Children's health insurance coverage and family structure, 1977-1996

Using data from a series of nationally representative medical expenditure s urveys, the authors document changes in children's health insurance coverag e in a period of two decades. Overall, it is found that the proportion of c hildren with private coverage declined, while the proportions publicly insu red and uninsured increased. However, when the authors account for differen ces in family structure, they find striking disparities in children's insur ance experiences. Contrary to overall trends, children in single-parent hou seholds made significant gains in private health insurance coverage after 1 977 and experienced reductions in public insurance. Coincident with Medicai d expansions in the late 1980s, children in two-parent households experienc ed significant increases in public health insurance. It is found that the r ise in the proportion of children who were uninsured in this period was lar gely a single-parent family phenomenon, and that parents' marital status, e mployment status, and family income are crucial factors associated with chi ldren's insurance status.