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Letters |
Children And Compartmentalized Coverage: An Author Responds
I agree with Nina Owcharenko that addressing the health insurance needs of children should be considered in the context of both the family and the overall health care market. Recent data from the Medical Expenditure Panel Survey (MEPS) indicate that although 6 percent of low-income children were uninsured for the two years covered by the survey, close to 24 percent of their parents were continuously uninsured. We know that not only does insuring parents have clear benefits for parents, it also is associated with greater use of preventive care for children.1 However, the political will does not yet exist to address the larger problem of the uninsured, of whom 18 percent are children, 25 percent are parents, and 57.2 percent are childless adults.2
With reauthorization of the State Children’s Health Insurance Program (SCHIP), Congress has an opportunity to make it easier for states to maintain the employer-sponsored base of SCHIP-eligible families by altering the cost-effectiveness standards required to subsidize employer-sponsored coverage, removing administrative obstacles to doing so, and allowing states to provide wraparound coverage under SCHIP. Congress also can continue to allow states to cover parents under SCHIP, which will support keeping families in the same insurance system.
Finally, reforming the tax treatment of health insurance might be necessary to obtain fundamental health insurance reform. But it is unlikely that such a change would dramatically alter the face of the uninsured, the vast majority of whom have premiums that exceed 10 percent of their family income.3 Guaranteed subsidized access to affordable, accessible, and adequate health insurance—whether through a public program or the private market—will likely be necessary to solve the increasing problem of the uninsured in our nation.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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- A. Davidoff et al., "The Effect of Parents’ Insurance Coverage on Access to Care for Low-Income Children," Inquiry 40, no. 3 (2003): 254–268.[ISI][Medline]
- L. Dubay, J. Holahan, and A. Cook, "The Uninsured and the Affordability of Health Insurance Coverage," Health Affairs 26, no. 1 (2007): w22–w30 (published online 30 November 2006; 10.1377/hlthaff.26.1.w22).
[Abstract/Free Full Text] - Ibid.
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