Figure 1 Percentage of Children, Under Age 18, With Employment-Based Bibliography Employment-Based Health Insurance of Children: Testimony Submission for the Record Coverage, With Medicaid, and Without Health Insurance, 1994–2005 Fronstin, Paul. “Children Without Health Insurance: An Analysis of the Increase in Why Coverage Decreased Between 2000 and 2005 70% Uninsured Children Between 1992 and 1993.” Inquiry 32(3), Fall 1995. 1 Senate Finance Committee By Paul Fronstin, EBRI 60% ______. “Characteristics of Uninsured Children.” EBRI Notes 18(1), January 1997. 1994 1995 1996 1997 1998 1999 Hearing on: ______. “Employment-Based Health Insurance for Children: Why Did Coverage Increase 50% “Improving Health of America’s Children” The percentage of children covered by an employment-based health plan decreased in the Mid-1990s?” Health Affairs. Vol. 18 (September/October 1999): 131–136. every year between 2000 and 2005, from Jan. 31, 2007, 10 a. 62.3 percent to 57.7 percent (Figure 1). The m. 2000 2001 2002 2003 2004 2005 decline in employm 40% ent-based coverage among children followed a strong expansion of 215 Dirksen Senate Office Building ______. “Sources of Health Insurance Coverage and Characteristics of the Uninsured: coverage that started in 1994. Between 1994 and 2000, the percentage of children Analysis of the March 2005 Current Population Survey.” EBRI Issue Brief no. 298, covered by an employment-based health plan increased from 58.8 percent to 62.3 30% October 2006. percent. Prior research by the Employee Benefit Research Institute (EBRI) has shown why the ______, and Bill Pierron. “Expanding Health Insurance for Children: Examining the 20% likelihood of having employment-based health benefits increased for children during the Alternatives.” EBRI Issue Brief no. 187, July 1997. earlier period (Fronstin, 1999). The EBRI study found that the percentage of children 10% with a working parent increased, the percentage of children in families with incomes below the poverty level decreased, and more children had a working parent employed in a large firm. The increase in employment-based coverage among children during this 0% period was attributed in part Employment-Based Coverage to an increase in the num Medicaid ber of adult wome Uninsured n working. Submitted by: During this period, the percentage of women ages 18–45 in families receiving public Source: Employee Benefit Research Institute estimates from the Current Population Survey, March 1995–2006 Supplements. assistance or welfare income declined, while employment increased (Figure 2). Paul Fronstin While the expansion in employment-based coverage among children during the 1990s Employee Benefit Research Institute (EBRI) was experienced mainly among children, the erosion in coverage since 2000 has affected T-147 both children and adults. The percentage of children with employment-based health benefits fell from 62.3 percent to 57.5 percent from 1999 to 2005, and for the first time since 1998, the percentage of uninsured children increased, rising from 10.8 percent to “Employment-Based Health Insurance of Children: Figure 2 11.2 percent (Figure 1). As a result of the decrease in the percentage of children with Percentage of Women Ages 18–45 Who Were in Families Why Coverage Decreased Between 2000 and 2005” employment-based coverage and shifts in various factors affecting the likelihood of With Welfare Income or Who Were Employed, 1994–2005 having employment-based coverage, 2.5 million fewer children were covered by an 100% employment-based health plan in 2005, compared with 2000. Fewer children had 90% coverage in 2005 than in 2000 for the following reasons: 79.0% 79.0% 77.8% 78.3% 78.2% • The distribution of children by family income shifted away from 77.2% higher income 76.9% 77.5% 75.8% 75.0% 80% 74.4% 74.2% levels to the poor. 70% • The distribution of children by parents’ work status shifted toward fewer children in families in which the family head was employed. 60% • Fewer children were in families in which the family head was working full-year and full-time. 50% • Working family heads were less likely in 2005 than in 2000 to be employed by Percentage With Welfare Income Percentage Employed 40% large firms and in manufacturing jobs, which are the private-sector firms most likely to offer health insurance. 30% 20% 1 Paul Fronstin is director of the Health Research and Education Program at the Employee Benefit Research 8.0% 7.4% 6.7% 10% 5.5% 4.3% 3.9% 3.1% 3.1% Institute (EBRI), a nonprofit, nonpartisan research institute that focuses on health 2.7% , retiremen 2.6% t, and The Employee Benefit Research Institute (EBRI) is a nonprofit, nonpartisan research institute that 2.8% 2.8% economic security issues. EBRI does not take policy positions and does not lobby. Fronstin can be reached focuses on health, retirement, and economic security issues. EBRI does not take policy positions 0% at (202) 775-6352, fronstin@ebri.org and does not lobby. www.ebri.org 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Source: Employee Benefit Research Institute estimates from the Current Population Survey, March 1995-2006 Supplements.