This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health.

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This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health. Sub-Contract Research Corporation of the University of Hawaii. Research conducted by the University of Hawaii, Social Science Research Institute in collaboration with the Hawaii State Department of Health, Hawaii Institute for Public Affairs: Hawaii Uninsured Project and the Hawaii Health Information Corporation. 1 Uninsured Hawai`i Population Overview: Children Age 0-18 Children Age 0-17 Gerard Russo, Ph.D. Sang-Hyop Lee, Ph.D. Lawrence Nitz, Ph.D. Thamana Lekprichakul, Ph.D. Rui Wang, Ph.D. Candidate University of Hawai`i at Mānoa Kathleen Baker, Ph.D., Hawaii Department of Health HRSA SPG Technical Workshop VII 13 October 2005

Preliminary results. Revised October Subject to further revision. 2 Percent Without Health Insurance, Hawai`i: Current Population Survey (CPS) Hawai`i Health Survey (HHS) Behavioral Risk Factor Surveillance System (BRFSS) Note: U.S. Census Bureau CPS definition of uninsured is no health insurance in the entire 12-month period of the preceding year. CPS Verification question added March Hawaii State Department of Health definition of uninsured is no health insurance at the time of the interview. BRFSS surveys adults only. Sources: Current Population Survey (CPS), Annual Social and Economic (ASEC) Supplements (Annual Demographic Supplements), Public Use Files, Hawaii Sample. Hawaii State Department of Health, Hawaii Health Survey, Confidential Version and Behavioral Risk Factor Surveillance System, Confidential Version. Weighted tabulations. University of Hawaii, Social Science Research Institute. October CPS estimates based on March Supplement population weights.

13 October 2005Preliminary results. Revised October Subject to further revision. 3 Hawaii Uninsured Population: Multi-Year Survey Averages with 95% Confidence Intervals CPS (3-year Average) Persons Age 0-99 HHS (6-year Average) Persons Age 0-99 BRFSS (4-year Average) Persons Age 18-99

13 October 2005Preliminary results. Revised October Subject to further revision. 4 Percent Without Health Insurance, Hawai`i with 95% Confidence Intervals: Current Population Survey (CPS)

13 October 2005Preliminary results. Revised October Subject to further revision. 5 Uninsured Persons Hawai ` i : Current Population Survey

13 October 2005Preliminary results. Revised October Subject to further revision. 6 Table 1: Hawaii Uninsured Population: CPS 2001 – 2005 Survey Year Total Population Uninsured Population Standard Error 95% Confidence Interval Percent Uninsured Standard Error 95% Confidence Interval Lower Limit Upper Limit Lower Limit Upper Limit 20011,155,864116,00618,16480,303151, %1.49%7.11%12.96% 20021,213,328116,90410,79195,730138, %0.83%8.00%11.27% 20031,224,275122,80310,421102,356143, %0.81%8.44%11.63% 20041,253,067127,69111,051106,008149, %0.84%8.55%11.83% 20051,249,806120,29110,68599,327141, %0.81%8.04%11.21% Source: U.S. Census Bureau, Current Population Survey (CPS), Annual Social and Economic (ASEC) Supplement, Hawaii Sample ( ). Weighted tabulations, University of Hawai`i at Mānoa.

13 October 2005Preliminary results. Revised October Subject to further revision. 7 Age Distribution of Hawai`i’s Uninsured Population: CPS , 3-year Average 123,595 22,580 99,408 1,607

13 October 2005Preliminary results. Revised October Subject to further revision. 8 Uninsured Hawaii Children Age 0-18: with 95% Confidence Intervals CPS Survey Years

13 October 2005Preliminary results. Revised October Subject to further revision. 9 Percent Uninsured: Hawaii Children Age 0-18 with 95% Confidence Intervals CPS Survey Years

13 October 2005Preliminary results. Revised October Subject to further revision. 10 Highlights Children Age 0-18: CPS ,580 Uninsured Children Age 0-18 High Estimate=27,270 Low Estimate=17,890 16,920 appear to be Income Eligible for Free Medical Assistance under Medicaid, QUEST, SCHIP or Immigrant Children Program. 7% of all Children Age 0-18 are Uninsured

13 October 2005Preliminary results. Revised October Subject to further revision. 11 Number of Uninsured Children, Hawaii: Age 0-18 Survey (Years)Uninsured Children Age 0-18 CPS (3-year average) 22,580 HHS (3-year average) 10,461

