Man with kids The largest driverof the recent overall increase in use of Medicaid and CHIP has beendue to larger numbers of workers at larger employers coming intothe programs. (Photo: Shutterstock)

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It's not just small employers that have workers relying onpublic insurance for their children: many people working at largeprivate companies also insure their families through eitherMedicaid or the Children's Health Insurance Program (CHIP),according to a study by researchers at PolicyLab at Children'sHospital of Philadelphia.

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The study, published in Health Affairs, did not determinewhy parents at such companies cover their kids under publicinsurance. It could be that the premiums on the employer's plansfor family coverage became too expensive, or there were changes in theparent's own health care coverage, the authors speculate.

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Related: Florida college suggests professors enroll childrenin Medicaid

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Still, the study's results “may signal dependent coverage isbecoming unaffordable for working families across all sectors —even those we think of as having good benefits — creating greaterurgency for policymakers to protect Medicaid and CHIP as a safetynet,” says lead author Doug Strane, a PolicyLab researcher.

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Most of the children covered under public insurance had parentsworking for small businesses, with the overall percentage climbingfrom 53 percent in 2008 to 79 percent in 2016. However, the largestdriver of the overall increase in use of Medicaid and CHIP was dueto larger numbers of workers at larger employers coming into theprograms.

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Indeed, of the 8.6 million children in working families who arecovered by public insurance, more than 70 percent have a parent whoworks at a large, private company.

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But the biggest single increase of all occurred inmoderate-income families earning up to $72,750 a year (for a familyof four), in which a parent worked for a small business. Two thirds(64 percent of children) in these families were covered by Medicaidor CHIP in 2016, compared to 21 percent in 2008.

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“The landscape of children's health insurance coverage amongworking families is dramatically shifting, and at a much fasterpace than any substantive policy conversations about whathigh-quality, accessible coverage looks like for all children inthe future,” says senior author David Rubin, director of PolicyLaband a pediatrician at CHOP.

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“At the very least, we should be protecting Medicaid and CHIP asa safety net for families, while also considering other ways toensure that dependent coverage remains affordable and provides arobust set of benefits to keep children in working familieshealthy,” Rubin says.

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The data for this study comes from the Medical ExpendituresPanel Survey (MEPS), a nationally representative household panelsurvey. The other authors on the paper were Meredith Matone,Ahaviah Glaser and Genevieve Kanter. Kanter is from the PerelmanSchool of Medicine at the University of Pennsylvania.

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Katie Kuehner-Hebert

Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.