The late 1990s saw significant changes in insurance coverage and the health care delivery system for low-income children including expansions in coverage through the State Children’s Health Insurance Program (SCHIP), passage of federal welfare reform which had the unintended consequence of decreasing Medicaid participation, increased use of waivers by states to move large portions of the Medicaid population into managed care, and increased strain on the safety net. This paper uses new data from the 1997 and 1999 National Survey of America’s Families, a nationally representative survey of households which over-samples the low income population, to analyze how access and use among low income children with public, private and no insurance have changed between 1997 and 1999.
With the exception of confidence in ability to obtain needed care which was increasing, overall, access and use levels changed little for low-income children between 1997 and 1999. However, this varied by insurance coverage. Results show that health care use is deteriorating among low-income uninsured children: these children were less likely to have seen a physician or other health professional, to have received a well-child visit, and to have seen a dental provider in 1999 than in 1997. Few changes in access and use occurred for low-income children with private or public coverage.
Despite expansions in coverage under SCHIP, access to and use of health services did not improve for low-income children and these children continue to lag behind their higher-income counterparts. Moreover,the gaps in use between insured and uninsured low-income children are widening.
Learning Objectives: Recognize the importance of tracking changes in access and use among low -income children with different insurance status
Keywords: Access and Services, Child Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.