TABLE 3.
Awareness/Experience and Barriers to Insurance Coverage, Parents of Uninsured Children in the 2011–2012 National Survey of Children’s Health
| All Uninsured Children | 1st Generation | 2nd Generation | 3rd Generation | P Value | OR(CI) Multivariate Models* | |
|---|---|---|---|---|---|---|
| n = 4040 | n = 445; 14.9% | n = 779; 29.3% | n = 2508; 55.8% | 3rd Generation | ||
| % (SE) | % (SE) | % (SE) | % (SE) | Difference by Generation, Unadjusted | 2nd Generation | |
| 1st Generation, Reference | ||||||
| Awareness and experience with insurance options | ||||||
| Do you know where to get insurance information? % yes | 78.5 (1.7) | 51.5 (5.3) | 77.4 (3.6) | 86.7 (1.5) | P < .001 | 7.7 (3.8–15.4)***, 2.0 (1.1–3.8)** |
| Do you know how to enroll for insurance? % yes | 74.2 (1.8) | 43.5 (5.1) | 70.4 (3.9) | 85.0 (1.8) | P < .001 | 7.1 (3.6–13.0)***, 2.1 (1.2–3.8)** |
| Do you think your child is eligible for insurance? % yes | 47.1 (2.1) | 22.5 (4.5) | 49.2 (4.3) | 52.6 (2.5) | P < .001 | NS |
| Ever had employer based insurance, % yes | 39.8 (1.0) | 23.2 (5.6) | 51.8 (2.5) | 39.8 (2.0) | P < .001 | NS |
| Ever purchased your own insurance, % yes | 14.0 (1.6) | 10.9 (2.9) | 12.6 (2.8) | 15.5 (2.1) | NS | NS |
| Heard of Medicaid, % yes | 93.6 (0.8) | 86.7 (2.4) | 94.1 (1.7) | 95.4 (0.8) | P < .001 | 6.6 (2.4–17.1)***, NS |
| Child ever on Medicaid, % yes | 55.9 (2.0) | 8.8 (2.2) | 69.5 (3.7) | 61.0 (2.4) | P < .001 | 50.7 (20.6124.4)***, NS |
| Heard of CHIP, % yes | 75.3 (2.2) | 52.5 (6.5) | 73.9 (4.3) | 83.1 (2.1) | NS | 4.7 (2.2–10.4)***, NS |
| Child ever on CHIP, % yes | 33.3 (2.2) | 6.5 (2.8) | 43.6 (5.6) | 50.0 (5.5) | NS | 4.6 (1.3–15.8)**, NS |
| Barriers to obtaining insurance | ||||||
| Perceived difficulty of enrolling in Medicaid | ||||||
| Very easy | 13.7 (1.4) | 8.7 (3.2) | 11.5 (3.0) | 16.4 (1.8) | NS | NS |
| Somewhat easy | 29.2 (1.9) | 33.9 (5.1) | 29.7 (4.0) | 27.7 (2.3) | ||
| Somewhat difficult | 30.3 (2.0) | 36.3 (5.2) | 34.4 (4.3) | 26.2 (2.2) | ||
| Very difficult | 22.1 (1.7) | 16.6 (3.9) | 22.5 (3.2) | 23.4 (2.3) | ||
| Perceived difficulty of enrolling in SCHIP | P = .006 | 2.0 (1.0–4.5)*, 2.1 (1.2–3.8)** | ||||
| Very easy | 19.3 (2.3) | 5.6 (2.2) | 10.8 (3.5) | 27.1 (3.4) | ||
| Somewhat easy | 36.6 (3.0) | 39.5 (9.2) | 5.0 (5.3) | 37.2 (3.9) | ||
| Somewhat difficult | 29.1 (2.9) | 40.1 (8.9) | 37.5 (5.8) | 21.7 (3.1) | ||
| Very difficult | 15.0 (2.4) | 14.8 (7.4) | 16.7 (4.3) | 14.0 (3.1) | ||
| Length of time uninsured | 9.1 (5.3–15.6)***, NS | |||||
| <6 mo | 32.0 (1.9) | 11.8 (3.5) | 31.1 (3.1) | 38.5 (2.5) | NS | |
| 6 mo–1 y | 13.0 (1.4) | 4.4 (1.1) | 18.0 (3.4) | 12.8 (1.6) | ||
| 1–3 y | 22.2 (1.6) | 15.8 (2.7) | 28.6 (3.9) | 20.6 (1.8) | ||
| >3 y | 16.8 (1.4) | 22.8 (4.4) | 15.2 (2.6) | 15.9 (1.7) | ||
| Never insured | 16.0 (1.5) | 45.1 (4.8) | 7.1 (1.8) | 12.3 (1.9) | ||
| Employer size | ||||||
| >50 | 33.4 (7.5) | 19.7 (16.0) | 22.1 (9.1) | 36.9 (9.2) | P < .001 | NS |
| Exactly 50 | 7.5 (4.5) | 20.8 (18.0) | 28.8 (17.2) | 1.3 (0.6) | ||
| <50 | 58.1 (7.7) | 58.9 (20.3) | 49.1 (15.0) | 60.5 (9.1) | ||
| Eligible for employer insurance? | 5.9 (2.1–16.7)*** | |||||
| Yes, current employer | 11.5 (1.3) | 2.3 (0.9) | 9.0 (2.4) | 16.0 (2.1) | P < .001 | NS |
Multivariate analyses adjusted for poverty level, child age, major census region, parent education, race/ethnicity, and child health status. Binary outcomes modeled the probability of “no” so that ORs are expressed as >1. Ordinal outcomes are modeled based on the probability of increasing difficulty and increased time spent uninsured. CI, confidence interval; NS, not significant; OR, odds ratio.
*
P < .05.; **P < .01; ***P < .0001.