Number of Families Enrolling in Public Insurance Continues to Increase, Study Finds

The number of families enrolling their children in Medicaid or the Children’s Health Insurance Program continues to increase, emphasizing the need for policies to recognize the role of public insurance as costs for private insurance continue to grow, according to a study published in Health Affairs.

The researchers used data from the Medical Expenditure Panel Survey (MEPS) to identify trends in insurance coverage among children with at least one full-time employed parent and with earnings greater than 100% of the federal poverty level during a period from 2008 to 2016. The study specifically focused on the data involving the types and sizes of the organizations at which the parents worked in order to demonstrate the different types of insurance among employers.

"While the cost of employer-sponsored family coverage has increased for all workers, parents’ place of employment is a substantial determinant of both the cost and the availability of family coverage," the authors exxplained. "Cost increases are likely to be the result of employers’ seeking to limit the financial burden of rising health care costs by shifting more of those costs to employees."

In total, 42,027 child-years were included in the sample for the 2008 to 20016 period. Among the children, 6% had parents employed at small private firms, 65.1% had parents employed at late private firms, and 28.9% had parents employed in public-sector organizations.

The data analysis revealed that for low-income families, children’s public health insurance coverage was highest for parents at small private firms with increased from 53% to 79%. The public insurance coverage rate also increased for children with parents working for large private firms—from 45% to 69%. As for moderate-income families working at small private firms, public coverage increased from 21% to 64%.

“Children in low-income families were increasingly covered by public insurance over time, regardless of the parental sector of employment,” wrote the authors. “Growth in the total number of low and moderate-income families with a child enrolled in public insurance was driven predominantly by families employed at large private firms. These changes are likely indicative of the deterioration in affordability of employer-based family coverage among low- and moderate-income families.”

The researchers concluded that significant policy efforts must be made in the coming years to maintain high pediatric coverage rates by ensuring the accessibility of affordable pediatric health insurance coverage for working families in both the public and private markets.

Reference

Strane D, Kanter GP, Matrone M, et al. Growth of public coverage among working families in the private sector. Health Aff (Millwood). 2019;38(7):1132-1139. doi: 10.1377/hlthaff.2018.05286.