13 October 2005Preliminary results. Revised October Subject to further revision. 12 Number of Uninsured Children, Hawaii: Age 0-17 Survey (Years)Uninsured Children Age 0-17 CPS (3-year average) 21,240 HHS (3-year average) 9,018 SLAITS-NSCH 1/2003-7/2004 (1 year) 15,295 SLAITS-CSHCN (1 year) 11,093

13 October 2005Preliminary results. Revised October Subject to further revision. 13 Hawai ` i Population: Children Age 0-18 by Eligibility, (3-Year Average) Survey Year Medicaid QUEST Income Eligible SCHIP Income Eligible % FPL 301% + FPL Total CPS ,94870,32066,331106,926331,526 HHS ,16067,95868,582108,010308,711

13 October 2005Preliminary results. Revised October Subject to further revision. 14 Comparison of CPS, HHS and SLAITS (age 0-17) Survey Year Medicaid QUEST Income Eligible SCHIP Income Eligible % FPL 301% + FPL Total CPS ,01267,10063,717101,037316,866 HHS ,94164,57364,928101,367291,810 SLAITS-NSCH 1/2003-7/ ,23860,25456,438114,169296,099 SLAITS- CSHCN ,08073,45962,53099,875295,944 Note: SLAITS and HHS Estimates Based on UHM Imputation for Missing Data

13 October 2005Preliminary results. Revised October Subject to further revision US HHS Poverty Guidelines: Hawaii vs. 48 Contiguous States & DC Family SizeHawaii Annual Family Income 48 Contiguous States & DC Annual Family Income 1$11,010$9,570 2$14,760$12,830 3$18,510$16,090 4$22,260$19,350 5$26,010$22,610 6$29,760$25,870 7$33,510$29,130 8$37,260$32,390 Note: For Hawaii family size more than 8 persons add $3,750 for each additional person. For Mainland family size more than 8 persons add $3,260 for each additional person. Source: Federal Register, Vol.70, No.3.

13 October 2005Preliminary results. Revised October Subject to further revision. 16 SCHIP Federal Medical Assistance Percentage: Hawaii Enhanced Federal Medical Assistance Percentage (FMAP): Hawaii Federal Fiscal Year (FFY)Enhanced FMAP: SCHIP % % % % % % Source: Federal Register

13 October 2005Preliminary results. Revised October Subject to further revision. 17 Hawai ` i SCHIP Program Eligibility by Age and Federal Poverty Level

13 October 2005Preliminary results. Revised October Subject to further revision. 18 Uninsured Hawaii Children Age 0-18 by Income Eligibility: CPS Survey Year Total Children 0-200% FPL Uninsured Children 0-200% FPL Percent Uninsured 0-200% FPL Children > 200% FPL Uninsured Children > 200% FPL Percent Uninsured > 200% FPL ,828132,87922, %161,9487, % ,952169,73121, %157,22110, % ,545154,02015, %186,52510, % ,080140,86015, %186,2209, % ,951119,8619, %182,0907, % Source: U.S. Census Bureau, Current Population Survey (CPS), Annual Social and Economic (ASEC) Supplement, Hawaii Sample ( ). Weighted tabulations, University of Hawai`i at Mānoa.

