Health Insurance: Uninsured Children, by State, 2005-2007

Health Insurance: Uninsured Children, by State, 2005-2007

Order Code 97-310
Updated August 29, 2008
Health Insurance: Uninsured Children,
by State, 2005-2007
Chris L. Peterson and April Grady
Domestic Social Policy Division
Summary
Based on data from the Census Bureau’s Current Population Survey (CPS), an
estimated 8.9 million children under age 191 were uninsured in 2007, representing
11.3% of all children in the United States.
When examining health insurance coverage among children at the state level, a
three-year average is used to provide more reliable estimates. During 2005-2007, the
estimated average percentage of children without health insurance nationally was 11.5%,
ranging from 4.8% in Massachusetts to 20.9% in Texas. The proportion of uninsured
children tended to be lower in the Midwest and New England, and higher in the South
and West. In 28 states and the District of Columbia, the 2005-2007 average uninsured
rate for children was significantly below the national rate; in seven states, it was
significantly higher. The 2005-2007 average uninsured rate among children in Texas
(20.9%) was significantly higher than any other state, including Florida, which had the
second-highest rate of uninsured children (19.1%).
Estimates of Health Insurance Coverage by State
During 2005-2007, the estimated average percentage of children under age 19 who
lacked health insurance coverage was 11.5%. Table 1 shows that 2005-2007 average
uninsured rates for children ranged from 4.8% in Massachusetts to 20.9% in Texas.
Twenty-nine states and the District of Columbia had average uninsured rates for children
of less than 10.0%. Six states (Arizona, Florida, Mississippi, Nevada, New Mexico, and
Texas) had rates of 15% or more. Generally, states with the lowest average uninsured
rates for children were located in the Midwest and Northeast; states with the highest rates
were in South and West (Figure 1).
1 Census Bureau estimates for children generally refer to individuals under age 18. Estimates in
this report refer to individuals under age 19, which corresponds with the cutoff used for Medicaid
poverty-related child eligibility and the State Children’s Health Insurance Program (SCHIP)
allotment formula.

CRS-2
Table 1 provides private health insurance,2 public health insurance,3 and uninsured
estimates with percentage rankings for children by state. The right side of the table
indicates whether a state’s three-year average uninsured rate for children is statistically
lower (shown with a “-”), statistically higher (shown with a “+”), or not statistically
different (shown with a “x”) than the national rate of 11.5%.4
Both private and public health insurance affect a state’s uninsured rate. For example,
as shown in Table 1, Maine and New Hampshire have similarly low uninsured rates.5
However, New Hampshire has the highest three-year average private coverage rate for
children in the country (81.4%) and the third-lowest public coverage rate (18.1%). On the
other hand, Maine has a much lower three-year average private coverage rate for children
(67.3%), and a public coverage rate (36.0%) that is roughly double that of New
Hampshire. Thus, even though there are differences regarding whether children in Maine
and New Hampshire obtain private or public health insurance, the impact is that both have
similarly low three-year average uninsured rates.
Estimates with 95% Confidence Intervals. The estimates in this report are
based on data from the March 2006, 2007, and 2008 supplements to the Current
Population Survey (CPS).6 The CPS is representative of the civilian, noninstitutionalized
population and is designed to produce reliable estimates at the national, regional, and state
levels.
The small sample sizes available from the CPS for many states, especially when
examining a subset of the sample such as children under the age of 19, make it prudent
to use a three-year average and consider state-level estimates in terms of a range of values.
Like Table 1, Table 2 shows the best point estimates, or single values, for the average
number and percentage of children covered and not covered by health insurance. The
table also reports a range of values — the 95% confidence interval — for these estimates.
The larger the confidence interval in relation to the size of the estimate, the less reliable
the estimate. The size of the range depends primarily on the sample size. A 95%
confidence interval means that if repeated samples were collected under essentially the
same conditions and their confidence intervals calculated, in the long run about 95% of
those intervals would contain the true number of children with (or without) health
insurance.
2 Coverage through an employer or union, all coverage from outside the home, and coverage
purchased directly from a private insurer.
3 Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), and other
government-provided health insurance, as well as coverage related to employment in the military.
