HealthDay News — Underinsurance is increasing among children, mainly due to rising insurance inadequacy, according to a study published online Dec. 6 in Pediatrics.

Justin Yu, M.D., from the UPMC Children’s Hospital of Pittsburgh, and colleagues describe the percentage of children lacking continuous and adequate health insurance (underinsurance) from 2016 to 2019 using data from the National Survey of Children’s Health.

The researchers found an increase in the proportion of U.S. children experiencing underinsurance, from 30.6 to 34.0 percent from 2016 to 2019, representing an additional 2.4 million children. The trend was mainly attributed to rising insurance inadequacy (24.8 to 27.9 percent); this was predominantly reported as unreasonable out-of-pocket medical expenses. There was an increase in children lacking continuous insurance coverage (from 8.1 to 8.7 percent), but this was not significant. Among White and multiracial children, those living in households with income ≥200 percent of the federal poverty limit, and those with private health insurance, there was a statistically significant increase in underinsurance. Significant associations were seen for increased child health complexity and private insurance with experiencing underinsurance (adjusted odds ratios, 1.9 and 3.5, respectively).


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“Our data, demonstrating a shift from public to private insurance that is more likely to be inadequate, in conjunction with existing literature linking Medicaid/Children’s Health Insurance Program coverage with improved access to medical care as well as improved long-term outcomes in adulthood, should give policy makers and payers pause as they contemplate strategies to improve child health,” the authors write.

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