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National Center for Health Statistics (US). Health, United States, 2010: With Special Feature on Death and Dying. Hyattsville (MD): National Center for Health Statistics (US); 2011 Feb.

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Health, United States, 2010: With Special Feature on Death and Dying.

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Health Insurance Coverage

Health Insurance Coverage Among Children

Between 1999 and 2009, the percentage of children with private coverage declined but Medicaid coverage grew at a faster rate, resulting in a decline in the percentage who were uninsured.

Children need access to the health care system for diagnosis and treatment of acute and chronic illnesses, treatment of injuries, and for preventive care such as vaccinations and health promotion teaching and counseling. Health insurance is a major determinant of access to care. Uninsured children are three times as likely as insured children to have not had a doctor’s visit in the past year (Table 79).

The Children’s Health Insurance Program (CHIP) provides coverage to eligible low-income, uninsured children who do not qualify for Medicaid. CHIP was originally enacted by the Balanced Budget Act of 1997 (BBA) (1). The Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA, P.L. 111–3) reauthorized CHIP through fiscal year 2013. CHIP is jointly financed by federal and state governments and is administered by the states.

Between 1999 and 2009, the percentage of children under 18 years of age with private health insurance declined from 69% to 56%. During this period, Medicaid coverage (which includes the CHIP category) increased from 18% to 35%. This led to a decline in the percentage of children who were uninsured, from 12% in 1999 to 8% in 2009.

In 2009, children 6–17 years of age were more likely to be uninsured than younger children, and children with a family income below 200% of the poverty level were more likely to be uninsured than children in higher-income families (Table 138).

Figure 21 is a line graph showing trends in health insurance coverage among children under 18 years of age, by type of coverage, for 1999 through 2009.

Figure 21Health insurance coverage among children under 18 years of age, by type of coverage: United States, 1999–2009

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NOTE: See data table for Figure 21.

SOURCE: CDC/NCHS, National Health Interview Survey.

Reference

1.
National CHIP policy: Overview [online]. Centers for Medicare & Medicaid Services; Available from: http://www​.cms.hhs.gov​/NationalCHIPPolicy.

Health Insurance Coverage Among Adults 18–64 Years of Age

Between 1999 and 2009, the percentage of working-age adults with private health insurance coverage decreased while the percentage who were uninsured increased.

The major source of health insurance coverage for working-age adults is private employer-sponsored group health insurance (Table 136). Private health insurance may also be purchased on an individual basis but is generally more costly and tends to provide less adequate coverage than group health insurance. Health insurance is a major determinant of access to health care (1). Uninsured working-age adults were less likely to have a usual source of care or a recent health care visit (Tables 75 and 79) and were more likely to forego or delay needed medical care, prescription drugs, or preventive care because of cost (Tables 76, 86, and 87; and Figure 19).

Among adults 18–44 years of age, the percentage with private coverage declined from 72% in 1999 to 62% in 2009, while Medicaid coverage increased from 6% to 10%, resulting in an increase in the percentage of persons 18–44 years of age who were uninsured. In 2009, more than one-quarter of adults 18–44 years of age were uninsured. In this age group, the percentage of adults without coverage is higher among those 18–34 years than those 35–44 years (Table 138).

Similar to the trend for younger working-age adults, the percentage of adults 45–64 years of age with private coverage declined, Medicaid coverage increased, and the percentage without coverage increased from 1999 to 2009. Although lack of health insurance coverage is less common among this age group than among those 18–44 years of age (15% compared with 26% in 2009), chronic illness is more prevalent in this older working-age group (Tables 49, 50, 67, and 68).

Figure 22 consists of two line graphs showing health insurance coverage among adults 18 through 44 years of age and 45 through 64 years of age, by type of coverage, for 1999 through 2009.

Figure 22Health insurance coverage among adults 18–64 years of age, by age and type of coverage: United States, 1999–2009

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NOTE: See data table for Figure 22.

SOURCE: CDC/NCHS, National Health Interview Survey.

Reference

1.
The uninsured and the difference health insurance makes [online] Kaiser Commissionon Medicaid and the Uninsured. 2010. Available from: http://www​.kff.org/uninsured​/upload/1420-12.pdf.

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