Continuous Medicaid Eligibility, Child Insurance, and Health Care Use.

Area of Science:

• Child Health Policy
• Health Services Research
• Public Health

Background:

• Health insurance gaps are prevalent among publicly insured children, impacting healthcare access and overall health.
• The COVID-19 public health emergency (PHE) led to a halt in Medicaid disenrollments, creating a unique opportunity to study continuous coverage.
• Understanding the effects of continuous Medicaid eligibility is crucial for improving child health outcomes.

Purpose of the Study:

• To evaluate the impact of continuous Medicaid eligibility on health insurance coverage gaps in children.
• To assess the effect of continuous Medicaid eligibility on healthcare access and utilization.
• To examine the association between continuous Medicaid eligibility and children's general health status.

Main Methods:

• Utilized data from the 2016-2022 National Survey of Children's Health (n=182,910).
• Employed a difference-in-differences approach to compare changes before and during the PHE.
• Analyzed health insurance coverage, unmet healthcare needs, healthcare use (preventive care, ED visits), and general health status, with subgroup analyses by age and special health care needs.

Main Results:

• Continuous Medicaid eligibility was linked to a 3.1 pp decrease in health insurance coverage gaps.
• A 3.9 pp reduction in emergency department (ED) use was observed among publicly insured children.
• Children with special health care needs (CSHCN) experienced a greater decrease in ED use (-7.5 pp) and a 6.4 pp increase in excellent general health status.

Conclusions:

• Policies ensuring continuous Medicaid eligibility can enhance child healthcare use and health by providing consistent coverage.
• These findings are particularly significant for children with special health care needs (CSHCN).
• Continuous eligibility represents a promising strategy for improving health equity and outcomes for vulnerable children.