4 Statistical significance was tested at the 95% confidence level (also referred to as the 5%
significance level). This means that one can be 95% certain that the difference between a state’s
uninsured rate and the national rate is not zero (i.e., the state’s rate is statistically higher or lower)
or could be zero (i.e., the state’s rate is not statistically different).
5 Their uninsured rates are statistically lower than the national rate and are not statistically
different from each other.
6 Because the supplement is now fielded from February through April, it has been officially
renamed the Annual Social and Economic supplement (ASEC) to the CPS, though many analysts
continue to refer to it by its traditional name.

CRS-3
Reasons for Differences in the Percentage Uninsured
Figure 1 indicates that children under age 19 in the South and West are more likely
to lack health insurance, and that those in the Midwest and New England are more likely
to be covered. Various characteristics of a state’s population may account for these
differences. Nationwide, the uninsured rate for children is related to race and ethnicity,
family structure, and family members’ employment. The prevalence of particular
population and employer characteristics may account for some of the regional or state
variation in uninsured rates for children. The percentage of a state’s child population that
is uninsured may also be affected by state policies, such as eligibility criteria for the
state’s Medicaid program or its State Children’s Health Insurance Program (SCHIP).

CRS-4
Table 1. Health Insurance Coverage Estimates with Rankings by State for Children
Under Age 19, 2005-2007 Average
(sorted by percentage uninsured ranking, numbers in thousands)
Public health insurance
Private health insurance
(including military)
Uninsured
Total
Percent
Percent
Percent
State
population
Number
Value
Rank
Number
Value
Rank
Number
Value
Rank
United States
78,256
50,884
65.0%
NA
23,173
29.6%
NA
9,016
11.5%
NA
NA
Massachusetts
1,565
1,183
75.6%
4
378
24.2%
43
76
4.8%
-
1
Iowa
743
563
75.8%
3
200
26.9%
33
41
5.5%
-
2
Michigan
2,611
1,894
72.5%
11
750
28.7%
27
148
5.7%
-
3
Hawaii
312
221
70.8%
16
110
35.3%
11
18
5.8%
-
4
Wisconsin
1,390
1,045
75.2%
5
364
26.2%
36
81
5.8%
-
5
Maine
302
203
67.3%
28
109
36.0%
10
19
6.4%
-
6
New Hampshire
317
258
81.4%
1
57
18.1%
49
21
6.6%
-
7
Alabama
1,175
780
66.4%
31
394
33.5%
15
78
6.7%
-
8
Connecticut
873
655
75.1%
6
203
23.3%
45
60
6.9%
-
9
Minnesota
1,320
1,036
78.5%
2
263
19.9%
47
91
6.9%
-
10
West Virginia
418
252
60.3%
41
170
40.6%
4
29
7.0%
-
11
Rhode Island
256
180
70.3%
21
81
31.5%
21
18
7.0%
-
