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APHA Scientific Session and Event Listing

Insurance coverage for children with special health care needs (CSHCN) in Connecticut: A public policy proposal

Nadine Kronfli, BSc, McGill1, Josh Pashman, BS, AB, Michigan2, Sara Shamos, BA, Stanford1, and Katherine J. Johnson, AB, Bryn Mawr1. (1) School of Epidemiology and Public Health, Yale University, 60 College Street, New Haven, CT 06510, 810.429.6934, katherine.j.johnson@yale.edu, (2) School of Epidemiology and Public Health, School of Management, Yale University, 60 College Street, New Haven, CT 06510

Background: Connecticut's limited access to supplemental health insurance places children with special health care needs (CSHCN) at a high risk of institutionalization. It is well-documented that institutionalization has serious negative effects on the health and development of children. A 2001 National Survey of CSHCN found that 33.4% of those currently insured in Connecticut have inadequate coverage. Furthermore, 11.7% have significant unmet health care service needs, and 17.6% of families with CSHCN have financial problems as a result of their child's condition. Currently, the families of CSHCN who are underinsured and over-income for Medicaid eligibility have only three resource options: (1) a “spend down” on out-of-pocket medical costs to qualify for Medicaid; (2) a Katie Beckett Waiver to access Medicaid, which currently has a three-year waiting list, and (3) a costly and limited “conversion” insurance through the state Re-insurance program. To increase access to care for Connecticut's CSHCN, policymakers must identify and develop flexible avenues to supplement inadequate coverage of health care costs.

Methods: (1) Assess public health insurance programs for CSHCN offered by Connecticut, other states, or the federal government; (2) Develop comprehensive recommendations to increase access to health insurance for CSHCN in Connecticut, and (3) Conduct an informational public hearing to inform the Connecticut General Assembly.

Outcome: This study will provide policy recommendations to the Governor and the General Assembly for increasing access to health insurance or supplements to insurance to cover the complex health care of CSHCN in Connecticut.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

Keywords: Children With Special Needs, Medicaid

Presenting author's disclosure statement:

Not Answered

Issues Related to Managed Care, Medicaid and Medications for the Uninsured

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA