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One-Fourth Of Kids Lack Insurance

Almost one-fourth of the children in the United States lack health insurance coverage for significant periods during their first three years, endangering their health care, a federally funded study found.

Children who don’t have insurance are less likely to see a doctor when they’re sick and more likely to require hospitalization when seen in an emergency room, authors said.

Coverage gaps threaten even healthy children by discouraging preventive care such as immunizations, said authors led by Michael D. Kogan, an epidemiologist with the National Center for Health Statistics, part of the federal Centers for Disease Control and Prevention.

Impending Medicaid cuts will further erode coverage for young children - more of whom are poor than any other age group, a co-author said.

“I don’t think it’s going to get better. I think it’s going to get worse,” said Martha A. Teitelbaum, a senior health analyst for the Children’s Defense Fund, a children’s advocacy group based in Washington, D.C.

The 1991 study, involving 8,129 children, found that 22.6 percent went without health insurance for at least a month during their first three years, and nearly 60 percent of those children had gaps of six months or more.

The findings are published in today’s issue of The Journal of The American Medical Association.

“Gaps in insurance coverage create a more chaotic environment in which families are more hesitant to seek out and maintain a regular source of primary care,” said Dr. Stephen Berman of the University of Colorado Health Sciences Center in Denver, in an editorial accompanying the study.

From 1991 to 1993, over 3 million children lost private coverage, Berman said. Economic changes have shifted jobs away from higher-paying manufacturers with good health benefits to the lower-paying service sector with poorer benefits, he said.

A separate editorial agreed that Medicaid cuts are likely to harm youngsters, who have not fared well in federal or state budget battles.

The Republican-sponsored “MediGrant” proposal in Congress would throw poor children’s medical fates to the states, said editorialists led by Paul W. Newacheck of the University of California, San Francisco, School of Medicine.

Medicaid finances health care for one in every four children in the United States, the editorials noted.

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