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Hourly Update

Parents in U.S. Can’t Always Pay to Cover Kids, Study Says

By Aliza Marcus
Bloomberg News
Tucson, Arizona | Published: 10.21.2008
More than a fourth of uninsured children in the U.S. have a parent with health coverage, according to a study whose authors said it shows private insurance is too expensive for many working families.
The insured parents of kids without coverage had a private plan rather than government health care in almost 90 percent of the cases, said the study published today in the Journal of the American Medical Association.
About 8.1 million children in the U.S. were uninsured in 2007, down from 8.7 million in 2006, according to the Census Bureau. Political debates over expanding U.S. health programs for children often focus on whether families will drop private policies they already have in favor of cheaper government- subsidized plans. The authors of the new survey said parents with private coverage often forego it for their kids because family policies cost too much.
“The working adults in these families may be able to afford private insurance for themselves but cannot afford to pay the premiums to cover the entire family,” said the researchers, led by Jennifer DeVoe of the Oregon Health and Science University, in Portland, in their report. “In this study, the private system did not do a good job of providing coverage for entire families.”
The researchers in the new study analyzed data collected from 2002 through 2005 through the Health and Human Services Department’s Medical Expenditure Panel Survey.
The study looked at children who lived with at least one parent. Of those, 3 million, or 27.9 percent, had a coverage gap, meaning they were uninsured for all or part of a year, even though their mother or father was covered the entire time.
Coverage at Work
Employees with coverage at work contributed on average $3,354 toward the $12,680 annual cost of a family plan this year, compared with $721 toward a $4,704 individual plan, according to a study in September by the Henry J. Kaiser Family Foundation in Menlo Park, California. The price of at-work insurance has more than doubled since 1999, outstripping a 34 percent increase in wages.
A majority of the uninsured children whose parents were covered came from low- or middle-income families, with about 25 percent of Hispanic background. Forty percent lived with a single parent. The study didn’t say how many of the kids had parents who got private coverage through their job, rather than buying it on their own.
“These kids fall into a gap where their families earn too much for government programs but they can’t afford private coverage,” DeVoe said in a telephone interview. “The solution will require a complete overhaul of the system and everyone getting together to solve this.”
State, Federal Efforts
Making health insurance more affordable and available requires states and the federal government to work together, wrote Senator Ron Wyden, a Democrat from Oregon, in a commentary in the medical association journal with Ezekiel Emanuel, chair of the bioethics department at the National Institutes of Health in Bethesda, Maryland.
Massachusetts began requiring last year that everyone have health insurance, creating an exchange where private insurers sell approved plans at prices deemed affordable. The state, using some federal money, also expanded the availability of subsidized coverage.
“States will and should have a role in any comprehensive health-care reform, but they cannot do it alone,” wrote Emanuel and Wyden. Wyden has sponsored a measure in Congress that would create a health insurance system relying on subsidies, employer contributions and a mandate to get everyone. It would be portable when workers leave their jobs.
Value-Added Tax
Health vouchers financed through a new value-added tax could help more people buy coverage and spread the cost more fairly, according to an additional commentary by Samuel Sessions, a researcher at the Los Angeles Biomedical Research Institute in Los Angeles, and Philip Lee, a professor emeritus at the medical school at University of California, San Francisco.
A value-added tax is applied to a product during each step of production, from raw material to finished good.
Under the proposal, insurers would have to accept all applicants, employer-provided benefits would be taxed and the Medicare health insurance program for the elderly and disabled, which covers about 44 million people, would be gradually phased out, according to the plan.
Giving people vouchers would make the health-care system more competitive, the authors wrote.