Insuring The Children: A Decade Of Change

Abstract

Prologue: The hard-fought budget legislation passed at the end of the 101st Congress's second session included a provision to expand Medicaid coverage amidst cuts in other social entitlement programs. The expansion would require states and the federal government to phase in coverage of all poor children through age eighteen by the end of the decade. According to The New York Times (4 November 1990), the Children's Medicaid Coalition, whose members include the Health Insurance Association of America, the U.S. Chamber of Commerce, and children's interest groups, were “motivated by a combination of altruism and financial self-interest” to exert sufficient political pressure to get the expansion through Congress. Medicaid is but one factor in the insurance status of America's children, however, as Peter Cunningham and Alan Monheit of the Agency for Health Care Policy and Research (AHCPR) report in this article. In their analysis, they focus on the role different family characteristics play in determining whether children's health care is covered adequately. They use data from over a decade of national medical surveys to trace changes in children's insurance coverage. Cunningham, a service fellow at AHCPR, received a doctoral degree in sociology from Purdue University in West Lafayette, Indiana. During his four-year tenure at the agency, he has worked on the 1987 National Medical Expenditure Survey. Monheit, a senior economist at AHCPR, received his doctorate in economics from the Graduate Center, City University of New York. In his years at AHCPR and its predecessor agency, the National Center for Health Service Research and Health Care Technology Assessment, he has been deeply involved in research into expenditures for medical care and the causes for uneven insurance coverage in this country.