Statewide Results
Below is a summary of the results of the Iowa Child and Family Household Health Survey specifically relating to insurance coverage. For those wishing more detail, tables presenting a comparison of the results for many questions for children with private insurance, those enrolled in Medicaid and uninsured children are available in the back of this report.
Demographics of children and families in Iowa

According to the 2000 US Census, there are 737,212 children under the age of 18 living in Iowa (25% of Iowa’s population). This is similar to national statistics indicating that 25.7% of children in the United States are under age 18. The Census data also indicates there are 361,153 families with children under age 18 in Iowa.

Results from the 2000 Iowa Child and Family Household Health Survey indicate that children in Iowa live in family households with an average of 4.5 people (2.1 adults and 2.4 children). Most families had either two (35%) or three (34%) children in the household. One quarter of the children were living in a household with three or more adults. The racial distribution of the children was 90% white, 3% African-American, just over 1% Native American and Asian, and 5% “other.” Three percent of Iowa’s children were considered to be of more than one race. Three percent were of Spanish or Hispanic origin. Four out of ten children were living in families with household incomes over $50,000 per year while about one-third (32%) were in families with household incomes below $25,000 per year.


Health insurance coverage

About 6% of Iowa children (46,000) were uninsured at the time of the call and another 6% (43,000) were uninsured at some point in the previous year. The percentage of uninsured children from this study matches the findings for a three-year Iowa average from the US Census Bureau's Current Population Survey (1999-2001), which also found that 6% of Iowa children were uninsured.6 Iowa's rate was half the national average for children (12%) and fifth lowest among all states.

Eighty percent of uninsured children in Iowa were eligible for either Medicaid (56%) or the State Child Health Insurance Program-SCHIP (21%) (SCHIP is called hawk-i in Iowa) based on the household income estimate provided during the interview (program eligibility is more complex so this is considered a rough estimate) (Figure 1). Medicaid eligibility for children in Iowa is up to 133% of the federal poverty level (FPL) and between 133% and 200% of FPL for hawk-i.

Figure 1. Percent of Federal Poverty Level and potential
program eligibility for uninsured children in Iowa


The majority of Iowa children (83%) had their primary health insurance coverage through private insurance; 92% of those with insurance had purchased if through an employer. The other 8% had their insurance purchased as an individual policy. About 10% of these children had public insurance through the Medicaid program as their primary insurance and <1% had some other insurance (e.g., hawk-i, CHAMPUS) for their primary coverage.

Over half (56%) of the uninsured children had been covered by Medicaid at some time in their lives. About one in six children (17%) who currently had private health insurance had been enrolled in Medicaid at some point as well. Twenty-two percent of all children covered by Medicaid had been uninsured at some point during the past year.

About 10% of the children had a parent who was uninsured at the time of the call (it was primarily mothers who completed the interview). As might be expected, there was a relationship between the insurance coverage of children and their parents. Eighty-eight percent of children had parents with the same insurance. One quarter of uninsured children had parents with insurance coverage. Also, the parents of almost one-third of children in Medicaid were uninsured. Three percent of children with private insurance had parents who were uninsured.

Rating insurance coverage

Public insurance coverage through the Medicaid program was rated higher than private health insurance for Iowa children (Figure 2).

Figure 2. Rating of health insurance coverage

Medicaid coverage was rated as excellent for 44% of children compared to 30% of those with private insurance. One in ten (10%) rated both types of insurance fair or poor.