More private sector workers are enrolling kids in public health insurance, study finds

Parents working in the private sector are increasingly enrolling eligible children into federal health insurance programs like Medicaid or the Children's Health Insurance Program, according to a study published in Health Affairs.

For the study, researchers with the Children's Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine in Philadelphia analyzed how increased cost sharing among employer-sponsored health plan members may affect the role Medicaid and CHIP play among privately employed families.

The study authors examined enrollment data from 2008-16 among privately employed families who earned more than 100 percent of the federal poverty level. Children's public health insurance use was highest among low-income families with parents employed at small private firms, with 79 percent covered under public programs in 2016. Children's public health insurance use also climbed among children whose low-income families worked for large private firms, with nearly 70 percent receiving public coverage in 2016.

Increases continued among families with moderate income at small private firms, where the share of children on public insurance grew from 21 percent in 2008 to 64 percent in 2016.

The researchers noted they couldn't definitively say why working families covered their children with public insurance, noting while rising health insurance costs for employer-based plans may have played a role, changes in parental health insurance coverage could also have affected the outcome.

"These changes are likely indicative of the deterioration in affordability of employer-based family coverage among low- and moderate-income families," the authors concluded. "To maintain high pediatric insurance coverage rates, substantial policy efforts will be needed in the coming years to ensure the continued accessibility of affordable pediatric health insurance coverage to working families, whether from public, employer-sponsored, or other private insurance markets."

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