Children of unemployed Americans experience avoidable loss of healthcare coverage: Research

Not only are the children of the 15.3 million unemployed Americans feeling the impact of financial hardship brought on by the economic recession, many of their children may be experiencing an avoidable loss of healthcare coverage, according to new research by the Child Policy Research Center at Cincinnati Children's Hospital Medical Center published in the July issue of Health Affairs.

"For every 1,000 jobs lost, 311 privately-insured children lose health insurance coverage," said Gerry Fairbrother, Ph.D., associate director of the Child Policy Research Center at Cincinnati Children's and a professor at the University of Cincinnati. "As if this is not alarming enough, our data indicate that for every 1,000 jobs lost to families earning less than 200 percent of the federal poverty level, 456 privately-insured children lose coverage. These data are significant because they show that the most vulnerable privately-insured children experience the greatest probability of losing or experiencing an unnecessary gap in their coverage."

The study's authors - who used a large national dataset containing information from randomly-selected people who were interviewed five times over the course of two years - took note of loss of healthcare coverage for children during a given three-month period following parental job loss. The data indicate that 29.4 percent, 30.4 percent and 40.1 percent of white, black and Hispanic children became uninsured when their parents experienced job loss, respectively. This is compared to 5 percent, 10 percent and 9.1 percent of white, black and Hispanic children who became uninsured while their parents remained employed, respectively.

The data indicated that a high proportion of privately-insured children from all racial and ethnic groups lose insurance coverage when their parents lose their jobs. The likelihood of Hispanic children, especially those who are young, poor and living on the West Coast, losing their coverage was the highest at 52 percent. In total, the study found that 30 percent of all privately-insured children whose parents lost jobs are considered low income.

Since the cost associated with extended coverage like that available through Consolidated Omnibus Budget Reconciliation Act (COBRA) is so high, low-income families are likely to have fewer options for retaining their coverage than those in high-income families. Despite the probable qualification for public insurance in most states through the Children's Health Insurance Program Reauthorization Act (CHIPRA), the study shows a substantial number of low-income children are not taking advantage of this opportunity within the first three months after a parental job loss, thus creating a gap in healthcare coverage.

"Several studies cite clear evidence of the adverse consequences of gaps in children's health insurance coverage, even for a brief period of time. These include unmet needs, decreased ambulatory visits, reduced likelihood of having a usual source of care, and increased use of emergency department and inpatient hospital care," said Dr. Fairbrother. "Maintaining coverage through transitions in life, such as parental job loss, is crucial for optimal general health and outcomes."

Results of the study suggest the need for more available and affordable coverage in the event of a job loss. Solutions proposed in the study include greater federal assistance for families to purchase and maintain COBRA insurance, increased funding at the state level through the stimulus package and CHIPRA, to modify CHIPRA's role as a safety net during economic contractions, and the introduction of incentives for enrollment and funds for outreach.

"With our current economic policy, the key implications of these findings are that much more effort is needed to reach out to children when their parents suffer job loss. More action must be taken to ensure that children become enrolled in available programs, and interruptions in their healthcare coverage are further reduced or eliminated," said Fairbrother.