The Statewide Children s Health Insurance Survey Betsy Shenkman, PhD Institute for Child Health Policy April 11, 2002
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
Procedures Same health insurance and demographic questions from the 1998 survey Child health questions substituted for adult health questions used on 1998 survey
Procedures Oversampled areas likely to have high uninsurance Same statistician did the sampling and weighting Data collected January 2002-March 2002 N=2600 surveys
Estimates of Uninsured Children FPL 1998 2002 1998 2002 Overall 507,164 593,213 13% 15% <100% FPL 157,412 182,999 27% 24% 100-133% 83,710 62,491 29% 20% 134-185% 96,848 97,198 20% 21% 186-200% 12,586 23,621 17% 21% >200% 156,608 205,544 7% 9%
Program Eligibilty Estimates Program 1998 % Eligible 2002 % Eligible 1998 N Uninsured 2002 N Uninsured Medicaid 26% 23% 232,305 216,305 Healthy Kids 20% 16% 119,885 126,511 MediKids 11% 3% 20,599 23,061
Program Eligibility by Race and Ethnicity Currently Uninsured 70 60 50 40 30 20 10 0 White Black Other Hispanic Non- Hispanic Medicaid Eligible Healthy Kids Eligible MediKids Eligible
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
Length of Time Without Insurance 100 90 80 70 60 50 40 30 20 10 0 <1 month 1-6 months 7-12 months 1-2 years >2 years Length of Time Uninsured
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
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
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
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
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
Knowledge of KidCare Program 80 70 60 50 40 30 20 10 0 KidCare Medicaid Healthy Kids MediKids CMS Overall
Percentage of Uninsured Who Know About KidCare 90 80 70 60 50 40 30 20 10 0 KidCare Medicaid HK MediKids CMS Yes No
How Heard About KidCare by Insurance Status of Child 60 50 40 30 20 10 0 School Newspaper Radio TV Employer Social Service Provider Family/Friend Insured Uninsured
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
Location of Usual Source 80 70 60 50 40 30 20 10 0 ER Hospital Clinic Doctor's Office CHC CPHU Other Insured Uninsured
Top Reasons For No Usual Source of Care 41% - Child seldom sick 27% - Can t afford it 16% - no health insurance
Summary Increased percentage of uninsured children overall Increased number of uninsured children in most categories Progress made in some sectors Good name recognition
Summary High percentage of CSHCN Documented problems of poor access to care among uninsured