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The Association Between Medicaid Coverage for Children and Parents Persists: 2002–2010

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Abstract

To assess the association between a child’s and their parent’s public health insurance status during a time when children had access to coverage independent of policies that impacted adults’ access. Secondary data from the Oregon Health Plan (OHP) [Oregon’s Medicaid and Children’s Health Insurance Programs] for families with at least one parent and one child with OHP coverage at any time during the study period (2002–2010). We linked children to their parents in the OHP data set and examined longitudinal associations between the coverage patterns for children and their parents, controlling for several demographic and economic confounders. We tested for differences in the strength of associations in monthly coverage status in five time periods throughout the nine-year study period. The odds of a child being insured by the OHP in months in which at least one parent had OHP coverage were significantly higher than among children whose parents were not enrolled at that time. Children with at least one parent who maintained or gained OHP coverage in a given month had a much higher probability of being enrolled in the OHP in that month, compared to children who had no covered parents in the given month or the month prior. Despite implementation of policies that differentially affected eligibility requirements for children and adults, strong associations persisted between coverage continuity for parents and children enrolled in Oregon public health insurance programs.

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References

  1. DeVoe, J. E., et al. (2008). “Mind the gap” in children’s health insurance coverage: Does the length of a child’s coverage gap matter? Ambulatory Pediatrics, 8(2), 129–134.

    Article  PubMed  Google Scholar 

  2. Cassedy, A., et al. (2008). The impact of insurance instability on children’s access, utilization, and satisfaction with health care. Ambulatory Pediatrics, 8(5), 321–328.

    Article  PubMed  Google Scholar 

  3. Ziegenfuss, J. Y., & Davern, M. E. (2010). Twenty years of coverage: An enhanced current population survey-1989–2008. Health Services Research, 46(1 Pt 1), 199–209.

    PubMed  Google Scholar 

  4. DeVoe, J. E., Tillotson, C. J., & Wallace, L. S. (2009). Children’s receipt of health care services and family health insurance patterns. Annals of Family Medicine, 7(5), 406–413.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Wisk, L. E., & Witt, W. P. (2012). Predictors of delayed or forgone needed health care for families with children. Pediatrics, 130(6), 1027–1037.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Yamauchi, M., et al. (2013). Does health insurance continuity among low-income adults impact their children’s insurance coverage? Maternal and Child Health Journal, 17(2), 248–255.

    Article  PubMed  Google Scholar 

  7. Dubay, L., & Kenney, G. (2009). The impact of CHIP on children’s insurance coverage: An analysis using the national survey of America’s families. Health Services Research, 44(6), 2040–2059.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kaiser Commission on Medicaid and the Uninsured (2008). Health coverage for children and families in medicaid and SCHIP: State efforts face new hurdles, in A 50-state update on eligibility rules, enrollment and renewal procedures, and cost-sharing practices in medicaid and SCHIP in 2008. Washington, DC.

  9. DeVoe, J., et al. (2008). Uninsurance among children whose parents are losing Medicaid coverage: Results from a statewide survey of Oregon families. Health Service Research, 43(1 Part II), 401–418.

    Article  Google Scholar 

  10. Ku, L., (2007). Collateral damage: Children lose coverage when their parents lose health insurance. Center on Budget and Policy Priorities: Washington, DC.

  11. DeVoe, J. E., et al. (2014). Recent health insurance trends for US families: Children gain while parents lose. Maternal and Child Health Journal, 18(4), 1007–1016.

    Article  PubMed  Google Scholar 

  12. Guendelman, S., et al. (2006). The effects of child-only insurance coverage and family coverage on health care access and use: Recent findings among low-income children in California. Health Services Research, 41(1), 125–147.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Davidoff, A., et al. (2003). The effect of parents’ insurance coverage on access to care for low-income children. Inquiry, 40(3), 254–268.

    PubMed  Google Scholar 

  14. Gifford, E., Weech-Maldonado, R., & Short, P. (2005). Low-income children’s preventive services use: Implications of parents’ medicaid status. Health Care Financing Review, 26(4), 81–94.

    PubMed Central  PubMed  Google Scholar 

  15. Sommers, B. D. (2006). Insuring children or insuring families: Do parental and sibling coverage lead to improved retention of children in Medicaid and CHIP? Journal of Health Economics, 25(6), 1154–1169.

    Article  PubMed  Google Scholar 

  16. Bodenheimer, T. (1997). The Oregon health plan: Lessons for the nation: First of two parts. New England Journal of Medicine, 337(9), 651–656.

