183635 Impact of Enrolling in Health Insurance on Low-Income Children with Medical Needs

Wednesday, October 29, 2008: 9:15 AM

Patricia Barreto, MD MPH , University of California at Los Angeles, Los Angeles, CA
Moira Inkelas, PhD , University of California at Los Angeles, Los Angeles, CA
Embry M. Howell, MSPH, PhD , Health Policy Center, The Urban Institute, Washington, DC
Louise C. Palmer, MA , KDH Research & Communication, KDH Research & Communication, Atlanta, GA
Ian T. Hill, MPA, MSW , Health Policy Center, The Urban Institute, Washington, DC
Research Objective:

To compare access and experiences with care for low-income children enrolling in a health insurance expansion with and without a current perceived medical need.

Study Design:

The Healthy Kids program provides health insurance for low-income children living in Los Angeles County that do not qualify for Medicaid or SCHIP. Data are from 491 parent surveys conducted with a sample of children ages 12–72 months one year after enrollment. A 91% response rate was obtained. Parents reported on access and care received in the 6 months prior to the interview.

Population Studied

Low-income children (< 300% FPL) in Los Angeles County ineligible for Medicaid or SCHIP and enrolled in new health insurance program.

Principal Findings

One-third (37%) of parents reported having enrolled their child because he/she had a particular medical need. There were no differences between those enrolling with or without a perceived medical need in having a usual source of care; using preventive care, using dental care, having an emergency department visit, having a specialty visit; or having unmet need for pharmaceuticals. More children entering with a medical need had unmet need for preventive (15% vs.10% p=0.05) and specialist care (9% vs. 5%, p=0.02).

Conclusions

The majority of enrollees' medical and pharmaceutical needs are being met, although more children who were enrolled for a medical reason had unmet preventive and specialist care needs.

Implications for Policy, Delivery or Practice

Health insurance expansions are associated with high levels of access to care. However, children with health needs may experience access barriers not addressed by health insurance, particularly in preventive and specialty care.

Learning Objectives:
1. Describe access to health care services for children enrolled in a subsidized health insurance program with and without a current perceived medical need 2.Recognize the advantages and limitations of enrolling in a health insurance program for low-income children that do not qualify for Medicaid or SCHIP 3.Discuss potential barriers to access to health care services for newly insured children with medical needs

Keywords: Access to Care, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Researcher
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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