Factors associated with Florida children not having continuous health insurance coverage

Current policy highlights children without health insurance. Previous research studies have documented outcomes of discontinuous health insurance coverage nationally, signifying a need to study coverage gaps on a state level. The National Survey of Children's Health (NSCH) provides a representative sample on national and state levels to determine if certain children in Florida (n=2116) were more likely than others to not have continuous health insurance coverage over a 12-month period. The dependent variable was a reported gap in continuous health insurance coverage the last 12 months, excluding children without health insurance. Using the Aday and Andersen Access to Medical Care model, the risk of not having continuous coverage was examined in relation to predisposing, enabling, and need factors. 14% of Florida children (0-17 years) did not have continuous health insurance coverage in the last 12 months, compared to 10.78% nationally. Initial analysis suggests children at risk are from households below the poverty level (OR [95% CI]=2.54 [1.15-5.61]), poverty 100-199% (OR [95% CI]=4.44 [2.38-8.30]), poverty 200-399% (OR [95% CI]=2.21 [1.21-4.02]), poverty level unknown (OR [95% CI]=3.91 [1.83-8.34]), and parents without health insurance (OR [95% CI]=3.67 [2.43-5.55]). Parents' employment, single parent, child's age, gender, race/ethnicity, chronic condition/special health care need, and medical home were not associated with gaps in coverage. Comprehensive, continuous health insurance is needed to assure access to health care, especially among the working poor. The NSCH can be used by states to compare coverage with other states, regions, and the nation to develop evidence-based health policy.