Health Insurance and Access to Care for Children and Adolescents
This knowledge path presents resources that analyze data, describe effective programs, and report on policy and research aimed at advancing health coverage and improving health care access for children and adolescents.
Resources for Professionals
Websites: resources from 12 key websites
for Healthcare Research and Quality (AHRQ).
Evidence-based information on health care outcomes;
quality; and cost, use, and access. See CHIPRA Children's Health Care Quality Measurement and Improvement Activities for resources related to the quality provisions of the Children's Health Insurance Program Reauthorization Act (CHIPRA). Also see the Child
Health Insurance Research Initiative (CHIRI) for research
findings for policymakers to help them improve
access to and quality of health care for children
and adolescents from families with low incomes.
Academy of Pediatrics (AAP). Publications
and tools for health professionals and advocates
at the federal, state, and community
levels to improve access to care for children
and adolescents. Topics include implementation
of the ACA at the federal and state levels,
the ACA's essential
health benefits, CHIP, Medicaid, Medicaid
payment rates, and enrollment. Resources include
analysis of net
medical costs paid by insurers
for physician services for
children. Also see the Community
Access to Child Health (CATCH) Program,
Tomorrows Partnership for Children
Program, and the Community
Pediatrics Grants Database.
Publications, data, presentations, and tutorials
for policymakers, program administrators, and
about improving health care coverage and financing
for children and adolescents
with special health care needs. Presents strategies
to cover more children and adolescents, close
benefit gaps, pay for additional services,
and build capacity.
for Children and Families (CCF). Analyses
of policy developments and implementation efforts
related to Medicaid, CHIP, and the ACA. See
CCF's blog, Say Ahhh!
Fund. Health policy reports, data, maps, surveys,
and a blog on
topics that include health insurance, state
health policy and Medicaid, the ACA, health
insurance premiums, and state health insurance
USA. Background information, issue
briefs, fact sheets, charts, state news, advocacy
tools, a blog,
and e-news for
advocates and policymakers about Medicaid,
CHIP, CHIPRA, the uninsured, and the
ACA. Topics include outreach, enrollment, eligibility,
Kids Now: For Professionals. Information,
policy guidance, and data about Medicaid and
CHIP. Includes state participation rates, information about state eligibility and enrollment options, and tools to support the outreach and
enrollment initiative, Connecting Kids to Coverage.
Family Foundation (KFF). Issue briefs,
public polling statistics, graphics, and interactive
about Medicaid and CHIP, health reform and
the ACA, private insurance, and the uninsured. See KFF's State Health Facts and Kaiser Health
- Medicaid.gov. Information
about Medicaid, CHIP, and the ACA, including federal policy guidance and state-specific
program information and data. Topics include benefits, cost sharing, delivery
systems, eligibility, financing and reimbursement, managed care,
outreach and enrollment, and quality of care. Includes tools to help support outreach and enrollment efforts that covers eligibility for Medicaid and CHIP, benefits of both programs, and how individuals can enroll. Also
presents an overview of
the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit,
which provides comprehensive health services for infants, children, and adolescents
enrolled in Medicaid.
Academy for State Health Policy (NASHP).
State policy and program information and analysis,
research, and tools about health insurance
coverage, access to care, and the ACA and state
health reform. See fact
sheets about each state's CHIP program.
Also see Maximizing
Enrollment, an initiative to increase enrollment
and retention of eligible children into Medicaid
programs and to establish and promote best
practices among states.
- National Disability Navigator Resource Collaborative (NDNRC). Information to assist Navigators and other health insurance enrollment specialists in helping people with disabilities and their families obtain accurate information when selecting and enrolling in insurance through the ACA Marketplaces.
Institute (UI): Health Policy Center.
Research and analysis about health insurance
coverage, access to care, and use of health
care services. Presents a wealth of publications
and statistics on topics that include private
insurance, the uninsured, Medicaid and CHIP,
disability and long-term care, vulnerable populations,
and state and federal health reform.
