Has public health care benefits helped to level the playing field for children with special health care needs as they transition into adulthood?

Children with special health care needs (CSHCN) from families with lower socioeconomic status rely on federal public service programs to support their healthy and educational development. Recently, several state governors have advocated that Medicaid, the state-federal health program that covers 50 million poor and disabled, be transformed into block grants in an attempt to reduce federal spending. The block grant could potentially cap the level of federal support and reduce the number of beneficiaries for this program. Using the 2007 Survey of Adult Transition and Health (SATH), this cross-sectional study compares the transition outcomes between children with special health care needs who received Medicaid (N= 210) versus other types of health insurance coverage (N=1649). The multivariate logistic regression analysis results indicated that CSHCN with Medicaid are 1) more likely to get help arranging or coordination care (AOR=1.47, 95% CI= 1.09, 1.98), 2) need extra help arranging care in the past 12 months (AOR=1.96, 95% CI= 1.33, 2.87), 3) have doctors help in connecting with youth/adult mentors (AOR=1.16, 95% CI= 1.06, 2.01), and 4) participate in transition plan development (AOR=1.86, 95% CI= 1.13, 3.07). Changes to Medicaid could lead to setbacks in the advance achieved over the decades and significantly impact in access to health care and successful transition to adulthood for CSHCN in health, work, and independent living.