Twenty Million U.S. Children Lack Access to Essential Health Care

Twenty Million U.S. Children Lack Access to Essential Health Care

Twenty-eight percent of children in the United States — including those who have health insurance — lack sufficient access to essential health care, a report from the Children's Health Fund finds.

The report, Unfinished Business: More Than 20 Million Children in the U.S. Still Lack Sufficient Access to Essential Health Care (24 pages, PDF), found that more than 20 million children under the age of 18 are either uninsured (3.3 million), insured but do not receive regular primary care (10.3 million), or are publicly insured and have access to primary care but do not receive essential and timely specialty care. In addition to discontinuous insurance coverage, barriers to better healthcare access include high co-payments, deductibles, and prescription drug costs; lack of transportation; and parents' limited English proficiency and/or difficulty navigating complex coverage eligibility language.

To ensure sufficient access to health care for all children, the report calls for amending the Affordable Care Act to eliminate financial barriers to coverage as well as federal and state policies to reduce or eliminate co-pays, premiums, cost-sharing, and out-of-pocket costs for lower-income families; increasing subsidies; and increasing public insurance reimbursement rates for providers. The report also recommends creating incentives for providers to practice in poor communities; boosting the number of Federally Qualified Health Centers and Rural Health Clinics as well as school-based health services; improving transportation options for low-income patients;  addressing health illiteracy; and increasing reimbursement for translation and interpreter services.

"While children's health care has experienced increased and significant attention in recent years, our analyses show there is still a long way to go before we can claim that all U.S. children have access to the care they need," said Irwin Redlener, CHF co-founder and president and the paper's lead author. "There has been a persistent misconception that simply providing health insurance is the same as assuring effective access to appropriate health care. It isn't. Although Medicaid, the Children's Health Insurance Program, and most recently the Affordable Care Act  insure more children than ever before, millions of kids are not getting the care they need."