Discrepancies in Health Care Funding for Individuals with Special Needs

Abstract

Approximately 47 million Americans ‐ 16% of the total US population ‐ lack health insurance [10]. An additional 25 million have insurance plans that limit their access to services, or cover only a small percentage of expenses ‐ they, in fact, are underinsured. In 1997, the original State Children’s Health Insurance Program (SCHIP) established coverage for children who did not qualify for Medicaid but whose families could not afford private insurance. This legislation reduced the rate of uninsured low-income children by almost one third, from 23% (7.6 million children) to 14% (5.6 million children) and improved health care quality. The prevalence of uninsured children in 2007 ranged from 4.1% to 21.2% across various states [7]. In 2009, 7 million children were enrolled in SCHIP and 29 million children were enrolled in Medicaid. CHIP’s (Children’s Health Insurance Program) reauthorization in 2009 liberalized the means test criteria (> 300% of the federal poverty level) of the initial legislation, extended coverage to more recent immigrants (less than 5 years) and authorized the states to cover an increased number of services, including dental and mental health care. Children under the age of 18 years comprise 26% of the US population, yet they are responsible for only 10% of total healthcare expenditures and consume only 9% of public funds for healthcare [10]. However, the 14% of children and youth in the United States with special health care needs account for 42% of the medi