Health Services Financing and Utilization

health care financing

In 2003, 8.4 million children younger than 18 years of age (11.4 percent) had no health insurance coverage, and almost one-third of children were publicly insured.

Children with family incomes below the Federal poverty level (FPL) were more likely than children with family incomes of 200 percent of FPL or above to have public insurance (66.8 versus 12.6 percent) or be uninsured (19.5 versus 6.7 percent). Only 12.4 percent of children with family incomes below the FPL had employment-based coverage, compared to 78.6 percent with family incomes of 200 percent of FPL or above.

Although over 90 percent of privately insured children received insurance that was employment-based, children of employed adults may not receive coverage because it is not offered by the employer or it is prohibitively expensive. In 2003, almost two-thirds of uninsured children lived in families whose head was employed year-round on a full-time basis.

In 1997, the Children’s Health Insurance Program (CHIP) was created in response to the growing number of uninsured children in low-income working families. In 2003, 5.8 million children were enrolled in CHIP. Although designed to cover children with a family income of below 200 percent of FPL, many States have expanded eligibility to children with higher family income; as of September 2003, 39 States and the District of Columbia had CHIP coverage for children living at 200 percent of FPL and higher.

> Bar Chart: Health Insurance Coverage Among Children Under Age 18: 2003

> Bar Chart: Health Insurance Coverage Among Children Living in Families Below 100 Percent of Poverty Level: 2003