1. Facts on Uninsured Kids Compared to insured children, uninsured children are: * 2 times more likely not to have a recent physician visit * 4 times more likely to delay in seeking care because parents are worried about payment * 8 times less likely to have a regular source of health care * 5 times more likely to use the emergency room as a regular source of care Stuart Altman, Ph.D., September 2000 2. Cost of Care This data helps support the argument that continuous coverage may not necessarily increase cost but may provide cost savings in some instances. This study compared costs of coverage and care for children insured under 3 subsets of Medicaid (N= 42,636 kids) versus privately insured (N=159,651) kids who were all enrolled in Kaiser Permanente's HMO between 1995-1997. The researchers found that after adjusting for age and sex, the costs of care for income-eligible (those that received Medicaid based on AFDC income criteria) Medicaid children was only slightly more ($5/month -- which did not reach statistical significance) than commerically-insured kids. As you might expect, medically needy Medicaid children cost $20/month more and SSI blind and disabled Medicaid kids cost $216/month more. Interestingly, the investigators also found that children with CONTINUOUS membership in the HMO (whether Medicaid or private) had the lowest cost per month ($51 for both income eligible Medicaid and private) whereas those who joined and quit during the follow up period were the most costly per month ($73 for private and $72 for income-eligible Medicaid). Ray GT, Lieu T, Weinick RM, Cohen JW, Fireman B, Newacheck P. "Comparing the Medical Expenses of Children with Medicaid and Commercial Insurance in an HMO." American Journal of Managed Care 2000, Vol. 6, #7, pp. 753-60. 3. Almost $13 Billion Is Paid Out of Pocket for Children's Health Care Of a total of more than $62 billion spent on medical care for children under age 18 in 1996, $12.8 billion, or 20.5 percent, was paid out of pocket. Slightly more than half (55 percent) was paid for by private insurance and 19.4 percent was paid for by Medicaid. About five percent was paid by other sources. This information was published in "Annual Report on Access to and Utilization of Health Care for Children and Youth in the United States-2000" in the January-February issue of Ambulatory Pediatrics. The article shows data derived from the 1996 Medical Expenditure Panel Survey (MEPS) of the Agency for Healthcare Research and Quality. The article is available without charge from the AHRQ Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907; phone: (800) 358-9295, and from AHRQ InstantFAX, (301) 594-2800. Request AHRQ Publication No. 01-R036. For a reproducible graphic showing the percent distribution of source of payment for total health care expenses for children under 18, 1996, go to http://www.ahrq.gov/news/press/pr2001/chexpense96.pdf 4. Healthy Solutions for Immigrant Families Many jobs available to new immigrants in today's economy do not provide health insurance or enough income to fully support a family, making these families especially vulnerable during their first years in the United States. A bipartisan group of House and Senate Members are proposing a number of bills to address the most severe of the restrictions--those that deny federal health care to certain lawfully present children and pregnant women; those that deny food stamps to many qualified immigrant families; and those that deny services to help domestic violence victims to recover from abuse. 5. Attitudes of Mothers with Young Children Enrolled in Medicaid This Commonwealth Fund report argues that physicians and public health officials could be more helpful to low-income mothers by addressing communication gaps. Recommendations include giving explanations as well as orders, attending to the mother's well-being as well as the child's, creating informational materials, and providing for home visits and ways to bring new mothers together. The report also includes the following recommendations for state Medicaid programs: * Help mothers form relationships with pediatricians and ensure continuity of care. * Extend benefits for mothers after birth to address maternal health problems, including depression. * Offer additional expertise such as visiting nurse programs and child development experts in doctors' offices. * Create media campaigns about the benefits of comprehensive well-child care. * Raise awareness among clinicians about the importance of their role in child development education. * Identify linkages with other programs serving the same population, such as WIC. * Tailor programs to age, experience, culture, and language and establish standards for interpreters.