Low- and middle-income children with public and private insurance have similar rates of unmet health care needs
Research Activities, September 2011, No. 373
Families with children report similar rates of unmet health care needs, whether their children have public or private health insurance, according to a new study. These findings are somewhat contrary to many earlier studies that have shown significant differences between public and private coverage. However, consistent with earlier studies, children with coverage gaps or those uninsured all year were more likely to have unmet needs, note the researchers.
They used combined data on 41,498 children from AHRQ's Medical Expenditure Panel Survey Household Component for 2002 through 2006. They compared publicly and privately insured children among families earning less than 4 times the Federal poverty level (FPL) or less than 2 times the FPL. For households earning less than 4 times the FPL, the researchers found that 32.2 percent of children had public coverage all year, 40.5 percent had private coverage all year, and 7.7 percent were uninsured all year. For children with family incomes under 2 times the FPL, 49.6 percent had public insurance all year, 18.5 percent had private insurance all year, and 8.4 percent had no insurance all year.
Among children from lower-income families, those with public insurance were 21 percent less likely to have a usual source of care. However, that was the only significant difference in the comparisons of unmet health care needs among lower- and middle- income children with public or private health insurance. Possible unmet needs used in the analyses included: no doctors' visits during the year, unmet medical or prescription needs, no yearly dental visits, unmet dental needs, and unmet preventive health and safety counseling needs. The study was funded in part by the Agency for Healthcare Research and Quality (HS16181 and HS18569).
More details are in "Comparing types of health insurance for children. A public option versus a 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 April 2011 Medical Care [Epub ahead of print].