12
Kansas
736
516
70.1%
23
223
30.3%
25
53
7.2%
-
13
District of Columbia
119
63
53.0%
48
54
46.0%
1
9
7.3%
-
14
Pennsylvania
2,944
2,132
72.4%
12
771
26.2%
35
222
7.6%
-
15
Ohio
2,922
2,063
70.6%
17
826
28.3%
30
224
7.7%
-
16
Vermont
140
91
64.8%
33
56
39.7%
6
11
7.7%
-
17
Washington
1,617
1,124
69.5%
25
492
30.5%
24
126
7.8%
-
18
Indiana
1,682
1,183
70.3%
20
454
27.0%
32
132
7.9%
-
19
Tennessee
1,537
970
63.1%
36
557
36.2%
9
130
8.5%
-
20
Kentucky
1,061
679
64.0%
34
366
34.5%
14
92
8.7%
-
21
New York
4,770
3,101
65.0%
32
1,561
32.7%
16
415
8.7%
-
22
Nebraska
467
347
74.2%
7
117
25.1%
41
41
8.7%
-
23
South Dakota
205
144
70.4%
19
58
28.4%
29
18
8.8%
-
24
Illinois
3,395
2,395
70.6%
18
871
25.6%
40
305
9.0%
-
25
North Dakota
155
114
73.6%
8
38
24.2%
42
14
9.1%
-
26
Missouri
1,483
991
66.8%
30
453
30.5%
23
138
9.3%
-
27
Arkansas
732
405
55.3%
47
322
44.0%
2
69
9.5%
-
28
Maryland
1,455
1,068
73.4%
9
348
23.9%
44
141
9.7%
-
29
Wyoming
130
91
70.2%
22
37
28.1%
31
13
9.7%
x
30
Virginia
1,933
1,341
69.4%
26
569
29.4%
26
194
10.0%
x
31
Alaska
193
122
63.0%
37
76
39.2%
7
20
10.3%
x
32
Delaware
216
150
69.6%
24
56
26.1%
37
23
10.6%
x
33
Idaho
427
293
68.6%
27
111
25.9%
38
51
12.0%
x
34
Oregon
920
619
67.2%
29
237
25.8%
39
111
12.1%
x
35
Georgia
2,568
1,543
60.1%
42
907
35.3%
12
313
12.2%
x
36
South Carolina
1,094
677
61.8%
38
356
32.5%
18
134
12.2%
x
37
New Jersey
2,237
1,639
73.3%
10
387
17.3%
50
279
12.5%
x
38
Oklahoma
948
539
56.9%
46
368
38.9%
8
119
12.6%
x
39
Louisiana
1,140
668
58.7%
44
398
34.9%
13
145
12.7%
x
40
California
10,089
6,032
59.8%
43
3,259
32.3%
20
1,294
12.8%
+
41
North Carolina
2,333
1,409
60.4%
40
757
32.5%
19
303
13.0%
x
42
Utah
841
607
72.2%
13
173
20.5%
46
109
13.0%
x
43
Colorado
1,254
896
71.4%
14
245
19.6%
48
172
13.7%
x
44
Montana
230
145
63.2%
35
66
28.6%
28
32
13.9%
x
45
Mississippi
820
421
51.3%
50
344
41.9%
3
122
14.9%
+
46
Nevada
686
486
70.9%
15
113
16.5%
51
111
16.2%
+
47
Arizona
1,747
1,013
58.0%
45
571
32.7%
17
286
16.4%
+
48
New Mexico
535
272
50.8%
51
215
40.1%
5
96
17.9%
+
49
Florida
4,295
2,612
60.8%
39
1,151
26.8%
34
822
19.1%
+
50
Texas
6,917
3,654
52.8%
49
2,131
30.8%
22
1,447
20.9%
+
51
Source: Congressional Research Service analysis of data from the March 2006-2008 Current Population Survey.
Note: People may have both private and public coverage. The symbol “-” indicates that a state’s uninsured rate is statistically lower
than the national rate, “+” indicates that it is statistically higher, and “x” indicates that it is not statistically different.

CRS-5
Table 2. Health Insurance Coverage Estimates with 95% Confidence Intervals by
