Uninsured Children in United States

Uninsured Children in United States

Literature Review

In response to the increase in the number of American children without health insurance, new federal and state programs have been established to expand health insurance coverage for children. However, the presence of insurance reduces the price of care for families participating in these programs and stimulates the use of medical services, which leads to an increase in health care costs. (Valdez et al. 1989) In this qualitative proposal, I will identify the additional expenditures associated with the provision of health insurance to previously uninsured children.

Lewit & Baker (1995) in their research described that a growing number of American children do not have health insurance; at any time during the year >11 million children (14%) are uninsured. (Lewit, Baker, 1995) Despite their lack of insurance, most uninsured children do receive some medical care, which is paid for from a variety of sources. Physicians and hospitals often provide charity care to uninsured patients. Other costs are borne by the families themselves, who pay out-of-pocket, and by other patients who are charged more to compensate for the costs of treating the uninsured. In response to the large number of children without insurance, President Clinton signed into law the State Children's Health Insurance Program (SCHIP), which will provide up to $40 billion through the year 2007 for states to expand health insurance coverage for children. (State Children's Health Insurance Program, 1997) With SCHIP, the government has assumed responsibility for most of the costs of caring for children who are eligible for the program.

One of the effects of expanding health insurance coverage is to increase costs at least in the short term as the new beneficiaries tend to increase their use of health care. Previous research has found that children also use more outpatient services when their out-of-pocket costs are lower. Accordingly, a program for insuring previously uninsured children is likely to stimulate the use of medical services. However, theoretical framework has focused on the additional short-term costs of providing insurance to children previously uninsured. (Manning, Newhouse, Duan, 1987)

Research Questions

Q.1. How and why uninsured children in the United States are increasing day by day?

Q.2. What are the reasons behind the implementation of the CHPlus program in the New York State for uninsured children?

Theoretical Framework

New York State implemented the CHPlus program in August 1991. Children <13 years old who were New York State residents having a gross family income below 222% of the federal poverty level and having no equivalent coverage were eligible for CHPlus. Children enrolled in CHPlus received a standard health insurance benefit package that offered coverage for the services of a comprehensive set of primary and specialty clinicians. During the study period, CHPlus only covered outpatient services. Since that time, the New York State legislature has expanded the program both by increasing the eligibility age to children up to 19 years (effective January 1, 1997) and by including coverage for inpatient services consistent with SCHIP guidelines.

Initially CHPlus was financed primarily through the Statewide Bad ...