Prenatal Care: Revisions to SCHIP Extend Health Care to “Unborn Children”

2003 ◽  
Vol 31 (1) ◽  
pp. 155-157 ◽  
Author(s):  
Valerie Gutmann
Keyword(s):  
Health Insurance ◽  
Prenatal Care ◽  
Low Income ◽  
Insurance Coverage ◽  
State Governments ◽  
Block Grants ◽  
Department Of Health ◽  
Federal Department ◽  
Definition Of ◽  
Poor Children

Effective November 1, 2002, the federal Department of Health and Human Services (DHHS) reclassified developing fetuses as “unborn children,” thereby providing health insurance benefits for prenatal care under the State Children's Health Insurance Program (SCHIP). By broadening the current definition of “child” —and thus expanding SCHIP insurance coverage — DHHS hopes to increase the number of low-income pregnant women who receive prenatal services. As noted by one commentator, the new rule represents the first time “any federal policy has defined childhood as beginning at conception.”In an attempt to improve access to publicly funded health insurance for poor children not covered by Medicaid, Congress established SCHIP a 10-year, $40 billion program jointly funded by federal and state governments. Through a series of block grants, SCHIP allows states to either expand income-eligibility for their existing Medicaid program or to create a separate child health program to decrease the number of uninsured poor and near-poor children.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

France

2021 ◽  
pp. 558-589
Author(s):  
Matthias Brunn ◽  
Patrick Hassenteufel
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Public Management ◽  
New Public Management ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
National Health Insurance System ◽  
Health Politics ◽  
New Public ◽  
Unusual Combination

This chapter offers an in-depth look at health politics and the national health insurance system in France. It traces the development of the French healthcare system through its series of political regimes, characterized by its unusual combination of statism and corporatism. Since the 1990s, a technocratic consensus emerged that has led to new public management reforms, tighter parliamentary control of social security budgets, and efforts to improve coverage by subsidizing supplementary voluntary health insurance coverage for low-income persons and increasing tax-financing. Other healthcare issues have been regional health inequalities, reimbursement of medical professionals, and individuals’ responsibility for their health.

scholarly journals Public health insurance and birth outcomes: evidence from Punjab, Pakistan

2020 ◽  
Author(s):  
Najam uz Zehra Gardezi
Keyword(s):  
Public Health ◽  
Health Insurance ◽  
Low Income ◽  
Fixed Effects ◽  
Insurance Coverage ◽  
Birth Certificate ◽  
Household Survey ◽  
Public Health Insurance ◽  
Health Seeking ◽  
Cross Sectional

Abstract Public health insurance targeted towards low-income households has gained traction in many developing countries. However, there is limited evidence as to the effectiveness of these programs in countries where institutional constraints may limit participation by the eligible population. This paper evaluates a recent health insurance initiative introduced in Pakistan and discusses whether eligibility for the programme improves maternal health seeking behaviour. The Prime Minister National Health Program provides free insurance coverage to low-income families. The programme is in the early phases of implementation and has, since 2016, only been rolled out in a few eligible districts within the country. This allows for a comparison of eligible households in districts where the programme has been introduced to those that are eligible to receive insurance at a future date. Using repeated cross-sectional data from multiple rounds of representative household survey, a difference-in-difference model has been estimated. Results show that at least for a specific beneficiary group (i.e. pregnant women), there has been a positive increase in utilization of hospital services. Furthermore, we provide evidence using mother fixed effects that the programme increased the likelihood of a child’s birth being documented. Since possession of a birth certificate can secure civic rights for a child, this is an unintended but positive outcome of the programme.

scholarly journals The Evolution of Medical Spending Risk

2009 ◽  
Vol 23 (4) ◽  
pp. 25-48 ◽  
Author(s):  
Jonathan Gruber ◽  
Helen Levy
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Low Income ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Health Spending ◽  
The United States ◽  
Consumer Expenditure ◽  
Out Of Pocket Payments ◽  
Over Time

How has the economic risk of health spending changed over time for U.S. households? We describe trends in aggregate health spending in the United States and how private insurance markets and public insurance programs have changed over time. We then present evidence from Consumer Expenditure Survey microdata on how the distribution of household spending on health—that is, out-of-pocket payments for medical care plus the household's share of health insurance premiums—has changed over time. This distribution has shifted up over time—households spend more on medical care and insurance than they used to—but for the purposes of measuring change in risk, it is not the mean but the dispersion of this distribution that is of interest. We consider two measures of dispersion that serve as proxies for household risk: the standard deviation of the distribution of household health spending and the ratio of the 90th percentile of spending to the median (the so-called “90/50 gap”). We find, surprisingly, that neither has increased despite the rapid rise in aggregate health spending. This conclusion holds true for broad subgroups of the population (for example, the nonelderly as a group) but not for some narrowly-defined subgroups (for example, low-income families with children). We next consider how much risk households should face, from the perspective of economic efficiency. Household risk may not have changed much over the past several decades, but do we have any evidence that this level represents either too much or too little risk? Finally, we discuss implications for public policy—in particular, for current debates over expanding health insurance coverage to the uninsured.

Impact of Subsidized Health Insurance Coverage on Emergency Department Utilization by Low-income Adults in Massachusetts

Medical Care ◽  
2015 ◽  
Vol 53 (1) ◽  
pp. 38-44 ◽  
Author(s):  
Jennifer Lee ◽  
Ru Ding ◽  
Scott L. Zeger ◽  
Aidan McDermott ◽  
Getachew Habteh-Yimer ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Emergency Department Utilization

scholarly journals Patterns of Care in Michigan Emergency Departments as Insurance Coverage Expands

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Fatema Mamou ◽  
Matthew Davis ◽  
Jim Collins ◽  
Jay Fiedler ◽  
Tiffany Henderson ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Syndromic Surveillance System ◽  
Care Services ◽  
Primary Care Services ◽  
Ed Visits ◽  
Increasing Trends

Using the Michigan Syndromic Surveillance System changes in emergency department (ED) volume are being monitored as health insurance coverage expands through the Healthy Michigan Plan (HMP), which provides healthcare coverage to low-income adults. Seasonally adjusted monthly ED visits prior to and after the HMP implementation on April 1, 2014 are being compared. Preliminary data show increasing trends in ED utilization among populations with previously low levels of health insurance coverage. Increased health insurance coverage may expand healthcare service options beyond EDs. Alternatively, the demand for primary care services may exceed the level of access leading to increased ED utilization for primary care.

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