Parents' Report of Their Children's Underinsurance Status After the Affordable Care Act

Document Type

Article

Publication Date

1-1-2021

Abstract

Objective: To determine the prevalence and correlates of children's underinsurance pre- and post-implementation of the Affordable Care Act (ACA). Study Design: A cross-sectional survey of a convenience sample of 5043 parents of children greater than 6 months old who had health insurance in the previous 12 months. Respondents completed the Medical Expenses for Children Survey. Pre-ACA data were collected in summer/fall of 2009 to 2011 (n = 3966); post-ACA data were collected in summer/fall 2016 (n = 1077). All data were collected within the Southwestern Ohio Ambulatory Research Network (SOAR-Net). Results: Some study parents (16.3%) were unable to follow at least 1 recommendation of their child's pediatrician due to their inability to pay for it, and 17.3% reported it had become more difficult to obtain “needed health care” in the past 3 years. Factors associated with underinsurance after adjusting for demographic factors did NOT include pre/post-ACA, but did include annual household income < $50,000 (adjusted odds ratio [AOR] = 2.71; 95% CI, 2.15-3.40). Poor child health was also a significant risk factor for underinsurance(AOR = 3.71; 95% CI, 2.61-5.29). Conclusions: About 1 in 6 study children were underinsured. The ACA did not affect the underinsurance rate. Parents continued to report that it had become more difficult to obtain needed health care over the past 3 years post-ACA. About one third of study parents consistently reported that the health of their underinsured child had suffered because they could not afford to pay for their child's health care.

DOI

10.3122/jabfm.2021.01.200036

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