Health Insurance and Access to Care for Children and Adolescents

Knowledge Path

 

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

Overview

Websites: resources from 12 key websites

  • Agency 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.
  • American 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 an actuarial analysis of net medical costs paid by insurers for physician services for children. Also see the Community Access to Child Health (CATCH) Program, the Healthy Tomorrows Partnership for Children Program, and the Community Pediatrics Grants Database.
  • Catalyst Center. Publications, data, presentations, and tutorials for policymakers, program administrators, and health professionals 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.
  • Center 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!
  • Commonwealth Fund. Health policy reports, data, maps, surveys, webinars, newsletters, and a blog on topics that include health insurance, state health policy and Medicaid, the ACA, health insurance premiums, and state health insurance marketplaces.
  • Families 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, and retention.
  • Insure 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.
  • Kaiser Family Foundation (KFF). Issue briefs, public polling statistics, graphics, and interactive tools about Medicaid and CHIP, health reform and the ACA, private insurance, and the uninsured. See KFF's State Health Facts and Kaiser Health News.
  • 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.
  • National 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 and CHIP 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.
  • Urban 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

Journal Articles and Other Literature and Research

  • PubMed. 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.

Programs

News and Commentary

  • Center for Children and Families: Say Ahhh! A Children's Health Policy Blog. This blog addresses current health care coverage issues for children and families.
  • Commonwealth 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 policy issues.
  • Families 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.
  • Kaiser 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

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.