State for Children Under Age 19, 2005-2007 Average
(numbers in thousands)
Public health insurance (including
Private health insurance
military)
Uninsured
State
Number
Percent
Number
Percent
Number
Percent
United States
50,884 +/- 414
65.0% +/-0.4%
23,173 +/- 318
29.6% +/-0.4%
9,016 +/- 204 11.5% +/- 0.2%
Alabama
780 +/- 53
66.4% +/- 3.1%
394 +/- 42
33.5% +/- 3.1%
78 +/- 19
6.7% +/- 1.6%
Alaska
122 +/- 9
63.0% +/- 3.2%
76 +/-
8
39.2% +/- 3.2%
20 +/- 4
10.3% +/- 2.0%
Arizona
1,013 +/- 65
58.0% +/- 2.9%
571 +/- 55
32.7% +/- 2.7%
286 +/- 40
16.4% +/- 2.1%
Arkansas
405 +/- 31
55.3% +/- 3.3%
322 +/- 30
44.0% +/- 3.3%
69 +/- 15
9.5% +/- 2.0%
California
6,032 +/- 160
59.8% +/- 1.2%
3,259 +/- 133
32.3% +/- 1.1%
1,294 +/- 86
12.8% +/- 0.8%
Colorado
896 +/- 60
71.4% +/- 3.0%
245 +/- 36
19.6% +/- 2.7%
172 +/- 31
13.7% +/- 2.3%
Connecticut
655 +/- 44
75.1% +/- 3.0%
203 +/- 28
23.3% +/- 2.9%
60 +/- 16
6.9% +/- 1.8%
Delaware
150 +/- 11
69.6% +/- 3.2%
56 +/-
7
26.1% +/- 3.1%
23 +/- 5
10.6% +/- 2.2%
District of Columbia
63 +/- 6
53.0% +/- 4.2%
54 +/-
6
46.0% +/- 4.2%
9 +/- 3
7.3% +/- 2.2%
Florida
2,612 +/- 101
60.8% +/- 1.7%
1,151 +/- 76
26.8% +/- 1.6%
822 +/- 65
19.1% +/- 1.4%
Georgia
1,543 +/- 75
60.1% +/- 2.2%
907 +/- 65
35.3% +/- 2.1%
313 +/- 39
12.2% +/- 1.5%
Hawaii
221 +/- 15
70.8% +/- 3.0%
110 +/- 12
35.3% +/- 3.2%
18 +/- 5
5.8% +/- 1.6%
Idaho
293 +/- 19
68.6% +/- 2.9%
111 +/- 13
25.9% +/- 2.8%
51 +/- 9
12.0% +/- 2.1%
Illinois
2,395 +/- 95
70.6% +/- 1.8%
871 +/- 66
25.6% +/- 1.7%
305 +/- 40
9.0% +/- 1.1%
Indiana
1,183 +/- 65
70.3% +/- 2.5%
454 +/- 47
27.0% +/- 2.4%
132 +/- 26
7.9% +/- 1.5%
Iowa
563 +/- 38
75.8% +/- 3.0%
200 +/- 26
26.9% +/- 3.1%
41 +/- 12
5.5% +/- 1.6%
Kansas
516 +/- 35
70.1% +/- 3.1%
223 +/- 27
30.3% +/- 3.1%
53 +/- 13
7.2% +/- 1.8%
Kentucky
679 +/- 49
64.0% +/- 3.3%
366 +/- 41
34.5% +/- 3.3%
92 +/- 21
8.7% +/- 1.9%
Louisiana
668 +/- 49
58.7% +/- 3.2%
398 +/- 42
34.9% +/- 3.1%
145 +/- 26
12.7% +/- 2.2%
Maine
203 +/- 16
67.3% +/- 3.7%
109 +/- 14
36.0% +/- 3.8%
19 +/- 6
6.4% +/- 1.9%
Maryland
1,068 +/- 63
73.4% +/- 2.7%
348 +/- 42
23.9% +/- 2.6%
141 +/- 27
9.7% +/- 1.8%
Massachusetts
1,183 +/- 64
75.6% +/- 2.4%
378 +/- 42
24.2% +/- 2.4%
76 +/- 19
4.8% +/- 1.2%
Michigan
1,894 +/- 83
72.5% +/- 2.0%
750 +/- 60
28.7% +/- 2.0%
148 +/- 27
5.7% +/- 1.0%
Minnesota
1,036 +/- 60
78.5% +/- 2.5%
263 +/- 35
19.9% +/- 2.5%
91 +/- 21
6.9% +/- 1.6%
Mississippi
421 +/- 32
51.3% +/- 3.2%
344 +/- 32
41.9% +/- 3.2%
122 +/- 20
14.9% +/- 2.3%
Missouri
991 +/- 61
66.8% +/- 2.8%
453 +/- 47
30.5% +/- 2.7%
138 +/- 27
9.3% +/- 1.7%
Montana
145 +/- 11
63.2% +/- 3.4%
66 +/-
8
28.6% +/- 3.2%
32 +/- 6
13.9% +/- 2.4%
Nebraska
347 +/- 23
