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New Research Shows Dramatic Rise in Children’s Health Care Access

New Research Shows Dramatic Rise in Children’s Health Care Access

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Study documents the success of public policies to expand access to health care, especially among vulnerable groups

New research suggests health policies aimed at improving access to health insurance and medical care for U.S. children are working.

A study in the December 2016 Pediatrics, “Trends in Access to Health Care Services for US Children 2000-2014,” found the percentage of U.S. children who lack health insurance dropped by more than half during that time period. The study also revealed millions more children now have access to doctors.

The study, published online Nov. 15, analyzed data from the Centers for Disease Control and Prevention National Health Interview Survey, which included 178,038 children under age 18.  In addition to finding uninsured rates declined from 12.1% in 2000 to 5.3% in 2014, researchers with the American Academy of Pediatrics (AAP) and the Albert Einstein College of Medicine found children’s access to health care improved according to several indicators, including whether they had a doctor visit or dentist visit within the past year, or whether they had a usual source of health care.

The uninsured rate also dropped dramatically in poor families, from 22.2% to 5.9%. The study showed access to health care improved across all income and racial/ethnic groups. By 2014, an additional 9.3 million children had a well-child visit during the year.

“While there is still a gap in uninsured rates by income, we’ve made significant progress in shrinking that gap,” said AAP President Benard Dreyer, MD, FAAP. “It’s critical for our nation’s future health that we provide children at all income levels access to quality health care.”

An increase in the number children who had well-child visits and a usual source of care was especially heartening, said pediatrician Andrew D. Racine, MD, PhD, FAAP, an author of the study and a member of the AAP Committee on Child Health Financing.

“When children see providers who know their medical history and can monitor their physical and socio-emotional development, for example, they are more likely to have better overall health, be up-to-date on immunizations, perform better in school and receive care in the most cost-effective way,” he said.

The study’s findings show the critical and profound impact of public policies that help U.S. children get health insurance, said Karen Remley, MD, MBA, MPH, FAAP, CEO and Executive Vice President of the AAP. It serves as a continued call to action for pediatricians, she said.

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“For decades, fighting to provide all U.S. children with health insurance and access to care has been a priority for the AAP,” Dr. Remley said. “This new research shows how far we have come in achieving these goals of improving access to health care for all children, and why it is so important we continue and improve these programs.”

The AAP has been a strong supporter of the Children’s Health Insurance Program, first enacted in 1997 and reauthorized in 2009. The program has grown to finance health coverage for more than 8 million children in families with incomes too high to qualify for Medicaid but whose employers may not pay for health coverage for dependents.

Among other findings, the study shows the rate of public health insurance coverage rose from 18.9% to 38.9%, while private coverage declined from 69% to 56%, during the study period. Researchers also examined how race/ethnicity and income affected the rate of uninsured children. The percentage of uninsured Hispanic children declined from 26.1% to 9.3%.

In a related, solicited commentary, “Can we go beyond care process measures to a new child health policy?” Stephen Berman MD, FAAP, calls for a national child health policy agenda that focuses on increasing access to care as well as addressing social determinants of health.

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