Parents' perception of their children's health insurance: The plight of the underinsured, 2009-2011

BACKGROUND: While uninsured children have received a lot of media attention, much less attention has been directed to the plight of underinsured children and their families OBJECTIVE: To describe childhood underinsurance from 2009-2011 among a group of children seen at their pediatricians' offices METHOD: Cross sectional study of children with health insurance seen during summer/fall months 2009 (N=1980), 2010 (N=1120) and 2011 (N=1069) at practices within the Southwestern Ohio Ambulatory Research Network. One half the sample size from 2009 was selected from each practice in 2010 and 2011. Parents were asked to complete the Children's Medical Care Survey. A child was “underinsured” if his/her parent responded “yes” to at least one of six questions regarding their inability to follow pediatrician's recommendations due to inability to pay the co-pay or deductible in the past 12 months. RESULTS: 86% of respondents were mothers, 76% were white, 68% were married and 54% reported annual household income of at least $35,000; 57% of study children were at least 5 years old and 18% were underinsured (range 19%-2009 to 16%-2011, p=0.053). In addition, for each study year, 17% of respondents agreed that, compared to three years ago, it was harder to get needed heath care for their child. CONCLUSION: Between 2009 and 2011 about one in six parents reported that, despite their child's health insurance, they were unable to follow at least one of their pediatrician's recommendations due to inability to pay. This is a critically important issue as this nation implements health care reform.