U.S. Department of Health and Human Services, Health Resources and Services Administration

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Health Care Financing

In 2008, approximately 7.4 million U.S. children under 18 years of age had no health insurance coverage, representing 9.9 percent of the population. This was a decrease from the previous year, when the rate was 11.0 percent. One-third of children were insured through public programs such as Medicaid and the Children’s Health Insurance Program, and 63.5 percent were covered by private insurance. The percentage of children covered by public insurance increased over the previous year, while the percentage of children with private insurance decreased.

Children’s insurance status varies by race and ethnicity. In 2008, 76.5 percent of non- Hispanic White children had private coverage, while the same was true of only 47.2 percent of non-Hispanic Black children and 40.6 percent of Hispanic children. Non-Hispanic Black children were the most likely to have public coverage (50.7 percent), and Hispanic children were the most likely to be uninsured (17.2 percent).

As family income increases, private health insurance coverage among children rises and the proportions of children with public coverage and no coverage decrease. In 2008, children living in households with incomes below 100 percent of the U.S. Census Bureau’s poverty threshold ($22,025 for a family of four in 2008) were most likely to have public coverage (71.5 percent) and to be uninsured (15.7 percent). Children with family incomes of 300 percent or more of the poverty threshold were most likely to have private coverage (90.5 percent), and least likely to have public coverage (10.8 percent) or to be uninsured (4.3 percent).

In 1997, the Children’s Health Insurance Program was created in response to the growing number of uninsured children in low-income working families. Although designed to cover children with family incomes below 200 percent of the poverty level, many States have expanded eligibility to children with higher family incomes.

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