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Does Health Insurance Continuity Among Low-income Adults Impact Their Children’s Insurance Coverage?

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Abstract

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.

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Acknowledgments

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.

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Authors and Affiliations

  1. Phoenix Children’s Hospital, Oregon Health and Science University, Portland, OR, USA

    Melissa Yamauchi

  2. Oregon Health and Science University, Portland, OR, USA

    Heather Angier & Jennifer E. DeVoe

  3. Portland State University, Portland, OR, USA

    Matthew J. Carlson

  4. Providence Center for Outcomes Research and Education, Portland, OR, USA

    Bill J. Wright

Authors
  1. Melissa Yamauchi
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  2. Matthew J. Carlson
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  3. Bill J. Wright
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  4. Heather Angier
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  5. Jennifer E. DeVoe
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Corresponding author

Correspondence to Heather Angier.

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Yamauchi, M., Carlson, M.J., Wright, B.J. et al. Does Health Insurance Continuity Among Low-income Adults Impact Their Children’s Insurance Coverage?. Matern Child Health J 17, 248–255 (2013). https://doi.org/10.1007/s10995-012-0968-0

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  • DOI: https://doi.org/10.1007/s10995-012-0968-0

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