While much progress has been made over the last decade in lowering the rate of uninsured children, the uninsured rate for parents remains significantly higher than for their children—and it has been growing rather than declining. States, however, can take steps similar to those that have been taken on behalf of children to expand coverage to parents and to ensure that those who are eligible are enrolled. With increased interest at the state level on finding solutions to the health care crises, covering parents is a logical “next step” for many states.

This fact sheet discusses five good reasons why states should strengthen the health and economic security of families by expanding health coverage for parents. As families cope with economic hardship and limited resources, states can use the proven strategy of parental coverage to ensure that every hard-working family has access to the health services it needs.

This report examines the experiences of 10 states (Arizona, Idaho, Illinois, Michigan, Minnesota, New Jersey, New Mexico, Oregon, Rhode Island, and Wisconsin) covering adults under SCHIP. GAO finds that the states vary with regard to program structure (covering parents, childless adults, or both; offering direct coverage or premium assistance) as well as enrollment and expenditures. Other issues examined include funding shortfalls, which faced 6 of the ten states, and outreach efforts, which tend to target the whole family.

This report examines 11 states that have been granted waivers to provide health care coverage to parents using SCHIP funds. It shows that while SCHIP parent enrollment nationwide is relatively small, the coverage provided helps fill a major coverage gap for low-income parents and their families.

This fact sheet provides information on health coverage of low-income parents, including recent trends, and discusses the current policy challenges to expanding care for this population. 

This study uses administrative data to track single mothers from 2 years before they left welfare until 2001 to examine the effects of Wisconsin’s SCHIP program, which has long covered parents, on the insurance status of these low-income single parents. The results indicate that the expansion of eligibility to low-income parents resulted in about a 17-25% increase in public coverage for all adults who have left welfare. 

Using data from 2002-2005, the researchers found that 3.3% of children and adolescents were uninsured with at least 1 insured parent. These children were more likely Hispanic; low income; from single-parent homes; and living with parents who had less than a high school education. Those whose parents had public coverage were less likely to be uninsured than were those whose parents reported private health insurance. Similar patterns of vulnerability were also found among a subset of uninsured children with privately covered parents.

This article examines the effect of restricting parents’ access to public health insurance on children’s insurance status.  Following the 2003 cutbacks to Oregon’s Medicaid program for parents, the authors find that children of parents who recently lost Medicaid coverage were 44 percent more likely to be uninsured than children whose parents had not lost coverage. This study shows that policy changes intended to affect adults can also have negative effects on children’s health coverage.

Providing health coverage for the entire family can both help to increase coverage of children and assist low-income families in obtaining more affordable health care services. This brief uses data from the 2005 Kaiser Low-Income Coverage and Access Survey to examine health coverage, access and the financial impacts of health care for low-income parents and their families, demonstrating that being uninsured affects not just a parent’s health, but also the well-being of the entire family.

This paper examines research published since 2000 that explores the relationship between public health insurance coverage of parents and the rate and effectiveness of coverage among children, as measured by insurance levels, coverage continuity, and appropriate use of pediatric health care. It includes a brief overview of current Medicaid and SCHIP coverage options for parents and children, as well as a discussion of the implications of existing studies for the question of whether to expand state flexibility to use federal SCHIP allotments to cover parents. 

This brief outlines the findings from recent literature on the effects of expanding public coverage for parents. Studies consistently show that when parents have coverage, their children are more likely to be insured and have better access and use of health care. Covering parents also improves parents’ access to health care.

This article examines whether expanding Medicaid eligibility to parents increases children’s participation in Medicaid. The results show that children in states that have expanded parent coverage have Medicaid participation rates about 20 percentage points higher than children in states that have not expanded coverage to parents, indicating that expanding family coverage has a positive spillover effect on eligible children’s enrollment in Medicaid.

This study examines whether having an uninsured parent reduces access to care for low-income children. Using three indicators of access to care—having a usual source of care, any medical provider visit, and any well-child visit—the authors find that children with uninsured parents are less likely to receive any medical provider visit and any well-child visit with magnitudes smaller than for the effect of the child’s insurance coverage. The authors conclude that expanding parental insurance coverage will have positive spillover effects on access to care for children.

This report examines health coverage at the family level, arguing that having at least one uninsured family member has negative consequences for the entire family.  Children have less access to care if they have an uninsured parent, and the burden of high medical costs is borne by the entire family.  Children’s long-term health and development can be compromised by a lack of insurance and care for their parents. It one in a series of six reports by the Institute of Medicine on the problems of having a large uninsured population in the United States.