TABLE 2.
Change in NPM 15, Insurance Continuity, Adequacy, and Type From 2016 to 2019, by Year
| Outcome | 2016 (% [95% CI]) | 2017 (% [95% CI]) | 2018 (% [95% CI]) | 2019 (% [95% CI]) | Difference 2016–2019 (% [95% CI]) |
|---|---|---|---|---|---|
| NPM 15 | |||||
| Had continuous and adequate insurance | 69.4 (68.4 to 70.3) | 67.5 (66.1 to 68.8) | 67.5 (66.4 to 68.6) | 66.0 (64.8 to 67.2) | −3.4 (−1.9 to −4.9) |
| Consistently insured throughout past year | 91.9 (91.2 to 92.5) | 91.8 (90.8 to 92.7) | 90.8 (90.0 to 91.6) | 91.3 (90.4 to 92.1) | −0.6 (−1.7 to 0.5) |
| Insured at time of survey | 94.0 (93.4 to 94.6) | 93.8 (92.8 to 94.6) | 93.4 (92.7 to 94.1) | 93.3 (92.5 to 94.0) | −0.7 (−1.7 to 0.2) |
| Insured all 12 mo | 91.9 (91.2 to 92.5) | 91.8 (90.8 to 92.7) | 90.8 (90.0 to 91.6) | 91.3 (90.4 to 92.1) | −0.6 (−1.7 to 0.5) |
| Insured but with gaps | 3.4 (3.0 to 3.8) | 4.2 (3.6 to 4.9) | 3.9 (3.4 to 4.4) | 3.4 (2.9 to 3.9) | 0.0 (−0.6 to 0.7) |
| No coverage entire past 12 mo | 4.7 (4.2 to 5.3) | 4.2 (3.6 to 4.9) | 5.3 (4.7 to 6.0) | 5.3 (4.7 to 6.1) | +0.6 (−0.3 to 1.5) |
| Adequate insurance coverage | 75.2 (74.4 to 76.0) | 73.5 (72.2 to 74.7) | 74.0 (73.0 to 75.0) | 72.1 (71.0 to 73.2) | −3.1 (−4.5 to −1.7) |
| Current insurance meets child’s needs | |||||
| Always | 67.6 (66.7 to 68.6) | 67.5 (66.1 to 68.8) | 67.1 (66.0 to 68.2) | 65.9 (64.6 to 67.1) | −1.8 (−3.3 to −0.2) |
| Usually | 26.3 (25.4 to 27.2) | 26.0 (24.8 to 27.3) | 26.3 (25.3 to 27.4) | 27.1 (26.0 to 28.3) | +0.8 (0.6 to 2.2) |
| Sometimes or never | 6.0 (5.6 to 6.5) | 6.5 (5.8 to 7.3) | 6.6 (5.9 to 7.2) | 7.0 (6.3 to 7.8) | +1.0 (0.1 to 1.8) |
| Child able to see needed providers | |||||
| Always | 79.7 (78.9 to 80.5) | 78.7 (77.4 to 79.8) | 78.4 (77.3 to 79.4) | 76.6 (75.5 to 77.7) | −3.0 (−4.4 to −1.7) |
| Usually | 16.7 (16.0 to 17.5) | 17.2 (16.1 to 18.3) | 18.0 (17.1 to 18.9) | 19.2 (18.2 to 20.3) | +2.5 (1.2 to 3.8) |
| Sometimes or never | 3.6 (3.2 to 4.0) | 4.1 (3.6 to 4.8) | 3.6 (3.2 to 4.2) | 4.1 (3.7 to 4.7) | +0.5 (−0.1 to 1.2) |
| Out-of-pocket expenses reasonable | |||||
| Always | 16.3 (15.6 to 16.9) | 17.3 (16.3 to 18.5) | 15.2 (14.4 to 16.0) | 14.7 (13.9 to 15.6) | −1.6 (−2.6 to −0.5) |
| Usually | 27.5 (26.7 to 28.3) | 26.3 (25.2 to 27.5) | 27.8 (26.9 to 28.8) | 26.4 (25.4 to 27.5) | −1.0 (−2.3 to −0.3) |
| Sometimes or never | 22.2 (21.5 to 23.0) | 23.6 (22.4 to 24.7) | 23.0 (22.0 to 23.9) | 25.1 (24.0 to 26.2) | +2.9 (1.5 to 4.2) |
| No out-of-pocket costs | 34.1 (33.0 to 35.1) | 32.8 (31.3 to 34.4) | 34.0 (32.7 to 35.3) | 33.8 (32.5 to 35.1) | −0.3 (−2.0 to 1.4) |
| Insurance type | |||||
| Public only | 31.7 (30.7 to 32.8) | 30.8 (29.3 to 32.3) | 31.2 (30.0 to 32.4) | 29.4 (28.2 to 30.7) | −2.3 (−0.8 to −3.9) |
| Private only | 56.4 (55.4 to 57.4) | 57.9 (56.4 to 59.4) | 58.1 (56.8 to 59.3) | 58.9 (57.6 to 60.2) | +2.5 (0.8 to 4.2) |
| Public and private | 4.3 (3.9 to 4.7) | 5.0 (4.3 to 5.8) | 4.1 (3.6 to 4.6) | 4.9 (4.3 to 5.6) | +0.6 (−0.1 to 1.4) |
NPM 15 is the percentage of children aged 0 to 17 y who are continuously and adequately insured. To qualify on this measure, a child had to (1) have insurance coverage at the time of the survey and consistently over the previous 12 mo and (2) have insurance benefits that usually or always (a) meets a child’s needs, (b) allows a child to see needed providers, and (c) had reasonable out-of-pocket medical expenses (or no out-of-pocket costs).