Abstract
Objective
To report on coverage and adequacy of health insurance for children with special health
care needs (CSHCN) in 2009–2010 and assess changes since 2001.
Methods
Data were from the National Survey of Children with Special Health Care Needs (NS-CSHCN),
a random-digit telephone survey with 40,243 (2009–2010) and 38,866 (2001) completed
interviews. Consistency and adequacy of insurance was measured by: 1) coverage status,
2) gaps in coverage, 3) coverage of needed services, 4) reasonableness of uncovered
costs, and 5) ability to see needed providers, as reported by parents. Bivariate and
multivariable analyses were conducted to assess factors associated with adequate insurance
coverage in 2009–2010. Unadjusted and adjusted prevalence estimates were examined
to identify changes in the type of insurance coverage and the proportion of CSHCN
with adequate coverage by insurance type.
Results
The proportion of CSHCN with private coverage decreased from 64.7% to 50.7% between
2001 and 2009–2010, while public coverage increased from 21.7% to 34.7%; the proportion
of CSHCN without any insurance declined from 5.2% to 3.5%. The proportion of CSHCN
with adequate coverage varied over time and by insurance type: among privately covered
CSHCN, the proportion with adequate coverage declined (62.6% to 59.6%), while among
publicly covered CSHCN, the proportion with adequate insurance increased (63.0% to
70.7%). Publicly insured CSHCN experienced improvements in each of the 3 adequacy
components.
Conclusions
There has been a continued shift from private to public coverage, which is more affordable,
offers benefits that are more likely to meet CSHCN needs, and allowed CSHCN to see
necessary providers.
Keywords
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Article info
Publication history
Published online: April 09, 2015
Accepted:
February 4,
2015
Received:
October 2,
2014
Footnotes
The authors declare that they have no conflict of interest. The opinions expressed by authors do not necessarily reflect the opinions of the US Department of Health and Human Services or the authors' affiliated institutions.
Identification
Copyright
Published by Elsevier Inc.