Data and Statistics
and Other Literature and Research
Citations and abstracts for biomedical articles indexed by the National
Library of Medicine (NLM), with links to full-text articles when
available. Type "health services
accessibility" OR "insurance coverage" in
the search box. Click on Search. Use the filters in the left sidebar
to further narrow your search. Click on Show additional
filters and select Ages: Child (birth-18 years). Under Search
fields, click on Choose; select MeSH Major Topic; and Apply. Also, under Publication dates, select a limit (e.g., 5 years).
You may further limit your search by selecting an article type or using the MeSH
(Medical Subject Headings) database to identify additional
search terms (e.g.,("health services
accessibility" OR "insurance coverage") AND "dental
care"). Also see Access to Health Services, a set of automated PubMed searches related to the Healthy
People 2020 objectives that were developed by the Partners
in Information Access for the Public Health Workforce. After you click on the search button, you can limit the results by age (i.e., Child: birth-18 years) using the search filters in the left navigation bar.
- Also see NCEMCH resource brief, Maternal and Child Health Literature and Research Databases.
News and Commentary
for Children and Families: Say Ahhh! A Children's
Health Policy Blog. This blog addresses current health care coverage issues for children and families.
Fund. A set
of newsletters addresses health reform, health
care quality, state health policy, federal
health policy, and new Commonwealth
Fund resources. The Commonwealth
Fund Blog presents analysis and commentary
about health reform and other pressing health
USA. The Families USA Blog offers analysis
and commentary about the ACA, children's
health, Medicaid, and other health policy topics.
Sign up for the Health
Action Network for e-mail updates with
information and action steps on Medicaid, Medicare,
children's health, private insurance, and other
important health care developments.
Health News. Coverage of health
policy issues and developments at the federal
and state levels and trends in the delivery
of health care and in the marketplace. Presents
daily summaries of major health care news from
across the nation, as well as videoclips
and commentary on topics that
include health reform, Medicaid, and the uninsured.
NCEMCH Guides on Related Topics
- Children and Youth with Special Health Care Needs knowledge path, family resource brief, school resource brief
- Community Services Locator: An Online Directory for Finding Community Services for Children and Families knowledge path
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid knowledge path, family resource brief
- Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents knowledge path, family resource brief, school resource brief
- Patient Protection and Affordable Care Act (ACA) professional resource brief, family resource brief
- Racial and Ethnic Disparities in Health knowledge path, family resource brief
Resources for Families
See NCEMCH family resource brief, Health Insurance and Access to Care for Kids and Teens
Resources for Schools
See NCEMCH school resource brief, School-Based and School-Linked Care
Health Insurance and Access to Care for Children and Adolescents:
Knowledge Path, 7th ed. (October
2013). (Updated: August 2014).
Author: Susan Brune Lorenzo, M.L.S., NCEMCH.
Contributor: Tracy Lopez, M.S.L.S., NCEMCH.
Reviewers: Rochelle Baer, L.C.S.W., University of Miami Leadership Education in Neurodevelopmental Disabilities (LEND); Ellen K. Bowser, M.S., R.D., L.D./N, R.N., University of Florida Pediatric Pulmonary Center Leadership Training Program; Cara de la Cruz, Ph.D., M.P.H., University of South Florida College of Public Health MCH Leadership Training Program; Susan Horky, M.S.W, L.C.S.W., University of Florida Pediatric Pulmonary Center Leadership Training Program; Jennifer Marshall, Ph.D., M.P.H., University of South Florida College of Public Health MCH Leadership Training Program; Angela Miney, B.A., University of Florida Pediatric Pulmonary Center Leadership Training Program; Anthony Panzera, M.P.H., University of South Florida College of Public Health MCH Leadership Training Program; Olivia K. Pickett, M.A., M.L.S., NCEMCH; Michelle Schladant, Ph.D., University of Miami Leadership Education in Neurodevelopmental Disabilities (LEND); Maria Toro, B.A., University of Miami Leadership Education in Neurodevelopmental Disabilities (LEND).
Editor: Ruth Barzel, M.A., NCEMCH.