Association Between Changes in Parental Medicaid Vision Coverage and Child Use of Vision Care

Abstract

Many low-income children do not receive regular vision care despite the fact that all state Medicaid programs cover these services. The primary objective of this study was to examine whether children were more likely to have at least one past-year eye doctor visit when their parents gained Medicaid vision benefits. Other indicators of child vision care access (ie, unmet needs for glasses and difficulty seeing) and eye doctor visits among Medicaid-enrolled parents were also assessed. Difference-in-differences regression analysis leveraged within-state changes to Medicaid adult vision benefits. Study samples included 17,345 children with a Medicaid-enrolled parent and 12,219 parents with Medicaid coverage interviewed during the 2000 to 2013 National Health Interview Survey. Providing Medicaid adult vision coverage was associated with a 5.4 percentage point increase (P=.009) in having at least one past-year eye doctor visit among parents and a 2.8 percentage point increase (P=.01) in this measure among children. These estimates represent increases of 22% and 14%, respectively, relative to unadjusted parent and child visit rates over the study period. These effects appeared to be concentrated among older children ages 12 to 17. Estimates for the other measures of child access to vision care were not statistically significant. Providing adult vision benefits was associated with having at least one past-year eye doctor visit among low-income children, and may help to reduce income-based disparities in children's receipt of vision care. This research adds to the limited evidence base on the role of public policy in increasing access to vision services.