Health Insurance and Access to Care for Children and Adolescents
Professional Resource Guide
This professional resource guide presents resources that analyze data, describe effective programs, and report on policy and research aimed at advancing health coverage and improving health care access for children and adolescents.
Resources for Professionals
- See Child Health USA 2012 (2013) by the Maternal and Child Health Bureau. The section Health Services Financing and Utilization presents narrative, graphs, and data about children's and adolescents' health insurance coverage and use of health services.
- See Health Coverage of Children: The Role of Medicaid and CHIP (2012) by the Kaiser Family Foundation (KFF). This fact sheet describes how Medicaid and the Children's Health Insurance Program (CHIP) provide health insurance coverage and access to health care for over one-third of infants, children, and adolescents in the United States.
- See Health Care Reform and Children: Planning and Design Considerations for Policymakers (2013) by the National Academy for State Health Policy (NASHP). This report describes some of the challenges for children's coverage under the Patient Protection and Affordable Care Act (ACA) and steps state policymakers can take to diminish negative consequences for outreach, eligibility, enrollment, affordability, access to providers appropriate for children and adolescents, and access to appropriate benefits.
2. Websites: resources from 12 key websites
- Agency for Healthcare Research and Quality (AHRQ). Evidence-based information on health care outcomes; quality; and cost, use, and access. See CHIPRA Children's Health Care Quality Measurement and Improvement Activities for resources related to the quality provisions of the Children's Health Insurance Program Reauthorization Act (CHIPRA). Also see the Child Health Insurance Research Initiative (CHIRI) for research findings for policymakers to help them improve access to and quality of health care for children and adolescents from families with low incomes.
- American Academy of Pediatrics (AAP). Publications and tools for health professionals and advocates at the federal, state, and community levels to improve access to care for children and adolescents. Topics include implementation of the ACA at the federal and state levels, the ACA's essential health benefits, CHIP, Medicaid, Medicaid payment rates, and enrollment. Resources include an actuarial analysis of net medical costs paid by insurers for physician services for children. Also see the Community Access to Child Health (CATCH) Program, the Healthy Tomorrows Partnership for Children Program, and the Community Pediatrics Grants Database.
- Catalyst Center. Publications, data, presentations, and tutorials for policymakers, program administrators, and health professionals about improving health care coverage and financing for children and adolescents with special health care needs. Presents strategies to cover more children and adolescents, close benefit gaps, pay for additional services, and build capacity.
- Center for Children and Families (CCF). Analyses of policy developments and implementation efforts related to Medicaid, CHIP, and the ACA. See CCF's blog, Say Ahhh!
- Commonwealth Fund. Health policy reports, data, maps, surveys, webinars, newsletters, and a blog on topics that include health insurance, state health policy and Medicaid, the ACA, health insurance premiums, and state health insurance marketplaces.
- Families USA. Background information, issue briefs, fact sheets, charts, state news, advocacy tools, a blog, and e-news for advocates and policymakers about Medicaid, CHIP, CHIPRA, the uninsured, and the ACA. Topics include outreach, enrollment, eligibility, and retention.
- Insure Kids Now: For Professionals. Information, policy guidance, and data about Medicaid and CHIP. Includes state participation rates, information about state eligibility and enrollment options, and tools to support the outreach and enrollment initiative, Connecting Kids to Coverage.
- Kaiser Family Foundation (KFF). Issue briefs, public polling statistics, graphics, and interactive tools about Medicaid and CHIP, health reform and the ACA, private insurance, and the uninsured. See KFF's State Health Facts and Kaiser Health News.
- Medicaid.gov. Information about Medicaid, CHIP, and the ACA, including federal policy guidance and state-specific program information and data. Topics include benefits, cost sharing, delivery systems, eligibility, financing and reimbursement, managed care, outreach and enrollment, and quality of care. Includes tools to help support outreach and enrollment efforts that covers eligibility for Medicaid and CHIP, benefits of both programs, and how individuals can enroll. Also presents an overview of the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, which provides comprehensive health services for infants, children, and adolescents enrolled in Medicaid.
- National Academy for State Health Policy (NASHP). State policy and program information and analysis, research, and tools about health insurance coverage, access to care, and the ACA and state health reform. See fact sheets about each state's CHIP program. Also see Maximizing Enrollment, an initiative to increase enrollment and retention of eligible children into Medicaid and CHIP programs and to establish and promote best practices among states.
- National Disability Navigator Resource Collaborative (NDNRC). Information to assist Navigators and other health insurance enrollment specialists in helping people with disabilities and their families obtain accurate information when selecting and enrolling in insurance through the ACA Marketplaces.
- Urban Institute (UI): Health Policy Center. Research and analysis about health insurance coverage, access to care, and use of health care services. Presents a wealth of publications and statistics on topics that include private insurance, the uninsured, Medicaid and CHIP, disability and long-term care, vulnerable populations, and state and federal health reform.
