Impact of Children's Health Insurance Program on Newly Enrolled Children
June 22, 1998
The following is a summary of an article recently published in the Journal of the American
Medical Association.  The summary is written by the Children's Defense Fund; the article
is cited below.
Lave JR, Keane CR, Chyongchiou JL, et. al.  Impact of a Children's Health 
Insurance Program on Newly Enrolled Children.  JAMA 279(22):1820-1825, June 
10, 1998.
The authors surveyed children who had recently acquired health insurance to examine the
effect of having insurance on access to medical and dental care.   Health insurance 
programs were implemented in Western Pennsylvania for families with incomes under 
235% of the federal poverty level, but incomes too high to qualify for Medicaid.  
Families with children who had newly enrolled in the child health insurance program
were interviewed on whether their child had a regular source of medical and dental care, 
unmet medical and dental needs, number of physician and dental visits, the impact 
of the newly acquired insurance on the children's activities and the effect of this
insurance on the concerns of the family.  The families were interviewed again 
after 6 months and 12 months of enrollment.   
Findings:  The authors found that enrollment in the health insurance programs 
increased access to care:   While 89% of children had a regular physician and 60% 
had a regular dentist at the time of enrollment, after 12 months enrollment 99% 
had a regular physician and 85% had a regular dentist.  Children who were 
enrolled for 12 months were also significantly less likely to have unmet 
medical/dental needs or delayed care than they were when they enrolled.  While 
57% of children had unmet medical or dental needs or delayed care at the time of 
enrollment, only 16% had unmet needs after 12 months of enrollment.
Physician and dentist contacts increased while emergency room use decreased:  
The percentage of children with any physician visit increased from 59% at the 
time of  enrollment to 64% after 12 months.  The percentage with any dental visit 
increased from 40% at the time of enrollment to 65% after 12 months.  During the 
same period, the percentage with any emergency department visits decreased from 
22% to 17%.
There was also a decrease in the percentage of children whose activities were 
limited because they lacked health insurance. At the time of enrollment, 12% of 
respondents reported that they limited their child's activities, such as bicycle
riding or roller-blading, or that the child had been refused participation in sports 
programs because of lack of health insurance.  However, none of these limitations 
were a problem at the 12 month interviews.
Finally, 61% of families with continuously enrolled children reported greater 
peace of mind, reduced worry and stress, 46% expressed appreciation for the
program, 38% indicated that they could now get their children the care they 
needed which they couldn't afford otherwise, and 12% reported that having 
insurance eased their financial burdens. 
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