74.2% +/- 3.0%
117 +/- 15
25.1% +/- 3.0%
41 +/- 9
8.7% +/- 1.9%
Nevada
486 +/- 33
70.9% +/- 3.1%
113 +/- 19
16.5% +/- 2.5%
111 +/- 18
16.2% +/- 2.5%
New Hampshire
258 +/- 17
81.4% +/- 2.8%
57 +/-
9
18.1% +/- 2.7%
21 +/- 6
6.6% +/- 1.8%
New Jersey
1,639 +/- 78
73.3% +/- 2.2%
387 +/- 44
17.3% +/- 1.8%
279 +/- 38
12.5% +/- 1.6%
New Mexico
272 +/- 23
50.8% +/- 3.6%
215 +/- 23
40.1% +/- 3.5%
96 +/- 16
17.9% +/- 2.8%
New York
3,101 +/- 111
65.0% +/- 1.6%
1,561 +/- 89
32.7% +/- 1.6%
415 +/- 47
8.7% +/- 1.0%
North Carolina
1,409 +/- 73
60.4% +/- 2.3%
757 +/- 60
32.5% +/- 2.2%
303 +/- 39
13.0% +/- 1.6%
North Dakota
114 +/- 8
73.6% +/- 3.1%
38 +/-
5
24.2% +/- 3.0%
14 +/- 3
9.1% +/- 2.0%
Ohio
2,063 +/- 87
70.6% +/- 1.9%
826 +/- 63
28.3% +/- 1.9%
224 +/- 34
7.7% +/- 1.1%
Oklahoma
539 +/- 41
56.9% +/- 3.4%
368 +/- 38
38.9% +/- 3.3%
119 +/- 22
12.6% +/- 2.2%
Oregon
619 +/- 46
67.2% +/- 3.4%
237 +/- 33
25.8% +/- 3.2%
111 +/- 23
12.1% +/- 2.3%
Pennsylvania
2,132 +/- 89
72.4% +/- 1.9%
771 +/- 61
26.2% +/- 1.8%
222 +/- 34
7.6% +/- 1.1%
Rhode Island
180 +/- 13
70.3% +/- 3.4%
81 +/- 10
31.5% +/- 3.5%
18 +/- 5
7.0% +/- 1.9%
South Carolina
677 +/- 50
61.8% +/- 3.3%
356 +/- 41
32.5% +/- 3.2%
134 +/- 25
12.2% +/- 2.2%
South Dakota
144 +/- 9
70.4% +/- 2.9%
58 +/-
7
28.4% +/- 2.8%
18 +/- 4
8.8% +/- 1.8%
Tennessee
970 +/- 60
63.1% +/- 2.8%
557 +/- 51
36.2% +/- 2.8%
130 +/- 26
8.5% +/- 1.6%
Texas
3,654 +/- 127
52.8% +/- 1.5%
2,131 +/- 109
30.8% +/- 1.4%
1,447 +/- 90
20.9% +/- 1.2%
Utah
607 +/- 32
72.2% +/- 2.5%
173 +/- 20
20.5% +/- 2.2%
109 +/- 16
13.0% +/- 1.9%
Vermont
91 +/- 8
64.8% +/- 3.7%
56 +/-
7
39.7% +/- 3.8%
11 +/- 3
7.7% +/- 2.1%
Virginia
1,341 +/- 70
69.4% +/- 2.4%
569 +/- 52
29.4% +/- 2.3%
194 +/- 31
10.0% +/- 1.5%
Washington
1,124 +/- 66
69.5% +/- 2.7%
492 +/- 50
30.5% +/- 2.7%
126 +/- 26
7.8% +/- 1.6%
West Virginia
252 +/- 19
60.3% +/- 3.3%
170 +/- 17
40.6% +/- 3.3%
29 +/- 7
7.0% +/- 1.7%
Wisconsin
1,045 +/- 62
75.2% +/- 2.6%
364 +/- 42
26.2% +/- 2.7%
81 +/- 21
5.8% +/- 1.4%
Wyoming
91 +/- 7
70.2% +/- 3.4%
37 +/-
5
28.1% +/- 3.3%
13 +/- 3
9.7% +/- 2.2%
Source: Congressional Research Service analysis of data from the March 2006-2008 Current Population Survey.
Note: People may have both private and public coverage. The 95% confidence interval is a measure of an estimate’s variability
(see text for more information).

CRS-6
Figure 1. Percentage of Children Under Age 19 Uninsured, by State, 2005-2007 Average
Source: Congressional Research Service analysis of data from the March 2006-2008 Current Population Survey.
Note: States in the 10.0%-12.7% category are not statistically different from the national rate.