Editor’s Note: Welcome to the fifth in a series of blogs on how covering parents helps children. Previous blogs on this topic have pointed out that extending Medicaid coverage to parents will provide a good value to states; maternal, infant and early childhood home visiting programs help prevent child maltreatment; covering parents can help depressed mothers get treatment and improve child development; and the single best way to ensure kids access the coverage and care they need is by covering their parents.
A new Urban Institute report by Dr. Genevieve Kenney analyzes participation rates among children and parents in Medicaid/CHIP between 2008 and 2010. Success has continued in covering kids—statistically significant improvements in Medicaid/CHIP participation rates were observed in 36 states and no state saw a statistically significant decline. However, there was not the same success in reaching parents: the participation rate for children (85.8%) was 20 percentage points higher than the comparable rate for parents (65.6%). States with a higher/lower participation rate among children were more likely to have a higher/lower participation rate among parents, suggesting that children’s coverage is linked to enrollment of their parents.
The study found that the increase in children’s participation in Medicaid/CHIP was associated with the reduction in uninsured children. Statistically significant increases in participation rates were observed for citizen children of all ages, incomes, races/ethnicities and regions of the country. Although Hispanic and American Indian/Alaska Native children have lower participation rates than other children, they experienced larger increases in participation over the time period. Adolescent (ages 13-18) participation rates increased by 4 percentage points to 79.5% but stayed below the participation rates of younger children (the rate for children age 0-5 is 89.9% and for age 6-12 is 86.7%). The combined effect of an increase in participation and decline in uninsurance was to lower the number of eligible but unrolled children by 10% between 2008 and 2010.
Consistent with the lower participation rates for parents, over 1 in 4 Medicaid eligible parents is uninsured compared to less than 1 in 10 eligible children in 2009/2010. The participation differential between children and parents varied from under 5 percentage points to over 40 percentage points, depending on the state. The report found a strong positive relationship between participation rates for parents and children varying in the same direction: six of the ten states in the top quintile of children’s participation rates were also in the top quintile for adult participation rates. These states also have Medicaid eligibility levels higher than average, signaling a positive relationship between eligibility levels and participation rates.
In 2010, about 70% of all uninsured children appeared to be eligible for Medicaid/CHIP—an increase from 67% in 2008. The increase is likely due to expansions in eligibility and the decline of incomes during the time period. Because parents must enroll their children in coverage in order to enroll themselves under the ACA, effective outreach to enroll parents will automatically reduce the number of eligible but unenrolled children.