Trends in Private and Public Health Insurance for Adolescents

Abstract

Context: Previous studies (1984-1995) of adolescent health insurance have shown little change in the proportion with coverage. Federally mandated expansions in Medicaid were offset by declines in private coverage. Further expansions of Medicaid and implementation of the State Children's Health Insurance Program (SCHIP) have opened new avenues for increasing coverage rates. Objectives: To assess the current health insurance status of adolescents, the demographic and socioeconomic correlates of insurance coverage, and document recent changes in public and private coverage rates. Design, Setting, and Participants: We analyzed data on 12 995 adolescents aged 10 to 18 years, who had been included in the 2002 National Health Interview Survey. We conducted multivariate analyses to assess the independent association of age, sex, race, poverty status, family structure, family size, and region on the likelihood of having insurance coverage. Results: are compared with previously published findings on adolescent health insurance coverage spanning 1984 to 1995. Main Outcome Measure: Insurance coverage for adolescents. Results An estimated 12.2% of adolescents were uninsured in 2002, which is a decrease from 14.1% in 1995 (P <100% of the federal poverty level) and near-poor (100%-199% of the federal poverty level) families. A substantial decrease in the differences between poor and higher-income groups occurred between 1995 and 2002 due to gains in coverage for adolescents in poor and near-poor families and losses in coverage among those in middle- and upper-income families (≤200% of the federal poverty level). Specifically, the proportion of adolescents in poor families without coverage declined from 27.4% in 1995 to 19.7% in 2002 (P