Study Stresses on Health Coverage Options for Children Across Different Income Levels

A new study published in JAMA Pediatrics stressed the importance of providing a variety of health coverage options for children under the Affordable Care Act. This is an increasingly significant need considering the ambiguity regarding the reauthorization of the Children’s Health Insurance Program (CHIP) beyond 2017.

The authors of the study compared some key factors across children from different households. The bases of comparison were accessibility to healthcare, the quality of healthcare and the cost associated with the insurance across 4 insurance coverage types, namely Medicaid, CHIP, private insurance, and no insurance. The authors compared these variables across children from households with low to moderate income.

The analysis included 80,655 children, all under the age of 17 years. The study used data from the 2003, 2007, and 2011-2012 US National Surveys of Children’s Health and conducted a repeated cross-sectional analysis. The household income of these children was an important factor. The incomes were between 100% and 300% of the federal poverty level (FPL). The study period was between July 2014 and May 2015.

The researchers found that out of the total study population, 57.3% children had private insurance, 18.4% had CHIP, 13.6% had Medicaid, and 10.8% did not have insurance. Additionally, children who had Medicaid and CHIP had a higher probability of receiving preventive medical and dental care compared with children who had private insurance.

On a more general level, children with any kind of insurance faced difficulties in access to specialty care. One in 4 children face this problem in access to specialty care. Caregivers of children insured by CHIP (28%) had the highest difficulty in this category. They experienced challenges in obtaining referrals as well as the actual healthcare services. Caregivers of privately insured children (29%) with special healthcare needs echoed this problem too.

Regarding the healthcare expenses, the differences were far more dramatic. More than 77% of caregivers of privately insured children were more likely to experience out-of-pocket costs compared with only 26% Medicaid-insured and 38% CHIP-insured children were likely to experience out-of-pocket health care expenses.

Caregivers across different insurance types divulged important information regarding out-of-pocket expenses, quality of healthcare, the accessibility to healthcare, and the ease of obtaining referrals. Based on these categories and the differences within them, the study provides a comprehensive basis for framing health policies.

It is essential to understand coverage quality and access to care for children because almost 40% of the children in US live in households with incomes between 100% and 300% of the FPL in 2013. All these findings account for a better reframing of policies regarding coverage for families with low to moderate incomes.