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Report: 70% Of Children On Medicaid, CHIP Have Parents Who Work At Large, Private Companies

Jul 9, 2019

By Daylina Miller

Of the 8.6 million children in working families who are covered by public insurance, more than 70% have a parent who works at a large, private company, according to a new study from PolicyLab at Children’s Hospital of Philadelphia.

From 2008 to 2016, researchers found an increase in the number of families with private insurance who opted for health coverage for their children through Medicaid and the Children’s Health Insurance Program - known as CHIP. 

The researchers, who published their report this month in the Health Affairs Journal, found that between 2008 and 2016, the number of children in low-and moderate-income working families who were covered by public insurance increased at significant rates, regardless of whether their parents were employed by small or large businesses.

While children’s public coverage was highest among low-income families working for small businesses, increasing from 53% to 79%, the largest driver of the overall increase in use of Medicaid and CHIP was in low- to moderate-income families working at large, private companies.

Doug Strane, research project manager at PolicyLab, said people think if a family has employer-sponsored insurance, they're "good to go.”

"What the findings tell us is that employer-sponsored coverage is just too expensive for a lot of families. And so, in the meantime, they're using public coverage,” he said.

Anne Swerlick, a health policy analyst and attorney with the Florida Policy Institute, said employers are passing on rising health care costs to workers, who are forced to seek insurance for their children elsewhere.

“The public coverage is much more affordable for people, there's very minimal cost sharing, and there's better coverage for kids,” Swerlick said.

From 2008 to 2016 the average employee premium for family coverage increased by 57% to $5,277, according to the Henry J. Kaiser Family Foundation, Health Research and Educational Trust’s “Employer health benefits: 2016 annual survey.” Deductibles have also become more common and more expensive.

“I think the other main takeaway from the study is how critically important it is to protect the Medicaid and CHIP programs for kids,” Swerlick said. “And so when we tinker with that program, we talk about making it harder for kids to qualify, talking about reducing the money in the program,  this is likely to have very harsh consequences for kids right now and for Florida's future.”

From the report:

“…to maintain the current low rate of pediatric uninsurance achieved in recent years, much rests upon policy makers’ willingness to meaningfully engage in efforts to control low- and moderate-income working families’ financial exposure to the rising cost of private health insurance. Importantly, this includes addressing the escalating cost of health care, which is the driving force behind increases in health insurance costs to employers and employees. In the absence of such reforms, even large employers may soon find it unsustainable to continue providing affordable dependent coverage to employees, thereby leading to further increases in public insurance enrollment among children for whom the private insurance market has historically provided coverage.”

In Florida, more than 50% of children born in the state are on Medicaid.

Read the full study here