A groundbreaking new study reveals more than 20 million children may have insurance but still experience severe barriers in accessing essential healthcare.
For the study, Children's Health Fund researchers examined national health data sets as well as its own clinical experiences and programmatic data.
Analyses revealed 20.3 million U.S. children — 28 percent of the pediatric population under the age of 18 — are without adequate healthcare. Researchers said this finding is based on three considerations: children who are uninsured; those who are insured, but do not receive regular primary care; and children who are publicly insured, connected to primary care, but do not receive essential and timely specialty care.
Of the 20.3 million children not receiving adequate care, more than 80 percent are insured but not receiving optimal care, according to a news release. By conducting analyses of National Health Interview Survey data from 2014 and 2015, researchers found 3.3 million U.S. children are uninsured while 10.3 million children with some form of health insurance do not have adequate access to primary care. In addition, CHF extrapolated findings from its own programs in New York City to estimate that 6.7 million children — 9 percent of all U.S. children — on Medicaid or CHIP who have access to primary care, are still not receiving the specialty care they need to be healthy.
"While children's healthcare has experienced increased and significant attention in recent years, our analyses show there is still a long way to go before we can claim that all U.S. children have access to the care they need. There has been a persistent misconception that simply providing health insurance is the same as assuring effective access to appropriate healthcare. It isn't," Irwin Redlener, MD, co-founder and president of CHF, and the paper's lead author, said in a statement. "Although Medicaid, the Children's Health Insurance Program and most recently the ACA insure more children than ever before, millions of kids are not getting the care they need."
The study's authors said federal and state governments, insurers and providers should make efforts to reduce, and ultimately eliminate, barriers to access, though acknowledging that doing so is a pressing task.
For non-financial barriers, CHF suggests increasing incentives encouraging healthcare providers to practice in poor communities, supporting improved access through telehealth and mobile clinics creating more healthcare access points including expanded school-based healthcare opportunities addressing transportation barriers, promoting health literacy and helping parents with limited English proficiency, the news release states.