13 October 2005Preliminary results. Revised October Subject to further revision. 19 Uninsured Children by Program Eligibility: CPS Survey Year EligibilityChildren Std. Err. 95% Conf. Int.UninsuredStd. Err.95% Conf. Int.PercentStd. Err.95% Conf. Int. 2001Medicaid77,5487,60062,17692,92014,4265,6163,06725, %6.90%4.64%32.56% 2002Medicaid90,9046,51678,005103,80214,1753,7336,78621, %3.95%7.77%23.42% 2003Medicaid84,6714,78275,18894,1539,6742,7154,29015, %3.22%5.04%17.81% 2004Medicaid81,9005,12871,73592,06410,5413,0424,51216, %3.65%5.64%20.10% 2005Medicaid56,9113,79249,37964,4446,8552,2112,46311, %3.81%4.48%19.61% 2001SCHIP55,3325,24344,57566,0898,2254,759017, %8.24%0.00%31.77% 2002SCHIP78,8274,51469,87387,7827,0322,4242,22411, %3.08%2.82%15.02% 2003SCHIP69,3494,21960,95577,7445,5831,7052,1908, %2.59%2.91%13.19% 2004SCHIP58,9604,38050,24767,6734,6682, , %3.76%0.43%15.40% 2005SCHIP62,9504,21554,58071,3202,5711,285205, %2.03%0.05%8.12% %61,4944,78851,81771,1712,5491,78006, %2.93%0.00%10.07% %63,3344,27154,84771,8225,4132,0921,2559, %3.28%2.04%15.06% %62,6473,73655,22470,0707,6722,3702,96212, %3.78%4.73%19.76% %71,9423,20365,59378,2903,9341, , %2.46%0.60%10.34% %65,3823,59858,24572,5183,7251, , %2.30%1.14%10.25% 2001>300% FPL100,4546,91286,624114,2854,6583,347011, %3.26%0.00%11.17% 2002>300% FPL93,8873,87286,240101,5344,7111,5221,7067, %1.62%1.81%8.22% 2003>300% FPL123,8794,915114,180133,5773,0681, , %1.03%0.44%4.51% 2004>300% FPL114,2794,940104,535124,0235,9171,9442,0839, %1.70%1.82%8.53% 2005>300% FPL116,7084,978106,892126,5243,5341,2181,1325, %1.06%0.93%5.12% Source: The Current Population Survey ( ). Weighted tabulations, University of Hawai`i at Mānoa. Hawai ` i Children Age 0-18 by Medicaid-QUEST & SCHIP Program Eligibility: CPS

13 October 2005Preliminary results. Revised October Subject to further revision. 20 Hawaii Children by Program Eligibility: CPS Year Moving Averages Survey YearEligibilityChildrenStd. Err.95% Conf. Int.UninsuredStd. Err.95% Conf. Int.Percent Std. Err. 95% Conf. Int Medicaid84,3744,32975,85092,89812,7582,4577,92017, %2.76%9.68%20.56% Medicaid85,8253,18679,55892,09111,4631,8387,84715, %2.10%9.23%17.49% Medicaid74,4942,68769,20779,7809,0231,5425,98912, %2.05%8.08%16.14% SCHIP67,8363,30561,32274,3506,9471,8833,23510, %2.69%4.93%15.55% SCHIP69,0452,53264,06174,0305,7611,2393,3228, %1.80%4.80%11.89% SCHIP63,7532,49058,85068,6554,2741,0372,2326, %1.63%3.50%9.91% %62,4922,90056,77668,2075,2111,2052,8377, %1.95%4.49%12.19% %65,9742,17061,70470,2455,6731,2113,2898, %1.82%5.01%12.19% %66,6572,03162,66170,6525,1101,1122,9227, %1.66%4.40%10.93% >300% FPL106,0733,97198,267113,8794,1461,2961,5986, %1.20%1.54%6.27% >300% FPL110,6812,682105,412115,9514, ,7496, %0.84%2.48%5.77% >300% FPL118,2892,882112,629123,9484, ,4575, %0.74%2.07%4.99% Source: The Current Population Survey ( ). Weighted tabulations, University of Hawai`i at Mānoa. Hawai ` i Children Age 0-18 by Medicaid-QUEST & SCHIP Program Eligibility: CPS Year Moving Averages

13 October 2005Preliminary results. Revised October Subject to further revision. 21 Uninsured Children Age 0-18 by Income Eligibility with 95% Confidence Intervals: CPS , 3-Year Average NOTE: Based on CPS Verification Question

13 October 2005Preliminary results. Revised October Subject to further revision. 22 Percent Uninsured Children Age 0-18 by Income Eligibility with 95% Confidence Intervals: CPS , 3-Year Average NOTE: Based on CPS Verification Question

13 October 2005Preliminary results. Revised October Subject to further revision. 23 Uninsured Hawai ` i Children Age 0-18 by Income Eligibility Before and After July Expansion. Survey Year Medicaid QUEST Income Eligible SCHIP Income Eligible % FPL 301%+ FPL Total HHS ,9623,7682,8442,34713,920 HHS ,2884,0511,5771,71210,568

13 October 2005Preliminary results. Revised October Subject to further revision. 24 Mahalo! This research is funded in part by U.S. Department of Health and Human Services Health Resources & Services Administration State Planning Grant Hawaii State Department of Health.