The Effect of Parents' Insurance Coverage on Access to Care for Low-Income Children

Author(s):  
Amy Davidoff ◽  
Lisa Dubay ◽  
Genevieve Kenney ◽  
Alshadye Yemane

This study examines the effects of having an uninsured parent on access to health care for low-income children. Using data from the 1999 National Survey of America's Families, we find that having an uninsured parent decreases the likelihood that a child will have any medical provider visit by 6.5 percentage points, and decreases the likelihood of a well-child visit by 6.7 percentage points. Estimates for low-income children who have insurance but have an uninsured parent indicate a 4.1 percentage-point reduction in the probability of having any medical provider visit, and a similar 4.2 percentage-point reduction in the probability of having a well-child visit relative to those with insured parents. The effects of having an uninsured parent are smaller in magnitude than the effects of a child being uninsured. Efforts to increase insurance coverage of parents, either by extending eligibility for public insurance or through other policy interventions, will have positive spillover effects on access to care for children. Although the magnitude of these effects is small relative to the direct effect of providing insurance to either the child or parent, they should be considered in analyses of costs and benefits of proposed policies.

2009 ◽  
Vol 124 (5) ◽  
pp. 682-691 ◽  
Author(s):  
Gregory D. Stevens ◽  
Michael Seid ◽  
Kai-Ya Tsai ◽  
Carmen West-Wright ◽  
Michael R. Cousineau

Objective. We examined population changes in access to care for children in California during a period of major efforts to improve access to care for children. Methods. We used cross-sectional data on 36,010 children aged 0–19 years from the 2001 and 2005 California Health Interview Survey to assess population changes in access to care. We assessed changes in access by individual risk factors and a composite risk profile. Results. In 2005, a smaller proportion of children were uninsured (8.2% vs. 10.9% in 2001), living in poverty (20.7% vs. 23.2% in 2001), and in families without a high school education (20.8% vs. 23.6% in 2001), all p<0.001. Before and after adjusting for these changes in risk, children were more likely in 2005 to have had a physician visit (odds ratio [OR] = 1.09, 95% confidence interval [CI] 1.07, 1.12) and dental visit (OR=1.11, 95% CI 1.08, 1.14). Children were slightly less likely in 2005 to have a regular source of care (OR=0.94, CI 0.91, 0.96). Children who had the highest risk profiles (≥4 risk factors) experienced the largest gains in access. For example, children with three and ≥4 risk factors had gains in dental visits of 11 and 20 percentage points, respectively ( p<0.001 for each), compared with ≤3 percentage points for children with fewer risk factors. Conclusions. This study found improvements in physician and dental visits between 2001 and 2005 that were not fully explained by changes in insurance coverage or other demographic risk factors. Vulnerable children fared well during this period, suggesting that California may be making important and potentially replicable strides in reducing disparities.


Author(s):  
Lara D. Shore-Sheppard

Abstract Despite considerable research, there is little consensus about the impact of Medicaid eligibility expansions for low-income children. In this paper, I reexamine the expansions’ impact on Medicaid take-up and private insurance “crowd-out” by investigating a number of critiques leveled at the seminal work of Cutler and Gruber (1996) and extending the analysis to include further expansions of Medicaid. I find that accounting for most critiques of Cutler and Gruber does not substantively affect their estimates of sizable take-up and crowd-out. However, controlling for age-specific time trends does substantially reduce the estimated take-up and crowd-out and recovers results close to those found elsewhere in the literature. I also find that later expansions generated much lower rates of take-up and crowding out.


2021 ◽  
Vol 2 (8) ◽  
pp. e212007
Author(s):  
Jose F. Figueroa ◽  
Peggah Khorrami ◽  
Aditi Bhanja ◽  
E. John Orav ◽  
Arnold M. Epstein ◽  
...  

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