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Published in: Maternal and Child Health Journal 4/2005

01-12-2005 | OriginalArticle

Increasing Health Insurance Coverage in the First Year of Life

Authors: Rhonda Sarnoff, DrPH, Dana Hughes, DrPH

Published in: Maternal and Child Health Journal | Issue 4/2005

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Abstract

Objectives: To determine the proportion of infants who are uninsured and the sociodemographic characteristics of their mothers, including prenatal and post-partum insurance coverage, in order to identify strategies to increase infant health coverage. Methods: Data from the 2001 California Maternal and Infant Health Assessment (MIHA) were analyzed. MIHA is a cross-sectional survey of a statewide representative sample of 3,475 postpartum women. We calculated the proportion of uninsured infants overall and by several maternal characteristics. Adjusted and unadjusted odds ratios for infant uninsurance are reported. Results: In the overall study sample, 8.7% of infants were uninsured. Low-income infants were significantly more likely to be uninsured than infants in households with incomes above 200% of the federal poverty level (13.7% vs. 2.5%). The mother's prenatal and post-partum health coverage, her age, and family income were associated with an increased risk of infant uninsurance after adjustment for other maternal characteristics. A large majority of the uninsured infants (88.1%) were living in low-income families. The mothers of 60% of the uninsured infants were enrolled in Medicaid during the pregnancy. Conclusions: Approximately 14% of California's low-income infants were uninsured at the time of the survey despite being income-eligible for Medicaid. The proportion of uninsured infants could potentially be reduced by more than one-half through strategies to provide 12 month continuous enrollment of infants with federally mandated Medicaid eligibility for the first year of life.
Literature
1.
go back to reference Health Coverage for Low-Income Children. Kaiser Commission on Medicaid and the Uninsured. Kaiser Family Foundation, Menlo Park, California, May 2002. Health Coverage for Low-Income Children. Kaiser Commission on Medicaid and the Uninsured. Kaiser Family Foundation, Menlo Park, California, May 2002.
2.
go back to reference Centers for Medicare and Medicaid: http://www.cms.hhs.gov/ researchers/pubs/datacompendium/2002/ and http://www. cms.hhs.gov/researchers/reports/2003/ellwood.pdf. Accessed December 21, 2004. Centers for Medicare and Medicaid: http://​www.​cms.​hhs.​gov/​ researchers/pubs/datacompendium/2002/ and http://www. cms.hhs.gov/researchers/reports/2003/ellwood.pdf. Accessed December 21, 2004.
3.
go back to reference Committee on practice and ambulatory medicine recommendations for preventive pediatric health care. Pediatrics 2000;105(3):645–6. Committee on practice and ambulatory medicine recommendations for preventive pediatric health care. Pediatrics 2000;105(3):645–6.
4.
go back to reference Institute of Medicine. Health Insurance is a Family Matter, September, 2002. United States General Accounting Office. Prenatal Care: Medicaid Recipients and Uninsured Women Obtain Insufficient Care. Report to the Chairman, Subcommittee on Human Resources and Intergovernmental Relations Committee on Government Operations, House of Representatives, U.S.G.A.O., September 1987. Institute of Medicine. Health Insurance is a Family Matter, September, 2002. United States General Accounting Office. Prenatal Care: Medicaid Recipients and Uninsured Women Obtain Insufficient Care. Report to the Chairman, Subcommittee on Human Resources and Intergovernmental Relations Committee on Government Operations, House of Representatives, U.S.G.A.O., September 1987.
5.
go back to reference Brown SS, editor. Prenatal care: Reaching mothers, reaching infants. Washington, DC: National Academy Press, 1988. Brown SS, editor. Prenatal care: Reaching mothers, reaching infants. Washington, DC: National Academy Press, 1988.
6.
go back to reference Goldenberg RL, Patterson ET, Freese MP. Maternal demographic, situational and psychosocial factors and their relationship to enrollment in prenatal care: A review of the literature. Women Health 1992;19:133–51.CrossRefPubMed Goldenberg RL, Patterson ET, Freese MP. Maternal demographic, situational and psychosocial factors and their relationship to enrollment in prenatal care: A review of the literature. Women Health 1992;19:133–51.CrossRefPubMed
7.
go back to reference Perez-Woods RC. Barriers to the use of prenatal care: Critical analysis of the literature 1966–1987. J Perinatol 1990;10(4):420–34.PubMed Perez-Woods RC. Barriers to the use of prenatal care: Critical analysis of the literature 1966–1987. J Perinatol 1990;10(4):420–34.PubMed
8.
go back to reference Braveman P, Bennett T, Lewis C, Egerter S, Showstack J. Access to prenatal care following major Medicaid eligibility expansions. JAMA 1993;269:1285–9.CrossRefPubMed Braveman P, Bennett T, Lewis C, Egerter S, Showstack J. Access to prenatal care following major Medicaid eligibility expansions. JAMA 1993;269:1285–9.CrossRefPubMed
9.
go back to reference California Policy Research Center Brief. Children in Immigrant Families: Issues for California's Future. CPRC Brief, 12(5), August 2000. California Program on Access to Care, California Policy Research Center, Berkeley, CA. California Policy Research Center Brief. Children in Immigrant Families: Issues for California's Future. CPRC Brief, 12(5), August 2000. California Program on Access to Care, California Policy Research Center, Berkeley, CA.
