Short coverage lapses limit children's access to health care services

Children's access to health care suffers when they spend any time-even a few months-without health care coverage, according to a new study appearing in the February 2009 issue of Medical Care Research and Review.

For children who are uninsured for as few as four months, there is a 2.8 percentage point decrease in the likelihood of having a health care visit, according to the study, Partial-Year Insurance Coverage and the Health Care Utilization of Children.

"This study is motivated by the fact that 10 million children spend part of the year without coverage and 8 million children spend the entire year without coverage. Children's loss of access to coverage-even for a short period-jeopardizes having a usual source of care," said Lindsey J. Leininger, Ph.D., a Robert Wood Johnson Foundation Health & Society Scholar at the University of Wisconsin and author of the report.

Improving enrollment retention in the State Children's Health Insurance Program (SCHIP) and Medicaid and in private health care coverage is needed to ensure that children maintain access to the health care that they need, the study suggests. Eliminating mandatory waiting periods for SCHIP enrollees is another necessary step to keep eligible children enrolled in the program. Reducing the administrative burden associated with re-enrolling in SCHIP and Medicaid will increase continuity of care for children enrolled in these programs.

"Short gaps without coverage can be detrimental to children's access to health care," Leininger said. "Even imposing two-or three-month waiting periods, as some SCHIP plans may be required to do due to funding shortfalls, leave children vulnerable to not receiving needed health care."

The study also finds:

  • More than half (57 percent) of low-income children with partial-year coverage were covered by private insurance for at least one month in the past year. Subsidizing COBRA premiums is a way to help low-income families retain private coverage when they change jobs, the study recommends.
  • Children who are uninsured for part or all of the year accessed well-child services at levels considerably below those recommended by the American Academy of Pediatrics.

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