Trends in Private Insurance, Medicaid/State Children's Health Insurance Program, and the Healthcare Safety Net: Implications for Vulnerable Populations and Health Disparities

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This chapter examines trends in private and public health coverage, as well as implications for vulnerable populations and health disparities. We find that there has been erosion in employment-based health benefits. Both the percentage of employers offering coverage and the percentage of workers with coverage declined in recent years. Those with coverage face eroding benefits and increased cost sharing. Within the public sector, Medicaid enrollment has decreased, with benefits increasingly restricted. Although State Children's Health Insurance Program (SCHIP) enrollment has increased among low-income children, the future of SCHIP remains uncertain. Meeting the healthcare needs of Americans and reducing health disparities requires both the provision of health coverage to all and sufficient comprehensiveness of benefits within private and public programs to meet enrollees' healthcare needs. Our findings suggest that we have a long way to go in reaching these goals.

Keywords: Medicaid; SCHIP; disparities; health policy; safety net providers; uninsured

Document Type: Research Article


Affiliations: 1: Georgetown Public Policy Institute, Georgetown University, Washington, DC, USA 2: Employee Benefit Research Institute, Washington, DC, USA

Publication date: June 1, 2008

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