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Ohio study shows that insurance coverage is critical for children with special health care needs as they transition
1Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, Arkansas, USA. agoudie@uams.edu
Insights
Young adults with special health care needs face significant insurance gaps, leading to unmet medical needs and increased healthcare costs. Continuous health insurance is crucial for their well-being during the transition to adulthood.
Area of Science:
- Health Services Research
- Pediatrics
- Public Health
Background:
- Young adults with special health care needs (SHCN) experience a critical transition period regarding health insurance.
- Many lose coverage through Medicaid or parental plans as they age out, leading to significant insurance gaps.
Purpose of the Study:
- To examine the impact of health insurance status on unmet healthcare needs among young adults with SHCN.
- To compare insurance coverage and access to care for young adults with SHCN versus children with SHCN.
Main Methods:
- Analysis of health insurance coverage rates for young adults and children with SHCN in Ohio.
- Assessment of the relationship between insurance status and unmet healthcare needs, including prescription fulfillment and care access.
Main Results:
- Nearly 30% of young adults with SHCN in Ohio are uninsured, compared to 5% of children with SHCN.
- Uninsured young adults with SHCN are more likely to experience unmet needs, including forgoing prescriptions and delaying care.
- Even with insurance, young adults with SHCN face greater challenges accessing care compared to children with SHCN.
Conclusions:
- Continuous and adequate health insurance is vital for the well-being of individuals with SHCN as they transition into adulthood.
- Addressing insurance gaps for young adults with SHCN is essential to prevent unmet needs and reduce costly healthcare encounters.
Abstract:
Nearly 30 percent of young adults with special health care needs in Ohio lack health insurance, compared to 5 percent of the state's children with special health care needs. As children with such needs become too old for Medicaid or insurance through their parents' employer, they face great challenges in obtaining insurance. Lack of insurance is highly predictive of unmet needs, which in turn are predictive of costly hospital-based encounters. Young adults with special health care needs who are uninsured are more than twice as likely as their peers with insurance to forgo filling prescriptions and getting care and to have problems getting care. Even after insurance status is accounted for, young adults with special health care needs are more likely than children with such needs to not fill prescriptions because of cost and to delay or forgo needed care. This study demonstrates that continuous and adequate health insurance is vital to the continued well-being of children with special health care needs as they transition to young adulthood.
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