title: Trade-offs between public and private coverage for low-income children have implications for future policy debates.
abstract: Much of the discussion around the Affordable Care Act has focused on likely changes in coverage and access to care for adults. However, the law also alters coverage options for many low-income children. We used data from the new Health Reform Monitoring Survey Child Supplement to examine access to care and related outcomes for low-income publicly and privately insured children. We found that over 90 percent of low-income insured children had a usual source of care and had parents who were confident that their children could get the health care they need, regardless of their type of coverage. However, on a variety of cost-related measures, including difficulty paying the child's medical bills, out-of-pocket expenses, and satisfaction with health insurance premiums and copayments, children with Medicaid or the Children's Health Insurance Program (CHIP) fared better than those with employer-sponsored insurance. These results have implications for debates about the future of CHIP and other policies that affect public and private coverage options available to children and families.
authors.affiliation: Stacey McMorrow (SMcMorrow@urban.org) is a senior research associate in the Health Policy Center, Urban Institute, in Washington, D.C.
authors.forename: Stacey
authors.initials: S
authors.lastname: McMorrow
authors.affiliation: Genevieve M. Kenney is codirector of and a senior fellow in the Health Policy Center, Urban Institute.
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Kenney
authors.affiliation: Nathaniel Anderson is a research assistant in the Health Policy Center, Urban Institute.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Anderson
authors.affiliation: Lisa Clemans-Cope is a senior research associate in the Health Policy Center, Urban Institute.
authors.forename: Lisa
authors.initials: L
authors.lastname: Clemans-Cope
authors.affiliation: Lisa Dubay is a senior fellow in the Health Policy Center, Urban Institute.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dubay
authors.affiliation: Sharon K. Long is a senior fellow in the Health Policy Center, Urban Institute.
authors.forename: Sharon K
authors.initials: SK
authors.lastname: Long
authors.affiliation: Douglas Wissoker is a senior fellow in the Statistical Methods Group at the Urban Institute.
authors.forename: Douglas
authors.initials: D
authors.lastname: Wissoker
mesh_terms: D000328:Adult; D005260:Female; D005102:Health Expenditures; D006291:Health Policy; D006801:Humans; D019458:Insurance Coverage / Q000191:economics*; D007348:Insurance, Health / Q000191:economics*; D008297:Male; D017057:Medically Uninsured; D058991:Patient Protection and Affordable Care Act; D011203:Poverty; D017149:Private Sector / Q000191:economics*; D017150:Public Sector / Q000191:economics*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: Access To Care; Children < Insurance; Children’s Health; Health Reform