Kentucky study highlights harms from disruptions in children's Medicaid coverage

New research being presented at the 2017 Pediatric Academic Societies Meeting suggest that when children lose state Medicaid coverage even for a short time, they are likely to go without needed health care, or to receive care in resource-intensive setting such as emergency departments rather than less expensive primary care offices.

The study abstract, "When the Prodigal Son Returns: Impact of Short-Term Coverage Loss for Low-Income Children," will be presented Monday, May 8, at the Moscone West Convention Center in San Francisco.

"With the potential repeal of the Affordable Care Act, which expanded Medicaid coverage to many low-income Americans, it's important to gauge the impact it might have on low-income children and on associated social costs," said lead author John Myers, PhD, MSPH, a professor of pediatrics at the University of Louisville School of Medicine.

The research team examined Kentucky Medicaid records from 2014 to evaluate the impact on children's healthcare when they lost coverage in the program for at least 45 days. Reasons for coverage loss weren't identified, but may have been due to loss of eligibility, for example, or transitions between public and private coverage. They found that a total of 37,118 (24 percent) of children enrolled in Kentucky Medicaid lost coverage in 2014.

Adjusting for demographic factors such as socio-economic status, the researchers compared children who were continuously insured during the year with those who'd had disrupted coverage. They found that those with disruption in were more than 3 times more likely to have visited an emergency department and nearly 5 times more likely to have an unmet health care need.

"Gaps in is a reality for many low-income children," Dr. Myers said. "A better understanding of the downstream effects of these disruptions on the health of children who experience them is needed, especially since our results suggest they may lead to unmet needs and sicker , along with costlier care when it is provided."


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