Children s Health. The Statewide. Policy. Institute for Child Health. Institute for Child Health Policy

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1 The Statewide Children s Health Insurance Survey Betsy Shenkman, PhD Institute for Child Health Policy April 11, 2002

2 Purpose To develop estimates of uninsured children in Florida at a state level To develop estimates of Healthy Kids Program eligibility To make comparisons to the percentage of uninsured children estimated from the 1998 Survey To determine the sociodemographic and health characteristics of children

3 Procedures Same health insurance and demographic questions from the 1998 survey Child health questions substituted for adult health questions used on 1998 survey

4 Procedures Oversampled areas likely to have high uninsurance Same statistician did the sampling and weighting Data collected January 2002-March 2002 N=2600 surveys

5 Estimates of Uninsured Children FPL Overall 507, ,213 13% <100% FPL 157, ,999 27% % 83,710 62,491 29% % 96,848 97,198 20% % 12,586 23,621 17% >200% 156, ,544 7% % 24% 20% 21% 21% 9%

6 Program Eligibilty Estimates Program 1998 % Eligible 2002 % Eligible 1998 N Uninsured Medicaid 26% 23% 232,305 Healthy Kids 20% 16% 119,885 MediKids 11% 3% 20, N Uninsured 216, ,511 23,061

7 Program Eligibility by Race and Ethnicity Currently Uninsured White Black Other Hispanic Non- Hispanic Medicaid Eligible Healthy Kids Eligible MediKids Eligible

8 Reasons for Uninsurance 58% can t afford it 33% other reasons 4% employer does not offer 2% children healthy 1% don t believe in insurance 1% pre-existing condition

9 Length of Time Without Insurance <1 month 1-6 months 7-12 months 1-2 years >2 years Length of Time Uninsured

10 Insurance Status of Parents of Uninsured Children 66% of parents whose children are Medicaid eligible are uninsured 89% of parents whose children are Healthy Kids eligible are uninsured 93% of parents whose children are MediKids eligible are uninsured

11 Children with Special Health Care Needs Used the CSHCN Screener Used in national surveys and recommended by NCQA Asks about Elevated service use Reliance on compensatory mechanisms Functional limitations

12 Children with Special Health Care Needs Survey designed to ask about general health and insurance status of each member of household CSHCN Screener asked to think about child with greatest health care needs if none, next birthday

13 CSHCN Screener Results 72% not identified with special needs 13% met one component of screener 11% met two components of screener 5% met all three components of screener

14 CSHCN Screener Results Some evidence that Black and Hispanic children may be under-identified Instrument may be measuring access to care in addition to presence of special needs

15 Knowledge of KidCare Program Overall KidCare Medicaid Healthy Kids MediKids CMS

16 Percentage of Uninsured Who Know About KidCare KidCare Medicaid HK MediKids CMS Yes No

17 How Heard About KidCare by Insurance Status of Child Insured Uninsured Newspaper Radio TV Employer Social Service Provider Family/Friend School

18 Presence of a Usual Source of Care Only 75% of uninsured children have a usual source of care compared to 95% of those with insurance

19 Location of Usual Source ER Hospital Clinic Doctor's Office CHC CPHU Other Insured Uninsured

20 Top Reasons For No Usual Source of Care 41% - Child seldom sick 27% - Can t afford it 16% - no health insurance

21 Summary Increased percentage of uninsured children overall Increased number of uninsured children in most categories Progress made in some sectors Good name recognition

22 Summary High percentage of CSHCN Documented problems of poor access to care among uninsured

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