10.
go back to reference Dubay L, Kenney G. Covering parents through Medicaid and SCHIP: Potential benefits to low-income parents and children, Kaiser Family Foundation, 2001. Dubay L, Kenney G. Covering parents through Medicaid and SCHIP: Potential benefits to low-income parents and children, Kaiser Family Foundation, 2001.
11.
go back to reference Ku L, Boraddus M. The importance of family-based insurance expansions: New research findings about state health reforms. Center on Budget and Policy Priorities, 2000. Ku L, Boraddus M. The importance of family-based insurance expansions: New research findings about state health reforms. Center on Budget and Policy Priorities, 2000.
12.
go back to reference Davidoff, Kenney G, Dubay L, Yemane A. Patterns of child–parent insurance coverage: Implications for coverage expansions. Washington, DC: Urban Institute, November, 2001. Davidoff, Kenney G, Dubay L, Yemane A. Patterns of child–parent insurance coverage: Implications for coverage expansions. Washington, DC: Urban Institute, November, 2001.
13.
go back to reference Braveman P, et al. Promoting access to prenatal care: Lessons from the California experience. Kaiser Family Foundation, Spring, 2003. Braveman P, et al. Promoting access to prenatal care: Lessons from the California experience. Kaiser Family Foundation, Spring, 2003.
14.
go back to reference California Department of Health Services, Maternal and Child Health Branch, personal communication, January 2005. California Department of Health Services, Maternal and Child Health Branch, personal communication, January 2005.
15.
go back to reference Title 42 of the Code of Federal Medicaid Regulations, Section 1396e(1) (4). Title 42 of the Code of Federal Medicaid Regulations, Section 1396e(1) (4).
16.
go back to reference Strategies for improving the Medi-Cal newborn enrollment process, Newborn Enrollment Project of Maternal and Child Health Access Stakeholder Meeting, April 2002, Los Angeles, California. Strategies for improving the Medi-Cal newborn enrollment process, Newborn Enrollment Project of Maternal and Child Health Access Stakeholder Meeting, April 2002, Los Angeles, California.
17.
go back to reference Perry M, Kannel S, Burciaga Valdez R, Change C. Medicaid and children overcoming barriers to enrollment findings from a national survey. The Kaiser Commission on Medicaid and the Uninsured, January 2000. Perry M, Kannel S, Burciaga Valdez R, Change C. Medicaid and children overcoming barriers to enrollment findings from a national survey. The Kaiser Commission on Medicaid and the Uninsured, January 2000.
18.
go back to reference Kenney G, Haley J. Why aren't more children enrolled in Medicaid and SCHIP? Washington, DC: Urban Institute, May 2001. Kenney G, Haley J. Why aren't more children enrolled in Medicaid and SCHIP? Washington, DC: Urban Institute, May 2001.
19.
go back to reference Cahow E. Analysis of eligibility loss at recertification, neighborhood health plan of Rhode Island, February 2001. Cahow E. Analysis of eligibility loss at recertification, neighborhood health plan of Rhode Island, February 2001.
20.
go back to reference Ku L, Nimalendram S. Losing out: States are cutting 1.2 to 1.6 million low-income people from Medicaid, SCHIP and Other State Health Insurance Programs. Washington, DC: Center on Budget and Policy Priorities, December 2003. Ku L, Nimalendram S. Losing out: States are cutting 1.2 to 1.6 million low-income people from Medicaid, SCHIP and Other State Health Insurance Programs. Washington, DC: Center on Budget and Policy Priorities, December 2003.
21.
go back to reference Maternal and child health access letter to Director of the State Department of Health Services, July 22, 2002 (personal communication). Maternal and child health access letter to Director of the State Department of Health Services, July 22, 2002 (personal communication).
22.
go back to reference California Health Interview Survey: http://www.chis.ucla.edu/ main/DQ2/output.asp. Accessed December 21, 2004. California Health Interview Survey: http://​www.​chis.​ucla.​edu/​ main/DQ2/output.asp. Accessed December 21, 2004.
23.
go back to reference Braveman P, Pearl M, Egerter S, Marchi K, Williams R. Validity of insurance information on California birth certificates, Am J Public Health 1998;88(5):813–6.PubMedCrossRef Braveman P, Pearl M, Egerter S, Marchi K, Williams R. Validity of insurance information on California birth certificates, Am J Public Health 1998;88(5):813–6.PubMedCrossRef
24.
go back to reference Irvin C, Peikes D, Trenholm C, Kahn N. Discontinuous coverage in Medicaid and the implications for 12-month continuous coverage for children. Cambridge, MA: Mathematica Policy Research, October 2001. Irvin C, Peikes D, Trenholm C, Kahn N. Discontinuous coverage in Medicaid and the implications for 12-month continuous coverage for children. Cambridge, MA: Mathematica Policy Research, October 2001.
Metadata
Title
Increasing Health Insurance Coverage in the First Year of Life
Authors
Rhonda Sarnoff, DrPH
Dana Hughes, DrPH
Publication date
01-12-2005
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 4/2005
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-005-0023-5

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