Genevieve Kenney, Senior Fellow Health Action 2010 Families USA January 28, 2010 /(202) Covering Children in Medicaid/ CHIP: Who Remains Uninsured And What Are The Prospects for Covering More?

2 Eligibility of Uninsured Children for Medicaid/CHIP Coverage, million uninsured children Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation Note: Uninsured estimate reflects an adjustment for the underreporting of public coverage on the CPS. 5.2 million low-income uninsured children 64% of all uninsured children are eligible 88% of all low-income uninsured children are eligible

3 Participation Rates by Program Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

4 Medicaid/CHIP Participation Rates by Division Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

5 Characteristics of Uninsured Eligible Children by MSA and Region Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

6 Share of Low-income Uninsured Children Living in Rural Areas Source: Urban Institute analysis of American Community Survey (ACS) 2008 data from the Integrated Public Use Microdata Series (IPUMS). Note: Low-income is defined as incomes less than 300% of FPL. Rural is defined as not in metro area.

7 Characteristics of Uninsured Eligible Children by Age and Family Poverty Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

8 Share of year olds Among Low-income Uninsured Children Source: Urban Institute analysis of American Community Survey (ACS) 2008 data from the Integrated Public Use Microdata Series (IPUMS). Note: Low-income is defined as incomes less than 300% of FPL.

9 Characteristics of Uninsured Eligible Children by Family Type and Parental Medicaid Eligibility Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

10 Characteristics of Uninsured Eligible Children by Citizenship and Race/Ethnicity Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

11 Racial and Ethnic Composition of Uninsured Eligible Children by Region Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

12 Racial/Ethnic Composition of Low- income Uninsured Children Source: Urban Institute analysis of American Community Survey (ACS) 2008 data from the Integrated Public Use Microdata Series (IPUMS). Note: Low-income is defined as incomes less than 300% of FPL.

13 Share of Low-income Uninsured Children who Have Moved Within the Last 12 Months Source: Urban Institute analysis of American Community Survey (ACS) 2008 data from the Integrated Public Use Microdata Series (IPUMS). Note: Low-income is defined as incomes less than 300% of FPL.

14 Source: Urban Institute Analysis of the American Community Survey

15 Source: Urban Institute Analysis of the American Community Survey

16 Health Insurance among Low-Income Children (0-18) by Parish in Louisiana: Share of State's Total Uninsured and Rate and Rank for Uninsurance, 2008 Geography Distribution of Uninsured Children in Louisiana Insurance Status Private CoveragePublic CoverageUninsured Rate Rank Rate Rank Rate Rank (1 to 11) Louisiana78,158 (100%)34.70%-59.10%-10.30%- Parish Caddo3,071 (3.9%)42.00%* %36.10%*3 Calcasieu2,605 (3.3%)23.50%*172.00%*109.20%8 East Baton Rouge4,421 (5.7%)33.00%663.20%87.60%4 Jefferson6,677 (8.5%)31.60%561.50%610.40%9 Lafayette459 (0.6%)28.30%372.80%*112.30%*1 Orleans4,682 (6.0%)31.00%456.10%215.50%11 Ouachita3,446 (4.4%)34.80%757.20%412.60%10 Rapides1,370 (1.8%)40.50%957.30%55.50%*2 St. Tammany1,520 (1.9%)26.20%267.20%98.30%6 Tangipahoa2,167 (2.8%)39.20%862.20%78.60%7 Terrebonne1,553 (2.0%)44.20% %18.20%5 TOTAL:29,005 (37.1%) Source: Urban Institute analysis of American Community Survey (ACS) 2008 data from the Integrated Public Use Microdata Series IPUMS). Note:* rates indicate significant differences from the state mean at the.10 level. Public coverage is defined as having coverage from Medicare, Medicaid, or any government assistance plan for low-income or disabled individuals, and VA. Private coverage is defined as employer/union provided, directly purchased, and TRICARE/military. Health insurance coverage types are not mutually exclusive. Parishes are areas that are defined by the Missouri Census Data Center.

17 Perceptions of and Barriers to Enrollment in Medicaid/CHIP Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

18 Participation of Low-Income Families with Uninsured Children in Other Public Programs Source: Kenney, Cook, and Dubay. Progress Enrolling Eligible Children in Medicaid/CHIP: Who is Left and What Are the Prospects for Covering More Children? Urban Institute/Robert Wood Johnson Foundation

19 Among various groups of uninsured children, the estimated percentage whose families filed federal income tax returns: 2004 Source: Dorn, S., B. Garrett, C. Perry, L. Clemans-Cope, and A. Lucas. Nine in Ten: Using the Tax System to Enroll Eligible, Uninsured Children into Medicaid and CHIP. Urban Institute

20 Conclusions Prospects are favorable for further reducing the number of eligible uninsured children; But public programs face a number of challenges closing coverage gaps; Future progress will depend on state and federal policy choices and resources related to Medicaid and CHIP.