Children's Receipt of Health Care Services and Family Health Insurance Patterns

Abstract

PURPOSE Insured children in the United States have better access to health care services; less is known about how parental coverage affects children's access to care. We examined the association between parent-child health insurance coverage patterns and children's access to health care and preventive counseling services. METHODSWe conducted secondary analyses of nationally representative, cross-sectional, pooled 2002-2006 data from children (n = 43,509), aged 2 to 17 years, in households responding to the Medical Expenditure Panel Survey (MEPS). We assessed 9 outcome measures pertaining to children's unmet health care and preventive counseling needs.RESULTS Cross-sectionally, among US children (aged 2 to 17 years) living with at least 1 parent, 73.6% were insured with insured parents, 8.0% were uninsured with uninsured parents, and the remaining 18.4% had discordant family insurance coverage patterns. In multivariable analyses, insured children with uninsured parents had higher odds of an insurance coverage gap (odds ratio [OR] = 2.45; 95% confi dence interval [CI], 2.02-2.97), no usual source of care (OR = 1.31; 95% CI, 1.10-1.56), unmet health care needs (OR = 1.11; 95% CI, 1.01-1.22), and having never received at least 1 preventive counseling service (OR = 1.20; 95% CI, 1.04-1.39) when compared with insured children with insured parents. Insured children with mixed parental insurance coverage had similar vulnerabilities.CONCLUSIONS Uninsured children had the highest rates of unmet needs overall, with fewer differences based on parental insurance status. For insured children, having uninsured parents was associated with higher odds of going without necessary services when compared with having insured parents.

Recent Health Insurance Trends for US Families: Children Gain While Parents Lose

“…Others reported not being able to participate in activities with their children due to sickness and a lack of good health care. Previous studies have shown that insured children with uninsured parents have higher odds of experiencing health insurance coverage gaps and unmet health care needs, as compared to insured children with insured parents [15,[40][41][42][43][44]. One study found that, as compared to parents with continuous coverage, parents with the fewest months of coverage had the highest odds of having uninsured children [45].…”

The Association Between Medicaid Coverage for Children and Parents Persists: 2002–2010

“…Historically, children in the United States were covered by the same health insurance program as their parent(s)-an employer-sponsored plan or a public insurance program [3]. This tradition of a 'family health insurance plan' likely contributed to past reports of a strong association between coverage for children and parents [4][5][6]. More recently, programs target parents and children separately, and fewer families have just one plan covering all family members.…”

Predictors of Children’s Health Insurance Coverage Discontinuity in 1998 Versus 2009: Parental Coverage Continuity Plays a Major Role

“…This is problematic because insurance discontinuities are associated with higher rates of unmet medical and prescription drug needs and a lack of recommended preventive health services similar to the uninsured [12][13][14]: all leading to poorer health [15]. In comparison, having continuous health insurance leads to better access to health care and improved health outcomes [16][17][18].…”

“…Few studies have included parental health insurance continuity as a potential predictor of discontinuous coverage; many of which were conducted in one state only [12,[21][22][23][24]. Further, little is known about whether there have been changes in the predictors associated with discontinuous coverage for children in the first 12 years after implementation of CHIP.…”