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America's Children: Key National Indicators of Well-Being, 2017

Health Insurance Coverage

Health insurance is a major determinant of access to health care.⁴³ Children and adolescents need regular and ongoing health care to provide routine preventive care, including vaccinations, and to treat acute and chronic conditions and provide injury care.⁴⁴ Children with health insurance, whether public or private, are more likely than children without insurance to have a regular and accessible source of health care (see HC2). Children may be eligible for health insurance through private coverage or public programs such as Medicaid, enacted in 1966, and the Children's Health Insurance Program, started in 1997.^{45, 46} The percentage of children who have health insurance is one indicator of the extent to which families can obtain preventive care or health care for a sick or injured child.^{47, 48}

Indicator HC1: Percentage of children ages 0–17 by health insurance coverage status at the time of interview, 1993–2015

NOTE: A child was considered to be uninsured if he or she did not have any private health insurance, Medicare, Medicaid, Children's Health Insurance Program (CHIP), state-sponsored or other government-sponsored health plan, or a military plan. A child was also defined as uninsured if he or she had only Indian Health Service coverage or had only a private plan that paid for one type of service such as accidents or dental care. Private health insurance includes children covered by any comprehensive private insurance plan (including health maintenance organizations and preferred provider organizations). These plans include those obtained through an employer, purchased directly, or obtained through local or community programs. Public health insurance includes children who do not have private coverage, but who have Medicaid or other state-sponsored health plans, including CHIP.

SOURCE: National Center for Health Statistics, National Health Interview Survey.

The percentage of children ages 0–17 without health insurance at the time of interview decreased from 14 percent in 1993 to 5 percent in 2015.
The percentage of children with private coverage increased from 66 percent in 1993 to a high of 69 percent in 1999, then had a long downward trend through 2012, before stabilizing in the 53 percent to 55 percent range through 2015.
Public coverage of children had a long upward trend from 1998 to 2012, and then stabilized in the 38 percent to 39 percent range through 2015.
In 2015, the type of health insurance that children had varied by the age of the child. Adolescents were more likely to be uninsured or have private coverage than younger children. Those in the youngest age group, up to age 5, were less likely to be uninsured, but more likely to have public coverage than children ages 6–11 and ages 12–17.

table icon HC1 HTML Table

⁴³ Kaiser Commission on Medicaid and the Uninsured. (2012). The uninsured and the difference health insurance makes. Menlo Park, CA: Kaiser Family Foundation.

⁴⁴ American Academy of Pediatrics. (2015). 2016 recommendations for preventive pediatric healthcare. Pediatrics, 137 (1), 25–7.

⁴⁵ Title XIX of the Social Security Act, 42 U.S.C. 1396 et seq.

⁴⁶ Title XXI of the Social Security Act, 42 U.S.C. 1397aa–1397mm.

⁴⁷ Howell, E., & Kenney, G. M. (2012). The impact of the Medicaid/CHIP expansions on children: A synthesis of the evidence. Medical Care Research and Review, 69 (4), 376–92.

⁴⁸ Selden, T. M., & Hudson, J. L. (2006). Access to care and utilization among children: Estimating the effects of public and private coverage. Medical Care, 44 (5), I19–I26.