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Many Kids Lack Insurance, Despite Having Insured Parents

More than 3 million children fall into this category, study suggests

TUESDAY, Oct. 21, 2008 (HealthDay News) -- Insured parents don't necessarily mean insured kids.

So say researchers who found that more than 3 percent of U.S. children and adolescents are uninsured or underinsured at some point during any given year -- despite having at least one parent with health insurance.

That translates into almost 3 million U.S. children with no medical care at all and no access to prescription drugs over a full year. Slightly more than half of that number qualify for public coverage but aren't enrolled.

Overall, more than 9 million U.S. children are uninsured; some 18 million have a coverage gap at one time or another, according to the study.

"This is millions of parents unable to access stable, continuous health-care coverage for themselves and their children. These are painful realities, choices to forego and delay care every day," study author Dr. Jennifer E. DeVoe, an assistant professor of family medicine at Oregon Health & Science University in Portland, said at a news conference Tuesday.

The conference was sponsored by the Journal of the American Medical Association, which published DeVoe's study, along with other studies addressing health-care concerns, in a special Oct. 22/29 themed issue, "Health of the Nation."

A lack of health-care coverage for children can have serious consequences, according to a second study in the same issue of the journal. About half of U.S. children without health insurance had to go without medical care or prescription medications while they were uninsured, said researchers from the University of Rochester Medical Center. Even more children went without preventive care, including receiving necessary vaccinations.

The authors of the first study looked at data from 2002 to 2005 on children and adolescents under the age of 19 living with at least one parent. The study included more than 39,000 participants.

Their analysis found that 3.3 percent of children and adolescents were uninsured, even though they had at least one insured parent.

Uninsured children and adolescents were 58 percent more likely to be Hispanic than white non-Hispanic; had double the odds of being from a low-income versus a high-income family; were 48 percent more likely to be from a middle-income rather than high-income family; and twice as likely to come from a single-parent home than a home with two married parents.

Compared to children with at least one parent with a high school education, children whose parents had less than a high school education were 44 percent more likely to be uninsured; they were also 64 percent less likely to be insured if their parents had public coverage rather than being privately insured.

At Tuesday's teleconference, DeVoe played recorded testimonials from American parents frustrated at their inability to ensure health-care coverage for their children. "When it comes to your health, how can you say no to a kid?" one unidentified mom said. "It makes me feel really bad."

And in another study, researchers at the University of Rochester Medical Center propose that the State Children's Health Insurance Program (SCHIP) be expanded to cover families at 200 percent to 400 percent of the federal poverty level to get children needed care.

SCHIP was created to provide public health insurance to families who earned too much to qualify for Medicaid but not enough to buy private coverage. Current guidelines suggest that SCHIP cover families living at 100 percent to 200 percent of the federal poverty level. However, the Rochester team found that kids from families with annual incomes at 200 percent to 400 percent of the poverty level ($38,000 to $76,000) are now just as likely to be uninsured as children from poorer families.

"There's a great need for health-care coverage for children, and it's not isolated to the poor. It's moving up the income scale," lead researcher Laura Shone, an assistant professor of pediatrics, said in a news release.

One expert said the findings from both studies came as no surprise.

"There are a lot of uninsured kids and working families that are struggling to cope," said Rachel Klein, deputy director of health policy at Families USA, in Washington, D.C. "Things are harder now than they were a year ago. Everything has increased in price, food has gone up, gas has gone up, health-care premiums have gone up."

Other authors in the journal weighed in on the issue. Ezekiel Emanuel, director of clinical bioethics at the National Institutes of Health, pointed out that state/federal unity is needed for successful comprehensive health-care reform.

After Massachusetts passed a landmark health reform bill in 2006, other states tried to follow suit, he noted. Not one was successful.

And in yet another paper in this themed issue, Dr. Samuel Y. Sessions, of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in Torrance, Calif., proposes comprehensive tax reform as a way to effect comprehensive health reform.

More information

Visit Families USA for more on health insurance issues.

SOURCES: Oct. 21, 2008, press teleconference with Jennifer E. DeVoe, M.D., D.Phil., assistant professor, family medicine, Oregon Health & Science University, Portland; Rachel Klein, deputy director, health policy, Families USA, Washington, D.C.; Oct. 21, 2008, news release, University of Rochester Medical Center; Oct. 22/29, 2008, Journal of the American Medical Association
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