Does Health Insurance Continuity Among Low-income Adults Impact Their Children’s Insurance Coverage?
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Parent’s insurance coverage is associated with children’s insurance status, but little is known about whether a parent’s coverage continuity affects a child’s coverage. This study assesses the association between an adult’s insurance continuity and the coverage status of their children. We used data from a subgroup of participants in the Oregon Health Care Survey, a three-wave, 30-month prospective cohort study (n = 559). We examined the relationship between the length of time an adult had health insurance coverage and whether or not all children in the same household were insured at the end of the study. We used a series of univariate and multivariate logistic regression models to identify significant associations and the rho correlation coefficient to assess collinearity. A dose response relationship was observed between continuity of adult coverage and the odds that all children in the household were insured. Among adults with continuous coverage, 91.4% reported that all children were insured at the end of the study period, compared to 83.7% of adults insured for 19–27 months, 74.3% of adults insured for 10–18 months, and 70.8% of adults insured for fewer than 9 months. This stepwise pattern persisted in logistic regression models: adults with the fewest months of coverage, as compared to those continuously insured, reported the highest odds of having uninsured children (adjusted odds ratio 7.26, 95% confidence interval 2.75, 19.17). Parental health insurance continuity is integral to maintaining children’s insurance coverage. Policies to promote continuous coverage for adults will indirectly benefit children.
KeywordsHealth insurance coverage Child health Health disparities Access to care Health services research
This study was financially supported by an Robert Wood Johnson Foundation State Coverage Initiatives in Health Care Reform (0403017), the Commonwealth Fund (20040741), the Agency for Healthcare Research and Quality (R03 HS016119) (1 K08 HS16181) (1 R01 HS018569), the Oregon Health & Science University Department of Family Medicine, and the Oregon Office of Medical Assistance Programs. These funding agencies had no involvement in the design and conduct of the study; analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The authors also gratefully acknowledge the Oregon Health Research and Evaluation Collaborative, Dr. Charles Gallia, from the Division of Medical Assistance Programs, and the Office for Oregon Health Policy and Research.
- 12.Van Wie, A., Ziegenfuss, J., Blewett, L. A., & Davern, M. (2008). Persistent disparities in health insurance coverage: Hispanic children, 1996 to 2005. Journal of Health Care for the Poor and Underserved, 14(4), 1181–1191.Google Scholar
- 17.Carlson, M. J., & Wright, B. J. (2005). The impact of program changes on enrollment, access, and utilization in the Oregon health plan standard population. Portland, OR: The Office for Oregon Health Policy and Research.Google Scholar
- 19.Agency for Healthcare Research and Quality. (2002). CAHPS 2.0 survey and reporting kit. Silver Springs, MD: Agency for Healthcare Research and Quality.Google Scholar
- 20.Center for Studying Health System Change. (2004). Community Tracking study, Household survey instrument 2000–2001, Round three. Technical Publication #54. Washington, DC: Center for Studying Health System Change.Google Scholar
- 23.Archer, K. J., & Lemeshow, S. (2006). Goodness-of-fit test for a logical regression model fitted using survey sample data. The Stata Journal, 6(1), 97–105.Google Scholar
- 30.DeCamp, L. R., & Bundy, D. G. (2011). Generational status, health insurance, and public benefit participation among low-income Latino children. Maternal & Child Health Journal. doi: 10.1007/s10995-011-0779-8
- 34.U.S. Department of Health and Human Services. (2003). HHS poverty guidelines. Federal Register, 68(7), 6456–6458.Google Scholar