Medicaid and the Children’s Health Insurance Program (CHIP)have played a critical role in ensuring access to health insurance coverage among children and have been particularly important sources of coverage for rural children. More than 35.5 million children were enrolled in Medicaid or CHIP in September 2016—accounting for just over half of total Medicaid and CHIP enrollment. Given the large proportion of rural children covered by public insurance, it is critically important to understand the role of public health insurance in ensuring access to affordable health care for rural children. Using data from the 2011-2012 National Survey of Children’s Health, researchers from the Maine Rural Health Research Center examined rural-urban differences in children’s access to care, and their families’ perceived affordability of that care among those enrolled in Medicaid or CHIP and those covered by private insurance. Findings indicate that public coverage supported access to care for low-income rural children and low-income rural families reported fewer problems paying medical bills for their child’s care. CHIP reauthorization in 2017 is an important step in protecting low-income rural children’s access to affordable health care. In the event that CHIP funding ends, even those families that successfully transition to private health insurance are likely to face greater challenges in affording care for their children. Rural children who gain coverage through Qualified Health Plans in the Marketplace or who move into employer-sponsored insurance after losing public insurance will likely experience higher out-of-pocket costs compared with their experience in CHIP.
For more information on this study, please contact Erika Ziller, PhD
Suggested Citation: Ziller EC, Lenardson JD, Burgess AR. The Role of Public Versus Private Health Insurance in Ensuring Health Care Access & Affordability for Low-Income Rural Children. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; January, 2017. PB-67.