Health Insurance:

Coverage Leads to Increased Health Care Access for Children

HEHS-98-14: Published: Nov 24, 1997. Publicly Released: Nov 24, 1997.

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William J. Scanlon
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Pursuant to a congressional request, GAO reported on the relationship between health insurance and health care access, focusing on: (1) what effect health insurance has on children's access to health care; (2) whether expanding publicly funded insurance improves their access; and (3) barriers besides lack of insurance that might deter children from getting health care.

GAO noted that: (1) health insurance increased children's access to health care services in almost all the studies GAO analyzed; (2) most of the evaluations showed that insured children were more likely to have preventive and primary care than uninsured children; (3) insured children were also more likely to have a relationship with a primary care physician and to receive required preventive services, like well-child checkups, than uninsured children; (4) differences in access between insured and uninsured children held true even for children who had chronic conditions and special health care needs; (5) when ill, insured children were more likely to receive a physician's care for their health problems, such as asthma or acute earache; (6) in contrast, lack of insurance can inhibit parents from trying to get health care for their children and can lead providers to offer less-intensive services when families seek care; (7) several studies found evidence that low-income and uninsured children were more likely to be hospitalized for conditions that could have been managed with appropriate outpatient care; (8) two studies found that uninsured children sometimes received less-intensive hospital care than insured children; (9) while health insurance benefits differed and some excluded coverage for some basic health care needs, increasing the number of insured children increased the likelihood that more children would receive care; (10) although health insurance can considerably increase access, it does not guarantee entry into the health care system; (11) low family income and education levels, limited availability of neighborhood primary health care facilities, lack of transportation, and language differences are among the barriers to obtaining and appropriately using health care services; (12) both children who have no health insurance and those who have Medicaid coverage are more likely than privately insured children to face such barriers; and (13) to ensure access to high-quality care, public health and clinical experts recommend that children have a stable source of health insurance benefits that cover their health care needs, a relationship with a primary care provider that helps them obtain more complex care as needed, primary care facilities that are conveniently situated, and outreach and education for their families.

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