Healthcare Coverage for Children: Are We Making Progress?

Abstract

Residents| April 01 2005 Healthcare Coverage for Children: Are We Making Progress? AAP Grand Rounds (2005) 13 (4): 46. https://doi.org/10.1542/gr.13-4-46 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Healthcare Coverage for Children: Are We Making Progress?. AAP Grand Rounds April 2005; 13 (4): 46. https://doi.org/10.1542/gr.13-4-46 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: children's health insurance program (chip), healthcare payer, immunization, income, insurance, insurance coverage, medicaid, medical home, medical insurance coverage, poverty Source: Blewett L, Davern M, Rodin H. Covering kids: variation in health insurance coverage trends by state, 1996–2002. Health Affairs. 2004;23:170–180. To better understand the impact of state efforts to increase enrollment of children in public programs, investigators from the University of Minnesota, Minneapolis, estimated state-specific changes in health insurance coverage rates for children between 1996–1998 and 2001–2002. The analysis was performed using data from the Current Population Survey Demographic Supplement (CPS-DS), a survey conducted annually by the United States Census Bureau. Differences in rates of insured children and types of insurance were compared between the 2 time periods. Using a multinomial logistic regression model, and subsequent recycled probabilities methodology, investigators looked at specific family and child characteristics associated with change in health insurance coverage. Between 1996–1998 and 2001–2002 there was a decrease in the percentage of uninsured children in 27 states, and an increase in the number of children enrolled in public insurance in 29 states (P<.05 to <.001). Nationally, there was a significant increase in the number of children with public health insurance. There was no significant change in children receiving private coverage. It was estimated that 12.7% of US children were uninsured in the period 2001–2002; using adjusted analyses, this was not significantly different from the rate in 1996–1998. Analyses showed that children living in homes with incomes below 200 percent of poverty had the largest increase in public program coverage (P<.05). A decrease in the percentage of uninsured children was seen with incomes below 100 percent of poverty (P<.01), but not for incomes of 100–199% of poverty. Dr. Hargunani has disclosed no financial relationships relevant to this commentary. Over the past 10 years, major efforts have been made to decrease the numbers of uninsured children in the US. However, many states have been faced with funding cuts and SCHIP enrollment freezes leading to increased premiums and/or enrollment caps. Insurance coverage is directly correlated with improved access to healthcare, improved immunization rates, and decreased ED utilization.1–,4 While this article gives us hope that public program coverage is on the rise and uninsured rates are decreasing in some states, the results do not provide insights into which specific efforts or challenges have affected these rates. In addition, these data do not help us to predict future insurance coverage rates given the current fiscal environment. As practicing pediatricians, we need to advocate for improved insurance coverage and support legislative efforts to ensure steady improvements in children’s healthcare. While these trends are encouraging, until such time as Medicaid reimbursement is comparable to that of other payers, Medicaid coverage will not assure access to a medical home for all children. You do not currently have access to this content.