Children's Health Needs Unmet as Low-Income Famili

Newswise — In one of the first studies to assess the impact of lost public health care coverage on children in low-income families, researchers at RTI International found that health care needs of these children go unmet as they lose public health insurance.

The study, funded by the Agency for Healthcare Research and Quality (AHRQ), the David and Lucile Packard Foundation and the U.S. Health Resources and Services Administration, appears in the October issue of Medical Care Research and Review.

The report is part of the Child Health Insurance Research Initiative that funded nine research studies to help public health insurance programs and health care delivery systems improve health care for low-income children. "This study's findings indicate that public health insurance programs are not providing the hoped-for bridge families require to successfully transition from public to private health care insurance," said Jan Mitchell, Ph.D., RTI International's principal investigator for the study. "Unfortunately, there appears to be a significant gap between the income level that qualifies families to receive public health care for the children and a low-income family's ability to afford private health care insurance."

The study found that, while enrolled in a public health insurance program, more than 95 percent of children had a standard source of physician care. However, after losing public health coverage, the number of children without standard physician care grew. About 20 percent of children previously enrolled in Oregon's State Children's Health Insurance Program (SCHIP) and 10 percent of those formerly enrolled in Family Health Insurance Assistance Program (FHIAP) reported an unmet medical need.

The majority of parents who had reapplied to the programs reported losing public health insurance coverage because of increased family incomes. Even with the increased incomes, many of these families were unable to afford the costs of private health insurance, which left their children uninsured.

The study found that children who acquired health insurance coverage after their public health coverage ended were significantly more likely to have seen a physician since disenrolling than children who were no longer insured. However, less than half of the children studied obtained health insurance coverage after leaving the public health programs. The majority of parents said they would have kept their children enrolled in the programs if at all possible.

"Our study found that health insurance coverage has a significant impact on access to care," Mitchell said. "There is a critical need to improve that access to coverage for low-income families. Health care costs are a barrier to these families as they try to achieve financial stability. Raising the income eligibility ceiling for these public programs is one way to help bridge the gap to private health insurance."

Since the study was conducted, Oregon has implemented modest increases in the income eligibility ceilings for both public health insurance programs, but a lack of funding has prevented further increases.

RTI researchers conducted a telephone survey of more than 1,200 children from two public health insurance programs in Oregon, SCHIP and FHIAP. Both programs provided health insurance coverage to children up to 170 percent of the federal poverty level.

About RTI International RTI International is dedicated to conducting research and development that improves the human condition by turning knowledge into practice. With a worldwide staff of more than 2,500, RTI offers innovative research and technical solutions to governments and businesses worldwide in the areas of health and pharmaceuticals, education and training, surveys and statistics, advanced technology, democratic governance, economic and social development, energy, and the environment. The second largest independent nonprofit research organization in the United States, RTI maintains nine offices in the U.S., five international offices, and one international subsidiary, as well as project offices around the world. For more information, visit http://www.rti.org.