The impact of Medicaid on children's healthcare and health.
OBJECTIVE
This article reviews the impact of the Medicaid program, including the proportion of children in America insured by Medicaid; the extent to which Medicaid-enrolled children have access to care; the use of services and the quality of care received by Medicaid enrollees, including evidence for disease reduction; and family satisfaction with the program.


RESULTS
More than a quarter of all children in the United States were insured through public programs, primarily Medicaid, in 2002. Public insurance programs are even more critical for low-income children: 69.5% of children in families with incomes below 100% of the federal poverty level are covered by public programs. The reach of Medicaid is extensive, although substantial numbers of eligible children remain uninsured. Although Medicaid-insured children still face access barriers, particularly for certain types of specialty care, parents of children with public insurance report high levels of satisfaction with their experience with well-child care. While the study findings are mixed, several recent studies show very favorable comparisons between the experience of privately insured children and that of publicly insured children.


CONCLUSIONS
Medicaid plays a critical role in providing health insurance coverage for children, particularly for very low-income families. Additional efforts are needed to fully enroll all eligible families and to assure full access to high-quality care.
Vivier
Patrick M
PM
Department of Community Health, Brown Medical School, Providence, Rhode Island 02912, USA. Patrick_Vivier@Brown.edu
D002648:Child; D002662:Child Health Services / Q000191:economics / Q000592:standards*; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D006304:Health Status; D006801:Humans; D008484:Medicaid / Q000191:economics*; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration; D014481:United States