Children's unmet health needs similar for low- and middle-income families with either public or private insurance
Research Activities, February 2012, No. 378
Both public and private health insurance appear equally able to guarantee children access to needed health services, concludes a new study. Previous studies have reported that children with public insurance may have worse access to outpatient specialist care and higher use of inpatient services (such as hospital emergency departments), while children with private insurance may have poorer access to trauma facilities. However, studies have not determined whether public or private health insurance is more effective in reducing children's unmet health needs, a finding that could influence the direction of future health care reform.
The researchers compared children whose family income was either low-income (less than 200 percent of the Federal poverty level [FPL]) or middle-income (between 200 and 400 percent of the FPL), and who had full-year coverage by public or private insurance. They examined whether the child had a usual source of care (USC), no doctor visits in the past year, unmet medical or prescription needs, less-than-yearly dental visits, or unmet dental needs. The findings were comparable for both children with full-year public and full-year private health insurance. The only difference was that children in low-income families with public insurance had a 21 percent lower likelihood of having a USC than children with private insurance. All other comparisons between the publicly and privately insured groups related to unmet health care or preventive counseling needs were essentially the same, regardless of family income. However, unmet needs were higher among children with coverage gaps or no health insurance coverage during the year than among children with full-year private insurance, regardless of family income level.
The findings were based on analysis of pooled data from the Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey-Household Component for 2002 through 2006. The study was funded in part by AHRQ (HS16181 and HS18569).
More details are in "Comparing types of health insurance for children: A public option versus private option," by Jennifer E. DeVoe, M.D., D.Phil., Carrie J. Tillotson, M.P.H., Lorraine S. Wallace, Ph.D., and others in the September 2011 Medical Care 49(9), pp. 818-827.