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Health Insurance Coverage For Families With Children: Findings From The Consumer Expenditure Survey

Geoffrey D. Paulin and Elizabeth M. Dietz


Note: This work is substantially abridged. For a complete version, see Monthly Labor Review, August 1995, pp. 13-23. The views expressed herein are those of the authors and do not reflect the policies of the Bureau of Labor Statistics (BLS) or the views of other BLS staff members.

Health insurance coverage is important in the maintenance of good health for families with children. Cunningham and Monheit (1990, p. 78) find children in families with no coverage are "at a disadvantage regarding access to, quality of, and continuity of health care." Kasper (1987) finds uninsured children are least likely to have seen a doctor in the past year, even for immunization or general check-up (tables 4 and 7). Preventive care is important for children, who are prone to illness.

However, health care costs have risen substantially in recent years. From 1989-94, the Consumer Price Index for medical care increased 41.3 percent, compared with 18.2 percent for all other items. In 1993, the Nation's costs rose 7.8 percent from 1992 (HHS News 1994). Paulin and Weber (1995) suggest that as a result of these increases, direct costs of care are shifting from business and government to families, thus affecting expenditures for nonhealth items.

Meanwhile, in 1992, more than 8 million American children had no health coverage (U.S. Bureau of the Census 1994). While many of the poorest families received Medicaid benefits (Cunningham and Monheit, pp. 77-78), the percentage of children without public or private coverage grew by more than 40 percent between 1977 and 1987 (Ibid., pp. 80-81). This study identifies families that have full, partial, and no health insurance coverage. It examines the characteristics of each insurance group, policies held, health expenditure patterns, and relationships between demographics and the probability of being insured.