Medicaid And Beyond

PROLOGUE: Addressing the continuing disparities in access tohealth care and insurance coverage is likely to be at the topof policymakers’ to-do list in the coming year. The papersin this section focus on the interaction between public andprivate insurance and how well public programs—particularlyMedicaid—maintain a safety net for poor children, especiallyin light of recent welfare reforms.

Medicaid covers nearly half of poor people; one of every fivechildren in America are eligible. The 1996 federal welfare reformlaw delinked Medicaid enrollment from welfare participation.Karl Kronebusch examines the impact of reform using a uniquemethodology; his results indicate large declines in Medicaidenrollment, with approximately a million fewer poor childrenenrolled in the program after welfare reform.

But does having insurance coverage assure that low-income childrenget the health care they need? Not necessarily, according toLisa Dubay and Genevieve Kenney. They found that children withMedicaid and private insurance coverage have comparable accessto care. However, Medicaid enrollees may be better served, bemore likely to receive services, have more visits when theyreceive care, and get a wider range of services, such as preventiveand dental care, than their privately insured counterparts.

Alternative settings, such as schools, may be one way of improvingaccess and delivery of health services to poor children. JamesMorone, Elizabeth Kilbreth, and Kathryn Langwell examine theimpact of school-based health centers (SBHCs), which provideprimary and acute care, mostly to poor children and teens. Theyconclude that the centers have overcome myriad political andeconomic obstacles, successfully putting health care where thekids are. The authors believe that the SBHCs could serve asa new model for age-old problems.

What's this?

Home

Current Issue

Covering Kids

PROLOGUE

Medicaid And Beyond