Oral

The number of children with any health insurance has been rising again. While estimates vary, it is generally accepted that as many as 9 million children go the full year without health insurance. When children who lose coverage for part of the year are also counted the number of children without adequate health insurance in the U.S. more than doubles. Uninsured children are far less likely to get health care when needed, including regular preventive care, compromising their health status. This session will focus on difficulties that low-income children and families have maintaining public health insurance, which has become much more complicated with new rules included in the 2005 Deficit Reduction Act (DRA). Our first presentation discusses the results of a survey among medically underserved urban and rural families to assess the impact of the new DRA rules to document identity and citizenship on establishing Medicaid eligibility. Our next presentation focuses on the problem of “churning,” the cycle of losing and eventually reestablishing public health insurance. Policy implications will be discussed. The problem of discontinuous health coverage for children with special health care needs, for whom continuity of care is especially important, is discussed next. We close with presentations that describe strategies to improve Medicaid enrollment and retention in California, and the effectiveness of a Florida health plan in delivering basic and preventive health care services.

Session Objectives: At the end of this session, participants will be better able to: Better understand problems in their state dealing with Medicaid enrollment Describe a profile of U.S. children with special health care needs who are at-risk for discontinuous health insurance coverage Define churning and understand negative impacts

CE Credits: CME, Health Education (CHES), Nursing