    Article  CAS  PubMed  Google Scholar 

  17. Bodenheimer, T. (1997). The Oregon health plan: Lessons for the nation: Second of two parts. New England Journal of Medicine, 337(10), 720–723.

    Article  CAS  PubMed  Google Scholar 

  18. Oberlander, J. (2007). Health reform interrupted: The unraveling of the Oregon health plan. Health Affairs (Millwood), 26(1), w96–w105.

    Article  Google Scholar 

  19. Carlson, M., DeVoe, J., & Wright, B. (2006). Short-term impacts of coverage loss in a Medicaid population: Early results from a prospective cohort study of the Oregon health plan (OHP). The Annals of Family Medicine, 4(4), 391–398.

    Article  Google Scholar 

  20. Oregon Division of Medical Assistance Programs (2008). OHP Standard Reservation List Final Report. [cited 2013 May 31]; Available from: http://www.oregon.gov/oha/healthplan/DataReportsDocs/OHP%20Standard%20Reservation%20List%20Final%20Report.pdf.

  21. Allen, H., et al. (2010). What the Oregon health study can tell us about expanding Medicaid. Health Affairs (Millwood), 29(8), 1498–1506.

    Article  Google Scholar 

  22. Baicker, K., et al. (2013). The Oregon experiment–effects of Medicaid on clinical outcomes. New England Journal of Medicine, 368(18), 1713–1722.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Oregon Health Authority (2011). Oregon Health Insurance Survey Initial Results. 2011 [cited 2013 May 31]; Available from: http://www.oregon.gov/oha/OHPR/RSCH/docs/uninsured/2011_ohis_initial_results.pdf.

  24. DeVoe, J. E., et al. (2007). Uninsured but eligible children: Are their parents insured? Recent findings from Oregon. Medical Care, 46(1), 3–8.

    Article  Google Scholar 

  25. Crocetti, M., et al. (2012). Characteristics of children eligible for public health insurance but uninsured: Data from the 2007 national survey of children’s health. Maternal and Child Health Journal, 16(Suppl 1), S61–S69.

    Article  PubMed  Google Scholar 

  26. United States Department of Agriculture (2013). Rural-Urban Continuum Codes. [cited 2013 August 22]; Available from: http://www.ers.usda.gov/data-products/rural-urban-continuum-codes/.aspx.

  27. United States Department of Agriculture (2013). Supplemental Nutrition Assistance Program (SNAP) Data System. [cited 2013 August 22]; Available from: http://www.ers.usda.gov/data-products/supplemental-nutrition-assistance-program-(snap)-data-system.aspx.

  28. United States Department of Agriculture (2013). Unemployment and median household income for the US and counties, 2000–2011. [cited 2013 August 22]; Available from: http://www.ers.usda.gov/data-products/county-level-data-sets/download-data.aspx.

  29. Bureau of Labor Statistics (2013). Local Area Unemployment Statistics. [cited 2013 August 22]; Available from: http://www.bls.gov/lau/.

  30. Angier, H., et al. (2014). Linkage methods for connecting children with parents in electronic health record and state public health insurance data. Maternal and Child Health Journal, 18(9), 2025–2033.

    Article  PubMed  Google Scholar 

  31. Kaiser Commission on Medicaid and the Uninsured (2011). Holding steady, looking ahead, in annual findings of A 50-state survey of eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and CHIP, 2010–2011. Washington, DC.

  32. Fairbrother, G., et al. (2011). Reporting on continuity of coverage for children in Medicaid and CHIP: What states can learn from monitoring continuity and duration of coverage. Academic Pediatrics, 11(4), 318–325.

    Article  PubMed  Google Scholar 

  33. DeVoe, J. E., Tillotson, C. J., & Wallace, L. S. (2011). Insurance coverage gaps among US children with insured parents: Are middle income children more likely to have longer gaps? Maternal and Child Health Journal, 15(3), 342–351.

    Article  PubMed  Google Scholar 

  34. Hill, H. D., & Shaefer, H. L. (2011). Covered today, sick tomorrow? Trends and correlates of children’s health insurance instability. Medical Care Research and Review, 68(5), 523–536.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Pepe, M., & Anderson, G. (1994). A cautionary note on inference for marginal regression models with longitudinal data and general correlated response data. Communications in Statistics: Simulation and Computation, 23(4), 939–951.

  36. Kim, H. J., et al. (2000). Permutation tests for joinpoint regression with applications to cancer rates. Statistics in Medicine, 19, 335–351.

