Providing Health Insurance to Low-Income Children Improves Their Quality of Life

Providing low-income children with government-sponsored health insurance improves their quality of life as it expands their access to doctors and other health services, according to a RAND Corporation study issued today.

Studying families in California, researchers found that children newly enrolled in a public health insurance program reported improvements such as doing better in school, feeling better physically and getting along better with their peers, according to a study published in the September edition of the Journal of Pediatrics.

“Having an insurance card makes it easier to get care when you need it and getting that care makes you feel better,” said Michael Seid, a RAND psychologist and lead author of the study.

The RAND Health study is the first to show that children enrolled in a government program intended to provide more youngsters with health insurance improved their quality of life in addition to expanding their ability to receive health care.

“We as a society have invested a lot of money to provide insurance to kids and there is still doubt about whether the money is well spent,” Seid said. “This shows the public and policymakers that the money is making a difference in kids' lives. It makes a tremendous and important difference to kids to get the care they need.”

The study examined the State Children's Health Insurance Program, a federal effort that is the largest expansion of spending for children's health care since Medicaid was created. The federal program is scheduled to come before Congress for reauthorization in 2007.

Researchers found that ethnic disparities in access to health care were largely reduced by the State Children's Health Insurance Program.

At the point of enrollment, black and Latino parents were more likely than whites to report that during the previous year their children had foregone needed care and that they had trouble finding care for their children. However, by the end of the first year of enrollment in the State Children's Health Insurance Program, those differences were substantially reduced, according to researchers. Blacks experienced the highest rate of improvement in access.

Beginning in 2001, researchers studied 3,438 children age 2 to 16 who were enrolled in Healthy Families, which is the name of California's State Children's Health Insurance Program.

Parents completed surveys about use of health care and family characteristics, while both parents and children age 5 and older completed the PedsQL, a 23-item survey that measures issues related to children's quality of life. Families were surveyed when they enrolled in the insurance program, and after one and two years of coverage.

Overall, the number of parents who reported that their children went without needed care dropped sharply during the study. At the point of enrollment, about 16 percent of parents said their children had foregone needed health care in the previous year, which dropped to about 7 percent after two years. The number of parents who reported problems getting care for their children also dropped.

Children who had no reports of foregone care or problems getting care scored about 8 points higher on the quality of life survey – a difference that should be noticeable by doctors and others, according to researchers.

“We found a difference in the quality of life that kids and their parents noticed, and it's a change large enough for clinicians to notice as well,” Seid said. Children whose parents reported foregone care year after year had scores on their quality of life surveys that were similar to those seen among children who had recently begun treatment for cancer, according to the study.

Funding for the study was provided by the David and Lucille Packard Foundation. Other authors of the study are James W. Varni of Texas A&M University, Leslie Cummings of the California Managed Risk Medical Insurance Board, and Matthias Schonlau of RAND.

RAND Health, a division of the RAND Corporation, is the nation's largest independent health policy research program, with a broad research portfolio that focuses on quality, costs and delivery, among other topics.