Date of Award


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)

School Name

Annsley Frazier Thornton School of Education



Major Advisor

Dr. Grant Smith

Second Advisor

Dr. Mary Ann Cahill

Third Advisor

Dr. David Paige


Abstract of the Dissertation

This study examines the impact of parents having health insurance on their children’s health care in Kentucky. Child health insurance status and child a usual source of medical care are the two health care measures analyzed. The author builds on prior research that indicated more children would become insured if parents had access to affordable health insurance options. Through the implementation of the ACA in 2014, Kentucky expanded Medicaid eligibility to low-income adults up to 138% of the federal poverty level (FPL) and offered discounts on private health insurance plans for families in certain income thresholds (Goodnough, 2015). The researcher analyzed data obtained from a web-survey completed by a random sample of Kentucky parents about one child ages 0 to 17 living in their household. Overall, 97.5% of children and 92.9% of parents were insured. Parent health insurance status was the best predictor of child health insurance status; children with uninsured parents were 31.76 times more likely to be uninsured than children with insured parents, after controlling for other factors, 95% CI, [12.77, 78.99], n = 1,179. Children with uninsured parents were no more likely to lack a usual source of medical care than children with insured parents in adjusted models. This study shows that providing affordable health insurance options to parents and children leads to most obtaining health insurance coverage. Furthermore, when affordable health insurance options are expanded for parents, additional children are likely to obtain health insurance coverage, even if children’s health insurance options do not change. This study implies that parent health insurance status becomes less important for children’s access to health care when most children and parents have health insurance. As changes to the health care system are discussed in Kentucky and at the federal level, policymakers should analyze how children could be impacted by potential changes, especially if those changes affect their parents.