Underinsurance among Children in the United States

Source: M.D. Kogan and Others, New England Journal of Medicine, August 26, 2010
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Policy discussions on children’s health insurance have been devoted largely to reducing the number of uninsured children. As compared with children who have health insurance, those lacking insurance are more likely to have needed care that is delayed or forgone; less access to preventive, specialist, or long-term care; lower utilization rates; care that imposes a high financial burden on their families; and poor health outcomes. Children with intermittent health insurance (i.e., periods without insurance throughout the year) are at greater risk for delayed care, unmet health care needs, lack of a usual source of care, and nonreceipt of well-child care.

Considerably less attention has been devoted to the problem of underinsurance, or insurance that does not sufficiently meet the child’s needs. Recently, the American Academy of Pediatrics issued a policy statement highlighting the importance of this issue. The major problems cited were cost-sharing requirements that are too high, benefit limitations, and inadequate coverage of needed services. Although some studies have addressed underinsurance among adults and others have addressed the adequacy of coverage for children with special health care needs, more information is needed about the adequacy of health insurance for all children.

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