Since 1997, the national program known as the State Children's Health Insurance Program (SCHIP) has provided health insurance to low-income children who are not eligible for Medicaid and do not have private coverage. Under the Federal law, states received grants of Federal dollars to help with costs of insurance expansions, and had several options for how to expand coverage for children using those dollars. New York received approval to use the Child Health Plus, which was created in New York in 1991.
More than 6 million children are affected by asthma every year in the U.S. Low income and minority children have higher rates of asthma and are less likely to receive preventative asthma care. Peter Szilagyi, M.D., M.P.H., chief of general pediatrics at the hospital and professor of pediatrics at the University of Rochester Medical Center, led the study because little is known about the impact of health insurance on asthma care.
Parents said that their children's asthma improved after enrolling in SCHIP. Unmet needs for prescriptions, and specialty, preventative and acute care also dropped dramatically after enrollment. Parents reported that they had an easier time getting a medical professional on the phone for advice and in scheduling appointments. Travel times to appointments decreased.
"Children had less scattering of care, meaning that they saw the same health care providers over time. At the same time, children did not require more high-cost specialty, emergency or hospital services," Szilagyi said. "In fact, rates for those expensive services dropped, perhaps because they were now receiving better healthcare at their primary care provider's office."
Parents also cited that their child's asthma care improved because they were able to afford medications they were not able to buy before enrollment.
"This study points out the definitive success and need of the State Children's Health Insurance Program (SCHIP). Earlier studies by this research group showed that the program improves access and continuity of health care for children in general, and also reduces the preexisting racial/ethnic gap in access and continuity of healthcare," Szilagyi said. "Now it is important to know that SCHIP also improved the healthcare of children with asthma, a group that is particular vulnerable to poor health outcomes.
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