21 Million Children’s Health:
Our Shared Responsibility

The Medical Child Support Working Group’s Report

APPENDIX D:
Health Care Coverage for
Child Support-Eligible Children

In this Report, 21 million children were considered to be potentially eligible for child support as of 1995. Child support-eligible children are children under age 19 whose parents are divorced, separated, or never-married (and not cohabiting). Children are considered eligible for support regardless of current child support award or custody status. About 17 percent of child support-eligible children live in a married two-parent household (with a custodial parent and step-parent). Age 18 was used as the upper age limit because most states limit mandatory parental obligations for support to children under age 18 or until completion of secondary school. Additionally, eligibility for employment-based dependent health care coverage and for public coverage often terminates around this age. It is recognized that some children older than 18 may continue to be eligible for child support (and for private or public health care coverage), depending on individual circumstances, such as adult disabled children or children attending college. In addition, some children under age 19 who do not live with either parent are also eligible for child support. However, national data does not allow us to identify these children.

The tables below provide information on the status of children's health care coverage. Data indicates that about 13 percent of child support-eligible children have at least two different kinds of coverage (such as multiple private, public and private, or private plus other insurance, such as CHAMPUS (health care for military dependents) during the course of a year. Coverage from any source may only be for part of the year. Children identified as being insured had some type of health care coverage during part or all of the year. Children identified as uninsured have no coverage during the entire year. Current data sources do not allow us to identify children who have coverage some part of the year and no coverage during other parts of the year. Therefore, these tables underestimate the number and percent of children who may not have coverage for some part of the year.

The first four tables (Tables 1-1 through 1-4) provide information based on the child support-eligible population as of 1995. Table 1-1 provides information on the number of children with and without health care coverage by family income expressed as a percent of the poverty. Health care coverage includes private, public, and other coverage such as CHAMPUS (health care for military dependents). Tables 1-2 and 1-3 are elaborations of Table 1-1. Information is presented for child support-eligible children who live with one parent and for children who live in a step-parent family. Table 1-4 provides information only for child support-eligible children with private coverage. In this table, income is expressed as a percent of the poverty and private coverage is broken down by provider source: from within the household (e.g., parent, step-parent), and from outside the household (most likely the noncustodial parent). For those children with private coverage, Medicaid and other coverage is also indicated.

TABLE 1-1
Child Support-eligible Children by Poverty and Health Coverage Status
(1996 CPS-CSS)

* Insured at any time during the year. Total of children with private, public and other health care coverage greater than total insured because 13% of children have simultaneous or sequential coverage during the year.
** Indicates no health care coverage at anytime during the year
*** Total child support-eligible children

TABLE 1-2

Child Support-Eligible Children in Single Parent Households with Private
Health Care Coverage by Poverty and Coverage Source (1996 CPS-CSS)

* Insured at any time during the year. Total of children with private, public and other health care coverage greater than total insured because children have simultaneous or sequential coverage during the year
** Indicates no health care coverage at anytime during the year
*** Total child support-eligible children in single parent household

TABLE 1-3

Child Support-Eligible Children In Two Parent Households with Private Health Care Coverage
by Poverty and Coverage Source (1996 CPS-CSS)

* Insured at any time during the year. Total of children with private, public and other health care coverage greater than total insured because children have simultaneous or sequential coverage during the year
** Indicates no health care coverage at anytime during the year
*** Total child support-eligible children two parent families

TABLE 1-4

Child Support-Eligible Children with Private Health Care Coverage by Poverty and Coverage Source (1996 CPS-CSS)

* Private coverage at any time during the year. Sum of private, public and other health care coverage greater than total with private coverage because children have simultaneous or sequential coverage during the year

Tables 2-1 and 2-2 (below) show health care coverage trends for 1995-1998 from the March Current Population Income Supplement in 1996-1999. This data is not limited to the child support-eligible population but includes all children in single- and two-parent households. This data is provided to show likely trends in health care coverage for the child support-eligible population from 1995-1998. For children in single parent households, the number and proportion of children with private health care coverage has increased, but the number of children and proportion with public coverage has decreased at a faster rate, thereby increasing the total number of children with no health care coverage of any kind. The changes for child support-eligible children are more likely to resemble the changes in single parent households, because the majority of child support-eligible children (83 percent) live in single-parent households.

TABLE 2-1

Children in Single Parent Households by Health Coverage Status and Year (1996-1999 CPS)

* Insured at any time during the year. Total of children with private, public and other health care coverage greater than total insured because children have simultaneous or sequential coverage during the year
** Indicates no health care coverage at anytime during the year
*** Total children in single-parent households

TABLE 2-2

Children in Two Parent Households by Health Coverage Status and Year (1996-1999 CPS)

* Insured at any time during the year. Total of children with private, public and other health care coverage greater than total insured because children have simultaneous or sequential coverage during the year.
** Indicates no health care coverage at anytime during the year
*** Total children in two parent households

Source: Data for tables 1-1 through 1-4 is from the 1996 March-April public use match file of the Current Population Survey(CPS)-Income(March) and Child Support (April) Supplements. The CPS is conducted by the Bureau of the Census. The 1996 data file represents income and child support status as of calendar year 1995. This was the latest data available that could identify the health care coverage status of child support-eligible children. Data for tables 2-1 and 2-2 are from the 1996, 1997, 1998, and 1999 CPS-March Income Supplement. All data tabulations were produced by HHS/Office of Planning and Evaluation specifically for this Report.

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Last updated: 11/17/00