Differential Health Insurance Coverage within Families:
Evidence from the National Health Interview Survey.
By Diane S. Shinberg, Ph.D.
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This research addresses health insurance in the United States from a family perspective
(IOM 2002). Private and public health insurances are typically accessed through a person’s
individual status (e.g., employment, age), although familial ties (e.g., marriage, parenthood) can
contribute to being insured. Thus, a family may experience differentials in coverage among its
members; some family members may have comprehensive health insurance, while their
immediate kin may have none. Role transitions can alter insurance access for the individual and
for kin. Retirement may necessitate a change from private health insurance to Medicare for the
retiree and from private sources to un-insurance for a spouse. Other families may experience
differential coverage through age and income-tested public insurance extended to children, but
not to parents. Finally, as premiums rise for employers and workers, fewer employers offer
family insurance while fewer employees can afford family coverage.
Health insurance coverage patterns within families are explored using the 2003-5
National Health Interview Survey (NHIS), which annually collects extensive information on plan
types, coverage lapses and premiums for family members in a nationally representative sample
of the civilian, community-dwelling U.S. population. The health insurance status of families
(with 2+ members), based on whether individual co-resident family members have
comprehensive health insurance is characterized in two ways: (1) in the terms of complexity of
current coverage and (2) in terms of the stability of family coverage or time. Complexity of
current coverage is categorized as: uniformly insured (all family members are insured with the
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Assistant Professor of Sociology, University of Memphis, 231 Clement Hall, Memphis, TN 38152-3530 USA.
email: ## email not listed ##
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