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Interruptions in Medicaid coverage harm children’s access to health care

Children are likely to go without needed health care or to receive care in resource-intensive settings like EDs during short-term loss of Medicaid coverage, according to research presented at the 2017 Pediatric Academic Societies Meeting.

“With the potential repeal of the Affordable Care Act, which expanded Medicaid coverage to many low-income Americans, it’s important to gauge the impact it might have on low-income children and on associated social costs,” John Myers, PhD, MSPH, professor of pediatrics at the University of Louisville School of Medicine, Kentucky, said in a press release.

Using a retrospective, observational study design, Myers and colleagues assessed how disruption of coverage impacted children enrolled in Kentucky Medicaid in 2014 who lost coverage for at least 45 days. They compared rates in outcomes during the 6 months prior to disruption in coverage with the 6 months after coverage was restored using bivariate and multivariable analyses to determine the effects of disrupted coverage on unmet health care needs and utilization.

A total of 37,118 children enrolled in Kentucky Medicaid lost coverage in 2014, and 32,383 had a disruption in coverage for at least 45 days. When compared with the 6 months prior to coverage interruption, the results showed that those with interrupted coverage were more likely to have visited an ED (OR = 1.63; 95% CI, 1.31-1.89; P < .001) and more likely to have an unmet health care need (OR = 1.78; 95% CI, 1.47-2.09; P < .001) in the 6 months following the disruption. Additionally, children with disrupted coverage were more likely to have visited an ED (OR = 3.12; 95% CI, 2.65-7.41; P < .001) and more likely to have an unmet health care need (OR = 4.82; 95% CI, 3.91-8.64; P < .001) compared with those continuously insured. The researchers also observed that disruption in Medicaid coverage may lead to more resource-intensive care required and more unmet health care need, which can be costly.

“Gaps in health insurance coverage is a reality for many low-income children,” Myers said in the release. “A better understanding of the downstream effects of these disruptions on the health of children who experience them is needed, especially since our results suggest they may lead to unmet health needs and sicker children, along with costlier care when it is provided.” – by Savannah Demko

References:

Myers J, et al. “When the prodigal son returns: Impact of short-term coverage loss for low-income children.” Presented at: The Pediatrics Academic Societies Meeting; May 6-9, 2017; San Francisco.

Disclosures: Healio Family Medicine could not confirm any relevant financial disclosures at the time of publication.