Uninsured

Indicator Definition 
Children (ages 0 – 12 years) are considered uninsured if they do not have a public or private source of health care coverage for the entire past calendar year.

Children without health insurance in Colorado6

Children without health insurance by income in Colorado7

Indicator Significance
Some 9 million children (11 percent) under age 18 years are uninsured nationwide. Sixty percent of these children live in two-parent families and 70 percent live in families with incomes below 200 percent of the federal poverty level (FPL) ($41,300 a year for a family of four in 2007).

The lack of insurance coverage is a significant barrier to health care access and increases the likelihood that uninsured children will not receive the medical care they need when they need it. Uninsured children are three times more likely to forgo seeing a doctor. Without access to primary care, children are less likely to be fully immunized, less likely to receive recommended growth and developmental assessments, and parents and children are less likely to receive important guidance about health, nutrition and childhood safety. Finally, care for acute and chronic illness is often delayed until conditions become severe, resulting in more costly treatment.¹

Colorado Specifics
More than 69 percent of Colorado’s children are insured through private insurance, mostly through employer-sponsored coverage and sometimes through individually-purchased policies. An additional 17 percent are covered by Medicaid or the state’s Child Health Plan Plus (CHP+) and 5 percent are covered through some other type of insurance, including military coverage and Medicare.² Remaining are about 121,000 (14 percent or about one in six) of Colorado’s children without health care coverage. This rate puts Colorado at 45th among the 50 states. Over the past five years the rate has remained fairly stable. Families with incomes below the federal poverty level are more than seven times as likely to be uninsured as families with incomes at 400 percent of FPL or above.³

Promising Initiatives
In Colorado
The 2010 All Kids Covered initiative is a two-year-old collaborative effort among over 50 organizations in the health care community. Led by the Colorado Coalition for the Medically Underserved, the Colorado Children’s Campaign and Colorado Covering Kids and Families, members work together to craft and promote legislation to expand access to meaningful health insurance coverage for children in Colorado. In its first year, the initiative was instrumental in passing two important pieces of legislation. The first mandates that state government collect data on the number of publicly insured children who have a “medical home,” that is, a primary health care provider. The second provides for “presumptive eligibility,” a policy that enrolls eligible children in public health care programs so they may receive vital and timely care while their applications are processed and verified.⁴

Elsewhere
Illinois was the first state to implement a program to insure that all children there have health care coverage. In 2005, Gov. Rod R. Blagojevich signed into law the All Kids Program. The statewide initiative includes all children, regardless of income, under the age of 18. The coverage includes physician visits, hospitalizations, prescription drugs, dental care, and vision including eyeglasses. All Kids covers all recommended immunizations and special needs such as medical equipment, speech therapy and physical therapy. Depending on family size and income, the program imposes a monthly premium and some co-payments.⁵

Children without health insurance⁸

Text

1. American Medical Student Association.
   
   Kaiser Commission on Medicaid and the Uninsured. “Enrolling Uninsured Low-Income Children in Medicaid and SCHIP”; January 2007.
   
   
2. Rates in this sentence are based on estimates from the Current Population Survey (2005-2007) and refer to children ages 0 to 12 years. Those who report multiple types of insurance coverage (i.e. private, public, or military) are included in each category; therefore, total percentage can be more than 100 percent.
   
3. Colorado Children's Campaign. "Fulfilling the Promise: Opportunities and Strategies for Insuring Colorado's Kids"; 2007.
   
4. Colorado Coalition for the Medically Underserved.
   
5. Illinois' Program to Provide Healthcare for All Kids.

Charts

6. Source: Colorado Health Institute analysis of the U.S. Census Bureau’s Current Population Survey, 1999 – 2007.
   
7. Source: Colorado Health Institute analysis of the U.S. Census Bureau’s Current Population Survey, 2005 – 2007.
   
8. Source: U.S. Census Bureau, Current Population Survey, 2005 – 2007.