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Focusing on a variety of education, health and youth development issues of importance to children and families in Pennsylvania.

Are low-income kids second class citizens?

A study released last week concerning low-income children’s access to health care was particularly disturbing, though perhaps not surprising to some.

The study, conducted by the University of Pennsylvania, examined access to specialist care for children with private insurance vs. children insured by CHIP or Medicaid. Researchers included nearly 90 clinics providing specialist services (such as dermatology, allergy or orthopedics) in Cook County, Illinois, and called posing as mothers to get appointments for their “children,” some who were insured through an employer and some through public insurance.

In the end, the study found a disparity in access to outpatient specialty care between children with public insurance and those with private, employer-based insurance.

Some highlights (or lowlights!):

  • More than half of calls to clinics requested the caller to provide information about insurance coverage before an appointment would be scheduled;
  • 66% of callers with Medicaid or CHIP were refused an appointment, while just 11% of callers with private insurance were denied an appointment;
  • For those children who were scheduled an appointment, 20 days was the average wait time for a privately insured child while 42 days was the average wait time for a child with Medicaid or CHIP.

Among the specialty clinics that scheduled appointments for both Medicaid/CHIP enrollees and privately insured children, children with Medicaid/CHIP had greater delays in obtaining needed specialty care.

There are about 1.3 million children currently covered by either Medicaid or CHIP in Pennsylvania and it makes me sad to think these children would be treated any differently than kids whose parents have private health insurance. Oftentimes an employer, such as a small company, can’t afford to offer health insurance to its employees leaving workers to rely on CHIP or Medicaid for their dependents, and no one should be penalized for that!

Furthermore, whether an employer offers health insurance or not, relying on CHIP or Medicaid for children’s health care is not a degrading or offensive scenario worthy of substandard treatment by doctors’ offices.

The study concluded that policy interventions that encourage providers to accept patients with public insurance are needed to improve access to care.

I hope this fairness is on the horizon for children of all income levels.

Joan L. Benso is president and CEO, PA Partnerships for Children 

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