- Despite major legislation over the last half century to expand healthcare access for children, 20.3 million kids in the U.S. "lack access to care that meets modern pediatric standards,” a new Children’s Health Fund analysis concludes.
- Of that number, which comprises 28% of all children under 18 in the U.S., 10.3 million are insured but miss timely well-child checks and vaccinations, suggesting a lack of primary care.
- Barriers to healthcare include not only costs, such as high copays and deductibles, but also issues like transportation and a parent’s proficiency in English.
Programs like Medicaid, the State Children’s Health Insurance program and the ACA have allowed millions of children to gain health insurance. Between 1997 and 2015, the child uninsurance rate fell 67% from 13.9% to 4.5%, according to the report. But those numbers don’t tell the whole story.
The nonprofit group looked at three key components to determine the extent of the problem: children who are uninsured or incompletely insured, those with insurance who miss primary care visits, and those who have insurance but lack access to essential subspecialty services.
CHF said the families of more than 13.1 million children report struggling to pay medical bills or being unable to pay them. Some providers also refuse to take Medicaid patients because the reimbursement is lower.
While lacking access to healthcare can undermine a child’s health, it also may impact their success in school and in the workforce. “Loss of later productivity and the extraordinary costs of remediation will clearly have deleterious consequences for the future economic strength and vibrancy of the United States,” the report says.
CHF President Irwin Redlener, a professor of pediatrics and health policy and management at Columbia University, told The New York Times that the problem demands “the highest-priority attention” from the incoming administration.
Plans from president-elect Donald Trump and GOP leadership on Capital Hill to repeal the ACA could strip 3 million children of insurance, Redlener noted. “So far, none of the proposed replacements will do anything to mitigate what children would potentially lose if the ACA is actually repealed.”
The report makes a number of recommendations to increase access to care, including reducing or eliminating copayments, creating incentives for physicians to practice in poor communities, eliminating transportation barriers, and improving health literacy. A current trend that could help improve access is telemedicine, Michael Kappy, a pediatric endocrinologist at Children’s Hospital Colorado, told the NYT. But telemedicine services need to be adequately reimbursed to really have an impact.