Health Insurance Regain after a Spell of Uninsurance: A Longitudinal Comparison of Youth with and without Disabilities Transitioning into Adulthood
Received 13 November 2008; accepted 31 March 2009. published online 29 June 2009.
Abstract
Purpose
To examine insurance regain among youth with no, nonsevere, and severe disabilities.
Methods
The data source for this study was the Survey of Income and Program Participation 2001. We examined insurance regain among youth with no, nonsevere, and severe disabilities between the ages of 15 and 25 using a longitudinal design. Kaplan-Meier survival functions provided estimates of uninsurance spell durations measured in waves, or 4-month intervals. We conducted a discrete time survival analysis adjusting for personal characteristics.
Results
This study includes 1,310 youth who entered the SIPP with insurance and became uninsured. 985 youth (75%) regained insurance. Based on SIPP waves, median duration of uninsurance was two waves (between 5 and 8 months) for youth with severe disabilities and three waves (between 9 and 12 months) for youth with nonsevere disability. Youth with nonsevere disabilities had decreased odds of regaining health insurance compared to youth without disabilities (odds ratio .73; 95% confidence interval: .57, .92; p=.01).
Conclusions
Youth with severe disabilities and youth without disabilities had similar odds of and durations to insurance regain. In contrast, youth with nonsevere disabilities had lower odds of regaining insurance and experienced longer durations of uninsurance compared to peers without disabilities. We recommend additional research into the implications of Medicaid eligibility pathways and employment barriers for youth with nonsevere disabilities.
aInstitute for Public Health Genetics, School of Public Health, University of Washington, Seattle, Washington
bDepartment of Health Services, School of Public Health, University of Washington, Seattle, Washington
Address correspondence to: Grace Wang, M.P.H., Institute for Public Health Genetics, School of Public Health, University of Washington, Box 357236, Seattle, WA 98195-7236.
ABSTRACT