AHRQ Study: Children in Families With Mixed Insurance Eligibility More Likely To Lack Insurance and Preventive Health/Dental Care

An AHRQ-funded study found that Medicaid- and Children's Health Insurance Program (CHIP)-eligible children with siblings who are ineligible for public coverage are more likely to lack health insurance and less likely to receive preventive health and dental care compared with children in families in which all siblings are eligible for the same public insurance program (all-Medicaid or all-CHIP). Using data from AHRQ’s Medical Expenditure Panel Survey for 2001-2012, the researchers examined insurance coverage, access to care and health care use for children in families with a mix of either “Medicaid- and CHIP-eligible” children or “eligible and ineligible” children. The authors found no differences between children in Medicaid-CHIP mixed families and children in all-Medicaid- or all-CHIP-eligible families. Differences found for children in eligible-ineligible mixed families persisted even among eligible children who were covered by public insurance. The study, co-authored by AHRQ’s Julie L. Hudson, concluded that complications associated with mixed eligibility appear to be related to the difficulties faced by families when only some of their children are eligible for public coverage. The study was published online August 3 in Health Affairs. Read the abstract for the study, “Coverage and Care Consequences for Families Where Children Have Mixed Eligibility for Public Insurance.”

2015 Aug;34(8):1340-8. doi: 10.1377/hlthaff.2015.0128.

Coverage and care consequences for families in which children have mixed eligibility for public insurance.

Hudson JL1, Abdus S2.

Author information

Abstract

Public health insurance for low-income children in the United States is primarily available through Medicaid and the Children's Health InsuranceProgram (CHIP). Mixed eligibility occurs when there is a mix of either "Medicaid- and CHIP-eligible" children or a mix of "eligible (for public insurance) and ineligible (for public insurance)" children in the family. We used data from the Medical Expenditure Panel Survey (MEPS) Household Component for 2001-12 to examine insurance coverage, access to care, and health care use for eligible children in families with mixed-eligible siblings compared to those in families where all siblings were eligible for one program. We found that mixed eligibility has a significant dampening effect for eligiblechildren in families with a mix of eligible and ineligible siblings. These children were more likely to be uninsured and less likely to have a usual source of care, less likely to have any preventive dental or well-child visits during the year, and less likely to fully adhere to recommended preventive dental and well-child visits than eligible children with all-Medicaid- or all-CHIP-eligible siblings. We found no significant impact for eligible childrenliving in Medicaid-CHIP-mixed families.

Project HOPE—The People-to-People Health Foundation, Inc.