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Uninsured Children in the South

Over 4 million Southern Children have no Health Insurance

Embargoed for release until: 8:30 am, ET, Monday, December 9, 1996

For more information contact: Chris Ferris (202)347-5270

New Study:

Despite Recent Gains, South Still Home to Disproportionate Share ofNation’s Uninsured Children

Washington, D.C. — A new report, sponsored by the Kaiser Family Foundation and prepared by the Southern Institute on Children and Families, finds that the South was home to 4.1 million uninsured children in 1993. The number of uninsured children in the South declined 3 percent between 1989 and 1993, at the same time the number of uninsured children in the country on the whole increased 9 percent (Figure 1). Over a third (36 percent) of the nation’ children live in the South, but the region accounted for a disproportionatelyhigh share (43 percent) of America’uninsured children (Figure 2).

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“Although we witnessed a reduction in the number of uninsured children in the South,” said Sarah Shuptrine, principal author of the study, “in some states as many as one in four children are still uninsured.” The proportion of uninsured children in the South ranged from 25 percent in Louisiana to 10 percent in North Carolina and Missouri. Nineteen percent of the children in Texas, the largest state in the region, were without insurance. These 1 million uninsured Texan children accounted for one-fourth of all uninsured children in the South.

The reductions in the number of uninsured children in the South were due in part to changes in federal Medicaid laws that required states to expand income eligibility levels for children and to increase gradually the minimum eligibility age. All but three Southern states expanded eligibility levels beyond the federal requirements, making even more children eligible for coverage under Medicaid.

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The number of uninsured children under age 6–the focus of Medicaid expansion efforts–decreased by 37 percent in the South during this period. In contrast, the number of uninsured teenagers (age 13-18) increased 31 percent (Figure 3). That more younger children have insurance is closely related to the targeted extension of Medicaid coverage to these age groups.

“The impact of Medicaid expansions is clear when the changes in number of uninsured children between 1989 and 1993 are examined by age groups,” said Diane Rowland, Senior Vice President of the Kaiser Family Foundation. “Medicaid has filled many of the gaps in health insurance for children, but not all children eligible for Medicaid are currently covered.” Lack of information about the availability of Medicaid coverage and eligibility barriers leave many Southern children outside of the program’s reach.

The report suggests steps that states could take to increase enrollment in Medicaid that do not require federal waivers: raising age and income eligibility levels even further; eliminating the Medicaid assets test for children; and engaging in outreach to enroll children already eligible for Medicaid.

The study analyzed 1994 Current Population Survey (CPS) data for 17 Southern states and the District of Columbia. Because of recent revisions to the CPS questionnaire, the 1994 CPS–which provided 1993 data–is the latest that can be reliably compared to earlier years. The report provides estimates of the number of uninsured children in 1993, trends in the number of uninsured children between 1988 to 1993, and 1996 Medicaid eligibility levels for each of the states. Data from the following states, along with the District of Columbia, were included in this report’s analysis: Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia.


The Kaiser Family Foundation, based in Menlo Park, California, is a non-profit, independent national health care philanthropy and is not associated with Kaiser Permanente or Kaiser Industries.

Single copies of Uninsured Children in the South are available by calling the Kaiser Foundation’s publication request line at 1-800-656-4533.

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