Poor kids' health insurance situation changes often, affecting their medical care, study finds

ANN ARBOR, Mich. Amid the flood of recent news about America's uninsured, a new study finds a troubling undercurrent: millions of low-income children whose health care gets interrupted because they start the year with one kind of insurance, but end it with another kind -- or go without any coverage at all for part of the year.

More than 5.7 million low-income children may experience a transition in their health insurance sometime during each year, the University of Michigan study finds. They may shift to or from being uninsured, or may join or leave private insurance policies and public programs like Medicaid, as their family income or situation changes.

And, the study finds, low-income kids who experience these changes in their coverage each year are more likely to postpone doctor visits and prescriptions, to go a year without seeing a doctor, or to be in fair or poor health.

The study is the first to show a link between health insurance transitions and child health care trends. It's published in the May issue of Ambulatory Pediatrics by a team from the Child Health Evaluation and Research Unit of the U-M Medical School's Department of Pediatrics and the U-M Health System's C.S. Mott Children's Hospital.

"The uninsured in America are not a homogenous group, but a rather mixed group, with some children and families remaining uninsured for a long time and others becoming uninsured more recently, or finding a new source of insurance after being without coverage for some period of time," says senior author and assistant professor Matthew Davis, M.D., MAPP. "These data show a lot of coverage transitions for low-income children, affecting one in every five of them each year. And the data indicate that these transitions can disrupt children's access to health care."

The study is based on an analysis of the Urban Institute's National Survey of America's Families, using data from 1999, the most recent year for which survey results

Contact: Kara Gavin
University of Michigan Health System

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