The effects of child-only insurance coverage and family coverage on health care access and use: recent findings among low-income children in California.
OBJECTIVE
To compare the extent with which child-only and family coverage (child and parent insured) ensure health care access and use for low income children in California and discuss the policy implications of extending the State Children's Health Insurance Program (California's Healthy Families) to uninsured parents of child enrollees.


METHODS
We used secondary data from the 2001 California Health Interview Survey (CHIS), a representative telephone survey.


METHODS
We conducted a cross-sectional study of 5,521 public health insurance-eligible children and adolescents and their parents to examine the effects of insurance (family coverage, child-only coverage, and no coverage) on measures of health care access and utilization including emergency room visits and hospitalizations.


METHODS
We linked the CHIS adult, child, and adolescent datasets, including the adolescent insurance supplement.


RESULTS
Among the sampled children, 13 percent were uninsured as were 22 percent of their parents. Children without insurance coverage were more likely than children with child-only coverage to lack a usual source of care and to have decreased use of health care. Children with child-only coverage fared worse than those with family coverage on almost every access indicator, but service utilization was comparable.


CONCLUSIONS
While extending public benefits to parents of children eligible for Healthy Families may not improve child health care utilization beyond the gains that would be obtained by exclusively insuring the children, family coverage would likely improve access to a regular source of care and private sector providers, and reduce perceived discrimination and breaks in coverage. These advantages should be considered by states that are weighing the benefits of expanding health insurance to parents.
Guendelman
Sylvia
S
Division of Health Policy & Management, The Maternal and Child Health Program, School of Public Health, University of California, Berkeley, CA 94720, USA.
Wier
Megan
M
Angulo
Veronica
V
Oman
Doug
D
D000293:Adolescent; D002140:California; D002648:Child; D002662:Child Health Services / Q000191:economics*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005190:Family; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D011203:Poverty