Decision-Makers Briefed on Trends in Children's Health Insurance

Monitoring public and private efforts to increase children's access to health insurance

From 1995 to 1997, investigators at the Tides Center—a California-based national, nonpartisan, nonprofit organization that sponsors social innovation projects—researched and monitored reports on health care coverage for children.

Key Findings

  • The number and proportion of U.S. children with no health insurance has been on the rise—up from 8.3 million in 1992 to 9.6 million in 1993.
  • Between 1988 and 1993, the proportion of children covered by employer-based private insurance fell from nearly 61 percent to less than 54 percent.
  • The proportion of children receiving medical coverage from Medicaid had increased from 15.6 percent in 1988 to 23.9 percent in 1993.
  • Some state programs went beyond Medicaid to rely on taxes on health providers, cigarettes and/or alcohol, and hospital surcharges to cover the costs of public insurance for children.
  • Public-private partnerships to insure children were rare and extremely limited.
  • Nationwide changes were redefining the health policy decision-making environment.
  • A "strategic audit" report produced by the research team suggested several short-term solution strategies, including:
    • Make policy-makers, community leaders and the public aware of the problem.
    • Provide practical information to state officials on how to protect children now covered, make programs more effective, and create a unified safety net.