Medicaid and CHIP Premiums and Access to Care: A Systematic Review

Saloner, Brendan; Hochhalter, Stephanie; Sabik, Lindsay M.

doi:10.1542/peds.2015-2440

Cited by 7 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Patient Protection and Affordable Care Act, enacted in 2010, requires Medicaid coverage for all children up to 133% of the federal poverty line. 23 The 1997 Children's Health Insurance Program was created to subsidize health insurance for children 24 in working families with incomes too high to qualify for Medicaid. In 13 states, the income eligibility threshold for the Children's Health Insurance Program is up to 400% of the federal poverty line.…”

Section: Health Insurance-based Disparitiesmentioning

confidence: 99%

“…23 Health insurance is also used as a measure of health care access, given that the ability to pay for health services or have them covered is a determinant of the care sought and received. 24 In pediatrics, disruptions in health insurance coverage are associated with reduced access to care. 26 Among adult patients with cancer, a review found that those with disruptions were more likely to present at an advanced stage (odds ratio, 1.2-3.8) and have worse survival (HR, 1.28-2.43) compared with patients without insurance disruptions.…”

Section: Health Insurance-based Disparitiesmentioning

confidence: 99%

See 1 more Smart Citation

Disparities in Pediatric Oncology: The 21st Century Opportunity to Improve Outcomes for Children and Adolescents With Cancer

Aristizabal

Winestone

Umaretiya

et al. 2021

American Society of Clinical Oncology Educational Book

View full text Add to dashboard Cite

Adult cancer disparities have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Pediatric cancer survival has improved significantly in the United States for the past 5 decades to over 80%; however, disparate outcomes among children and adolescents with cancer still affect many populations in the United States and globally, including racial and ethnic minorities, populations with low socioeconomic status, and residents of underserved areas. To achieve equitable outcomes for all children and adolescents with cancer, it is imperative that concerted multilevel approaches be carried out to understand and address health disparities and to ensure access to high-quality cancer care. Addressing social determinants of health, such as removing barriers to health care access and ensuring access to social supports, can reduce pediatric cancer disparities. Nevertheless, public health policy, health system interventions, and innovative delivery of evidence-based services are critically needed. Partnerships among patients, caregivers, and health care providers, and among health care, academic, and governmental institutions, have a pivotal role in reducing cancer disparities and improving outcomes in the 21st century.

show abstract

Section: Health Insurance-based Disparitiesmentioning

confidence: 99%

Section: Health Insurance-based Disparitiesmentioning

confidence: 99%

Disparities in Pediatric Oncology: The 21st Century Opportunity to Improve Outcomes for Children and Adolescents With Cancer

Aristizabal

Winestone

Umaretiya

et al. 2021

American Society of Clinical Oncology Educational Book

View full text Add to dashboard Cite

show abstract

“…Brooks et al [20] established that 30 states charge premiums or enrollment fees and 25 charge cost sharing for children in Medicaid or CHIP, although most states make charges only for children on CHIP since the income requirement for CHIP is higher than for Medicaid recipients. Family health care spending increases with premiums but research on relationship to financial hardship is limited [21].…”

Section: Discussionmentioning

confidence: 99%

Cost barriers to asthma care by health insurance type among children with asthma

et al. 2019

View full text Add to dashboard Cite

Introduction-Children with asthma have ongoing health care needs and health insurance is a vital part of their health care access. Health care coverage may be associated with various cost barriers to asthma care. We examined cost barriers to receiving asthma care by health insurance type and coverage continuity among children with asthma using the 2012-2014 Child Asthma Call-back Survey (ACBS).Methods-The study sample included 3,788 children under age 18 years with current asthma who had responses to the ACBS by adult proxy. Associations between cost barriers to asthma care and treatment were analyzed by demographic, health insurance coverage, and urban residence variables using multivariable logistic regression models.Results-Among insured children, more blacks reported a cost barrier to seeing a doctor (10.6% [5.9, 18.3]) compared with whites (2.9% [2.1, 4.0]) (p=0.03). Adjusting for demographic factors (sex, age, and race), uninsured and having partial year coverage were associated with cost barrier to seeing a doctor (adjusted prevalence ratio aPR=8. 07 [4.78, 13.61] and aPR=6.58 [3.78, 11.45], respectively) and affording medication (aPR=8. 35 [5.23, 13.34] and aPR=4.93 [2.96, 8.19], respectively), compared with children who had full year coverage. Public insurance was associated with cost barrier to seeing a doctor (aPR=4. 43 [2.57, 7.62]), compared with private insurance.

show abstract

“…A review conducted by Saloner et al . (2016) summarized a 10‐dollar increase in CHIP premiums leads to 1.4–3.9 percentage points decrease in public insurance enrollment rates . If we assume the effects in Marketplace pediatric SADPs are similar, one more insurer entering the market will reduce the premium of Marketplace SADP premiums by approximately one dollar, which will yield around 0.14–0.39 percentage points increases in Marketplace SADP enrollment rates.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting the Affordable Care Act Marketplace stand‐alone pediatric dental plan premiums

Qiao

Carroll

Bell

2018

J Public Health Dent

View full text Add to dashboard Cite

Background: Children from lower income families have inadequate dental insurance coverage and poorer dental health in the United States. The Affordable Care Act (ACA) created Health Insurance Exchange Marketplaces to increase competition among health insurers and to provide low-income families with less costly health plans. The study examined Marketplace pediatric stand-alone dental plans (SADPs) and factors that affect their premiums. Methods: The data used were 2016 Federal-Facilitated and State-Partnership Marketplace pediatric SADP data. Ordinary least squares regressions were applied to estimate contributing factors’ effects on SADP premiums. Results: Great premium variation was found among low and high coverage level SADPs, respectively. Premiums of Health Maintenance Organization (HMO) SADPs were significantly less expensive than Preferred Provider Organization (PPO) SADPs. SADPs charged significantly higher premiums for more types of services covered. SADPs also charged higher premiums in states where there are larger proportions of low-income people who report poor dental health, more dentists per capita, or higher dentists’ wages. The number of insurance companies offering pediatric SADPs in a Marketplace was negatively associated with premiums. Conclusion: The current Marketplace pediatric SADPs may have limited effects on increasing economically disadvantaged children’s access to quality dental care. Marketplaces can promote competition among its pediatric dental insurers on providing lower-cost pediatric SADPs.

show abstract

Medicaid and CHIP Premiums and Access to Care: A Systematic Review

Cited by 7 publications

References 25 publications

Disparities in Pediatric Oncology: The 21st Century Opportunity to Improve Outcomes for Children and Adolescents With Cancer

Disparities in Pediatric Oncology: The 21st Century Opportunity to Improve Outcomes for Children and Adolescents With Cancer

Cost barriers to asthma care by health insurance type among children with asthma

Factors affecting the Affordable Care Act Marketplace stand‐alone pediatric dental plan premiums

Contact Info

Product

Resources

About