Health insurance, whether financed through the public or private sector, is essential for children to access needed care. Without health insurance, children are more likely to forgo necessary preventive care, and acute health care when children are sick can leave their families with overwhelming medical bills.

This section reviews the survey’s findings on insurance coverage among CSHCN, including the proportion that have health insurance and the type of coverage (public or private) that they have. For children with insurance, the survey also assesses parents’ perceptions of the adequacy of that coverage. To do this, the survey measured whether the plan offers benefits and services that meet the child’s needs, whether the family considers any costs not covered by the plan to be reasonable, and whether the plan allows the child to see the providers that he or she needs.

The survey asked parents of CSHCN whether their child had insurance in the past 12 months and what kind of insurance they had. Health insurance was defined as private insurance provided through an employer or union or obtained directly from an insurance company; public insurance, such as Medicaid, the Children’s Health Insurance Program (CHIP), military health care (TRICARE, CHAMPUS, or CHAMP-VA); or some other plan that pays for health services obtained from doctors, hospitals, or other health professionals.

Overall, 90.7 percent of CSHCN were insured for all of the previous 12 months, while the remaining 9.3 percent were uninsured for all or some part of the year. The percentage of CSHCN without insurance varies by race/ethnicity. Hispanic children were the most likely to have been uninsured at some point in the past year (15.9 percent), and this percentage was even higher for those children whose primary language was Spanish (22.7 percent). Among non-Hispanic Black children, 10.0 percent were uninsured at some point during the year, as were 7.2 percent of non-Hispanic White children and 9.6 percent of children of other races.

Family income is also associated with the likelihood that children have consistent health insurance. Of children with family incomes below 200 percent of the Federal Poverty Level (FPL), over 14 percent were uninsured for some part of the year, compared to 8.5 percent of children with family incomes between 200 and 399 percent of the FPL and 2.3 percent of children with family incomes of 400 percent of FPL or more.

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