    Article  CAS  PubMed  Google Scholar 

  37. Medical Assistance Programs, (2012) Event narrative, In DHS|OHA Forecasting. Salem, OR.

  38. Hudson, J. L., & Selden, T. M. (2007). Children’s eligibility and coverage: Recent trends and a look ahead. Health Affairs, 26(5), w618–w629.

    Article  PubMed  Google Scholar 

  39. DeVoe, J. E., Ray, M., & Graham, A. (2011). Public health insurance in Oregon: Underenrollment of eligible children and parental confusion about children’s enrollment status. American Journal of Public Health, 101(5), 891–898.

    Article  PubMed Central  PubMed  Google Scholar 

  40. DeVoe, J. E., et al. (2012). Why do some eligible families forego public insurance for their children? A qualitative analysis. Family Medicine, 44(1), 39–46.

    PubMed Central  PubMed  Google Scholar 

  41. Chernew, M., Cutler, D. M., & Keenan, P. S. (2005). Increasing health insurance costs and the decline in insurance coverage. Health Services Research, 40(4), 1021–1039.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Gould, E. (2010). Employer-sponsored health insurance erosion continues in 2008 and is expected to worsen. International Journal of Health Services, 40(4), 743–776.

    Article  PubMed  Google Scholar 

  43. Kaiser Family Foundation and the Health Research and Education Trust (2011). Employer Health Benefits: 2011 Annual Survey. Available from: http://ehbs.kff.org/pdf/2011/8225.pdf.

  44. Vistnes, J.P., et al., (2012). Declines in employer-sponsored insurance coverage between 2000 and 2008: Examining the components of coverage by firm size. Health Services Research, 47(3 Pt 1), 919–938.

  45. 111th Congress (2010). Compilation of Patient Protection and Affordable Care Act. [cited 2011 December 16]; Available from: http://docs.house.gov/energycommerce/ppacacon.pdf.

  46. Sonier, J., Boudreaux, M. H., & Blewett, L. A. (2013). Medicaid ‘welcome-mat’ effect of affordable care act implementation could be substantial. Health Affairs, 32(7), 1319–1325.

    Article  PubMed  Google Scholar 

  47. Kenney, G., et al. (2012). Making the medicaid expansion an ACA option: how many low-income americans could remain uninsured. Health Policy Center June 29 [cited 2013 May 31]. Available from: http://www.urban.org/publications/412606.html.

  48. The Henry J. Kaiser Family Foundation, (2014). Children’s health coverage: Medicaid, CHIP and the ACA, in issue Brief, Kaiser Commission on Medicaid and the Uninsured, Editor. Washington, DC.

  49. Sommers, B. D., & Rosenbaum, S. (2011). Issues in health reform: How changes in eligibility may move millions back and forth between medicaid and insurance exchanges. Health Affairs, 30(2), 228–236.

    Article  PubMed  Google Scholar 

  50. Wright, B., et al. (2005). The impact of increased cost sharing on Medicaid enrollees. Health Affairs, 24(4), 1106–1116.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was financially supported by the Agency for Healthcare Research and Quality (AHRQ) Grant Number (1 R01 HS018569), the Patient-Centered Outcomes Research Institute (PCORI), and the Oregon Health & Science University Department of Family Medicine.

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Authors and Affiliations

  1. Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailcode FM, Portland, OR, 97239, USA

    Jennifer E. DeVoe, Courtney Crawford, Heather Angier & Miguel Marino

  2. OCHIN Practice-based Research Network, Portland, USA

    Jennifer E. DeVoe & Rachel Gold

  3. Public Health and Preventive Medicine, Oregon Health & Science University, Portland, USA

    Jean O’Malley & Miguel Marino

  4. Office of Health Analytics, Oregon Health Authority, Salem, OR, USA

    Charles Gallia

  5. Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA

    Rachel Gold

Authors
  1. Jennifer E. DeVoe
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  2. Courtney Crawford
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  3. Heather Angier
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  4. Jean O’Malley
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  6. Miguel Marino
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  7. Rachel Gold
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Correspondence to Heather Angier.

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DeVoe, J.E., Crawford, C., Angier, H. et al. The Association Between Medicaid Coverage for Children and Parents Persists: 2002–2010. Matern Child Health J 19, 1766–1774 (2015). https://doi.org/10.1007/s10995-015-1690-5

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  • DOI: https://doi.org/10.1007/s10995-015-1690-5

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