In a newly released study it was found that when parents from low-income families succeed in pulling themselves out of poverty and gaining employment with private health insurance, their kids are sometimes left uninsured.

“It was surprising to also find there was a higher rate of uninsured children among privately insured parents compared with parents covered by public insurance,” said Jennifer DeVoe, M.D., D.Phil., principal investigator,  research assistant professor of family medicine, OHSU School of Medicine.

The study, “Uninsured but Eligible Children: Are their Parents Insured? Recent Findings from Oregon,” was published recently in Medical Care, the journal of the Medical Section of the American Public Health Association.

DeVoe said that as parents gain access to employer-paid health insurance plans, parents sometimes struggle to afford the premiums for family coverage. Or perhaps, employers are not offering coverage to children who qualify for public coverage.

“For whatever reason some of these kids are going uncovered. Whether these are intentional or unintentional consequences, our children deserve the security of having a more comprehensive and sustainable health insurance system,” DeVoe said.

Surveys were sent to 10,175 households that were enrolled in the Oregon food stamp program, which requires that they have a family incomes of less than 185 percent of the federal poverty level and also be U.S. citizens. Therefore, if a child was enrolled in the food stamp program, it was assumed they would most likely be eligible for public health insurance through the Oregon Health Plan. The survey response rate was 31 percent, and the researchers weighted results back to the food stamp population. It was found that about 11 percent of Oregon children enrolled in the food stamp program, presumed eligible for public health insurance, remained uninsured.

Approximately 116,000 or 12.6 percent of children have no health insurance, according to the Office for Oregon Health Policy and Research. National efforts have been focused on getting more children insured. Children who qualify for public insurance gain more stable coverage when enrollment regulations are relaxed and when insurance coverage is extended to parents. Recent state cost containment policies have resulted in the loss of public insurance for many parents. DeVoe’s research focuses on why eligible children remain uninsured, with a specific focus on the interactions between parental and children’s insurance coverage.

Other researchers on this study include: Lisa Krois, M.P.H., Christine Edlund, M.Sc., and Jeanene Smith, M.D., M.P.H all from the Office of Oregon Health Policy and Research; and Nichole Carlson, Ph.D., OHSU division of biostatistics, Department of Public health and Preventive Medicine.  

The study was funded by the U.S. Department of Health & Human Services, Health Resources and Services Administration and the Agency for Healthcare Research and Quality.