Cutler Institute for Health and Social Policy

Health Insurance Coverage of Low-Income Rural Children Increases and is More Continuous Following CHIP Implementation


Prior to the passage of CHIP, about one in four low-income rural and urban children (family income below 200% of the federal poverty level) were uninsured in a given month. Using data from the Medical Expenditure Panel Survey (MEPS), this study found that in the years following CHIP’s implementation health insurance coverage and continuity increased among low-income children—particularly for those living in rural areas. By CHIP’s maturity, coverage for rural children improved so much that their uninsured rate dropped below that of urban children (14% compared to 20%, respectively). Among those with health insurance, rural children were more likely than their urban counterparts to lose coverage pre-CHIP, and were less likely to lose it after CHIP was in place for five or more years. Whether low-income rural adults will see similar gains in coverage continuity under the Affordable Care Act may depend on whether states choose to participate in Medicaid expansions, and what outreach strategies they use to enroll rural populations.

Suggested Citation: Ziller EC. Health Insurance Coverage of Low-Income Rural Children Increases and Is More Continuous Following CHIP Implementation. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; 2013. Policy Brief PB-53.

Publication Type: 
Research and Policy Brief
Publish Date: 
March 31, 2014