Private Insurance No Panacea for Kids Entering Federal Health Plan

MONDAY May 5, 2008 -- Patients who had private health insurance before enrolling in a U.S. government children's health insurance program called SCHIP still had unmet health-care needs, according to new research.

A waiting period to qualify for the State Children's Health Insurance Program (SCHIP), a federally funded program offering health insurance to low-income children not eligible for Medicaid and without private coverage, would prolong chronic health conditions such as asthma, the study by the University of Rochester Medical Center finds.

Thirty-five states require uninsured children to go without insurance for a period of time before they can enroll in SCHIP. The waiting period deters a situation called crowd-out, which can happen if patients switch to SCHIP when they could choose private insurance.

"First of all, we've found that few families switch their children to SCHIP when they have the option of private health insurance... in fact, only 7 percent do," study author Laura Shone, an assistant professor of pediatrics at the University of Rochester Medical Center, said in a prepared statement.

"Second, those who do switch have the same unmet health-care needs as those who didn't have insurance when they enrolled," Shone concluded.

Her team's findings are based on research done on New York's Child Health Plus SCHIP plan. Child Health Plus has never instituted a waiting period, giving researchers an opportunity to study the patients who switch from private insurance.

The study was scheduled to be presented Monday at the Pediatric Academic Societies meeting in Honolulu.

Shone said this study shows that families are not "saving up" health problems to address after enrollment in SCHIP. About 57 percent of children, both with and without prior insurance, had unmet health-care needs when enrolling in the program, she said. In fact, 10 percent who previously had private insurance had asthma and about 7 percent had some other chronic health condition.

More information

The American College of Emergency Physicians has more about access to medical care for the uninsured.

Posted: May 2008


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