Children’s Health Insurance, Family Income, and Welfare Enrollment

Historically, children from wealthier families are more likely to have health insurance than children from poorer families on average. However, the relationship between family income and health insurance is non-linear, as children near the Federal Poverty Line (FPL) are less likely to be insured than children from both wealthier families (who obtain health insurance from the private market) and poorer families (who obtain government-funded health insurance). This health insurance dip has persisted even as Medicaid has been expanded to cover those above the FPL. One explanation for this is that families who are far below the poverty line are better connected to the welfare system, and consequently, are more likely to enroll in Medicaid. This study uses data from the 1988-2012 Current Population Surveys and finds that (1) the relationship between family income and children's health insurance status has been flattening over time, (2) controlling for family income, those on other forms of government assistance (e.g, food stamps, public housing, or heat subsidies) are more likely to have health insurance, and (3) the relationship between family income and children's health insurance status is closer to monotonic after controlling for enrollment in other welfare programs