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New York City's Children: Uninsured and at Risk


New York City’s children are much more likely to be uninsured than children living in other areas. According to a new report by Fund staff Cathy Schoen and Catherine DesRoches, New York City’s Children: Uninsured and at Risk, one of six children living in New York City is uninsured—a rate significantly higher than both the nation’s and New York State’s. The erosion of private coverage for the city’s children has been especially severe: less than half are covered by private insurance, compared with two-thirds of children nationally.

Analysis of The Commonwealth Fund Survey of Health Care in New York City, conducted by Louis Harris and Associates, Inc., from October 1996 through March 1997, found that children living in low-wage, working families are particularly at risk. Nearly three of four (72 percent) of the city’s uninsured children are from working families, almost all of whom live on low wages. Two-thirds of these children are from two-parent families.

Uninsured children often go without health care or find it difficult to get care, despite New York City’s abundance of medical care resources. Nearly one-third (29 percent) of uninsured children had not seen a doctor in the past year, compared with 11 percent of insured children. Overall, the city’s uninsured children are nearly three times as likely as insured children to have problems gaining access to health care.

When uninsured children do receive health care, their families are often left struggling to pay medical bills: nearly one-third of uninsured children live in families who experienced this problem in the past year.

Moreover, uninsured children’s care experiences tend to be less positive than those with insurance: only 37 percent of uninsured children’s doctors received excellent ratings, compared with more than half (55 percent) of insured children’s doctors.

Schoen and DesRoches conclude that given the high cost of health insurance in New York City, the expansion of publicly subsidized coverage for children of low-income families is particularly timely.
The authors note, however, that current expansion proposals leave parents on their own. With child health clearly linked to family health and economic security, many of New York City’s children will remain at risk.

Facts and Figures

  • Seventeen percent of New York City’s children are uninsured, compared with 12 percent in New York State and 14 percent nationally.

  • Nine of 10 uninsured children live in families whose incomes are either below poverty or between poverty and 250 percent of poverty (about $32,000 for a family of three).

  • Forty percent of uninsured children do not have a regular source of care, in contrast to just 10 percent of insured children.

  • Without public subsidies or employer-provided health plans, families with incomes near poverty levels would have to pay a prohibitive 41 percent of their income for family coverage.

Publication Details



New York City's Children: Uninsured and at Risk, Cathy Schoen and Catherine DesRoches, The Commonwealth Fund, May 1998