Study: Children with State-Funded Health Insurance Receive Lower Quality Care

State-funded health insurance provides health care coverage for about one-third of the children in the United States. It is designed for lower-income families. Income guidelines, however, are less stringent than other state programs, like nutrition assistance. This allows even families that are not considered “poor,” just low income, to receive health insurance for their children.

The insurance programs like Medicaid and Medicare provide many benefits like well-checks, emergency room benefits and immunizations at little or no cost. However, the study found that there is one benefit that the families are not receiving– the same quality of care received by privately insured families.

Researchers from the University of Michigan Medical School analyzed data from a 2007 national survey of households that included children 17 and younger to determine if the children had a “medical home.” Used by the American Academy of Pediatrics, the term “medical home” refers to care that is “accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective.”

While the nationwide study found that more than 9 out of 10 publicly insured children received regular medical care, only 45% of children with state-funded health insurance met all five of the “medical home” criteria. This was compared privately insured children in which two-thirds met the criteria.

I have experienced the lack of quality care for myself. Admittedly, it is very beneficial to receive state-funded health care for your child when you know that you would not be able to afford it otherwise. I also realize that physicians who accept state health insurance receive lower payments for their services through state insurance than they do through private insurance. This, however, is not an excuse for lack of care.

It is a rare event when you find a physician that will treat a state-insured family the same as a privately insured family. You are often bustled out the door as quickly as possible. I recall a nurse even popping in after a few moments, trying to hurry me up because I was, apparently, taking too long to nurse my son after his shots.

Based on my own personal experiences, I have to agree with Dr. Joseph S. Zickafoose, the lead author of the study.

“While we need to continue to assure adequate access to primary care for publicly insured children, we also need to pay attention to the care they receive once they’re in the door. Particularly for family-centered care, we have a long way to go.”

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