they reflect the situation before the passage of both the Children’s Health Insurance Program Reauthorization Act (CHIPRA) and the Patient Protection and Affordable Care Act (PPACA), and before the greatest effects of the current recession were felt. Both CHIPRA and PPACA are expected to eventually reduce uninsurance among children. However, the effects of the recession on both employer-sponsored coverage and on state budgets may increase uninsurance among children in the short term. Therefore, it will be important to track how this picture shifts as the economy changes and as federal and state policies aimed at increasing insurance coverage among both children and adults are implemented

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