A Presentation of the Colorado Health Institute 303 E. 17 th Avenue, Suite 930 Denver, Colorado (Twitter) Child health and coverage in 2010 and beyond: Racial, ethnic and other demographic considerations Colorado children eligible but not enrolled (EBNE) in Medicaid and CHP+ and their parents September 15, 2010 All Kids Covered Culture and Coverage Forum Thornton, CO

About the data… 2

New CHI issue brief 3 Colorado Children’s Health Insurance Status: 2010 update Data Source: CHI analysis of the U.S. Census Bureau’s 2008 American Community Survey (ACS) Available for download on CHI’s website:

A few notes about CHI’s analysis… Estimates are a snapshot of Medicaid and Child Health Plan Plus (CHP+) eligibility in 2008 based on: – Age – Insurance status – Documentation and citizenship status – Income and poverty Estimates assume a fully mature program and do not account for population growth 4

What about CHI’s prior estimates of EBNE children? In 2009, CHI released EBNE estimates based on Current Population Survey (CPS) data In 2010, CHI released EBNE estimates based on 2008 American Community Survey (ACS) data Estimates are not comparable because data sources are different—different sampling and questions Because of differences, 2010 ACS estimates should NOT be interpreted as an increase over 2009 CPS estimates 5

Estimates of EBNE children: Medicaid and CHP+ 6

Colorado children’s health insurance coverage, 2008 The majority of Colorado children were privately insured at the time of the survey Approximately 14% of children ages 0-18 yrs were uninsured at the time of the survey 7 UninsuredPrivately insured All other insurance Total 176,360861,166213,4711,250,997 Colorado children ages 0-18 by insurance status, 2008 Source: CHI analysis of the 2008 American Community Survey. All estimates based on insurance status at the time of the survey.

Estimates of EBNE children in Colorado’s Medicaid and CHP+ programs, 2008 EstimateMargin of error (+/-) EBNE in Medicaid60,83911,475 EBNE in CHP+54,3269,240 Total EBNE children115,165 8 Source: CHI analysis of the 2008 American Community Survey

Medicaid caseloads at historic high level 9 SOURCE: Colorado Department of Health Care Policy and Financing, FY Budget Request, Nov. 2009

Projected CHP+ expansion in Colorado On May 1, 2010, the Colorado Healthcare Affordability Act (HB ) raised eligibility for CHP+ from 205% of the Federal Poverty Level (FPL) to 250% of FPL* CHI estimates that 11,953 additional children will become eligible for CHP+ under this expansion based on 2008 ACS data 10 *In 2009, the FPL for a family of four was $22,050.

Demographic characteristics of EBNE children 11

EBNE children by age group, 2008 Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS) 12

EBNE children by racial/ethnic group, 2008 Notes: NH = Non-Hispanic * Because of small sample sizes, this category includes people who identified as NH African-American, NH American Indian, NH- Asian, NH-Hawaiian/Pacific Islander and NH Multiracial 13 Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

Pre-HB EBNE children by federal poverty level (FPL), Note: In 2008, 100% of FPL was $21,200 in annual income for a family of 4. Total number of EBNE children = 115,165 Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

EBNE children by English language proficiency, Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

Demographic characteristics of parents of EBNE children 16

Parents of EBNE children by insurance status, Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

Parents of EBNE children by English language proficiency, Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

Parents of EBNE children by employment status, Full Time = Worked 35 hours or more per week Part Time = Worked fewer than 35 hours per week Full Year =Worked weeks in previous calendar year Part Year = Worked fewer than 50 weeks in previous calendar year (includes paid sick leave and vacation) Non-worker =Unemployed (but looking for work) or not in the labor force Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

Industrial classification of employed parents of EBNE children, Includes only parents of EBNE children (Medicaid or CHP+) prior to implementation of HB (90,610 parents) SOURCE: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

Parents of EBNE children by citizenship/ documentation status, Source: CHI analysis of U.S. Census Bureau’s 2008 American Community Survey (ACS)

Questions? Jeff Bontrager, Program Manager Center for the Study of the Safety Net 22