3. Reports, Briefs, and Other Electronic Resources: from the MCH Digital Library's catalog
- The MCH Digital Library has a large collection of items about health insurance and access to care for children and adolescents. To view a broad sample of these items, do an automated search of the library's online catalog, MCHLine®. For a more comprehensive search or to identify items on related topics, search MCHLine® using our online search form. Use the keyword field and set publication date limits. Suggested keywords (to be used individually or in combination with one or two other keywords): "health insurance", "access to health care", children, adolescents, barriers, eligibility, enrollment, "children's health insurance program", Medicaid, "health care reform", "affordable care act". Include quotation marks as indicated.
4. Data and Statistics
- Search the following databases for access to data and
statistics about health insurance and access to care for children and adolescents. The MCH Digital Library resource brief Maternal and Child Health Data and Statistics describes these databases and offers tips for searching them.
Data Resource Center for Child and Adolescent Health (DRC)
Health Resources and Services Administration (HRSA): Area Resource File (ARF)
Medical Expenditure Panel Survey (MEPS)
State Health Access Data Assistance Center (SHADAC)
State Health Facts
5. Journal Articles and Other Literature and Research
- PubMed. Citations and abstracts for biomedical articles indexed by the National Library of Medicine (NLM), with links to full-text articles when available. Type "health services accessibility" OR "insurance coverage" in the search box. Click on Search. Use the filters in the left sidebar to further narrow your search. Click on Show additional filters and select Ages: Child (birth-18 years). Under Search fields, click on Choose; select MeSH Major Topic; and Apply. Also, under Publication dates, select a limit (e.g., 5 years). You may further limit your search by selecting an article type or using the MeSH (Medical Subject Headings) database to identify additional search terms (e.g.,("health services accessibility" OR "insurance coverage") AND "dental care"). Also see Access to Health Services, a set of automated PubMed searches related to the Healthy People 2020 objectives that were developed by the Partners in Information Access for the Public Health Workforce. After you click on the search button, you can limit the results by age (i.e., Child: birth-18 years) using the search filters in the left navigation bar.
- Also see the MCH Digital Library resource brief, Maternal and Child Health Literature and Research Databases.
Academy of Pediatrics (AAP). Programs to improve access to health care.
Community Access to Child Health (CATCH) Program.
Healthy Tomorrows Partnership for Children Program.
Community Pediatrics Grants Database.
- Insure Kids Now: Learn About Programs in Your State. Information about each state's CHIP and Medicaid program.
- Also see the MCH Digital Library resource brief, Maternal and Child Health Programs Databases.
7. News and Commentary
- Center for Children and Families: Say Ahhh! A Children's Health Policy Blog. This blog addresses current health care coverage issues for children and families.
- Commonwealth Fund. A set of newsletters addresses health reform, health care quality, state health policy, federal health policy, and new Commonwealth Fund resources. The Commonwealth Fund Blog presents analysis and commentary about health reform and other pressing health policy issues.
- Families USA. The Families USA Blog offers analysis and commentary about the ACA, children's health, Medicaid, and other health policy topics. Sign up for the Health Action Network for e-mail updates with information and action steps on Medicaid, Medicare, children's health, private insurance, and other important health care developments.
- Kaiser Health News. Coverage of health policy issues and developments at the federal and state levels and trends in the delivery of health care and in the marketplace. Presents daily summaries of major health care news from across the nation, as well as videoclips and commentary on topics that include health reform, Medicaid, and the uninsured.
8. MCH Digital Library Guides on Related Topics
- Children and Youth with Special Health Care Needs professional resource guide, family resource brief, school resource brief
- Community Services Locator: An Online Directory for Finding Community Services for Children and Families professional resource guide
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid professional resource guide, family resource brief
- Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents professional resource guide, family resource brief, school resource brief
- Patient Protection and Affordable Care Act (ACA) professional resource brief, family resource brief
- Racial and Ethnic Disparities in Health professional resource guide, family resource brief
Resources for Families
See the MCH Digital Library family resource brief, Health Insurance and Access to Care for Kids and Teens.
Resources for Schools
See the MCH Digital Library school resource brief, School-Based and School-Linked Care
Please provide feedback on this professional resource guide.
Health Insurance and Access to Care for Children and Adolescents: Professional Resource Guide, 7th ed. (October
2013). (Updated: August 2014).
Author: Susan Brune Lorenzo, M.L.S., MCH Digital Library.
Contributor: Tracy Lopez, M.S.L.S., MCH Digital Library.
Reviewers: Rochelle Baer, L.C.S.W., University of Miami Leadership Education in Neurodevelopmental Disabilities (LEND); Ellen K. Bowser, M.S., R.D., L.D./N, R.N., University of Florida Pediatric Pulmonary Center Leadership Training Program; Cara de la Cruz, Ph.D., M.P.H., University of South Florida College of Public Health MCH Leadership Training Program; Susan Horky, M.S.W, L.C.S.W., University of Florida Pediatric Pulmonary Center Leadership Training Program; Jennifer Marshall, Ph.D., M.P.H., University of South Florida College of Public Health MCH Leadership Training Program; Angela Miney, B.A., University of Florida Pediatric Pulmonary Center Leadership Training Program; Anthony Panzera, M.P.H., University of South Florida College of Public Health MCH Leadership Training Program; Olivia K. Pickett, M.A., M.L.S., MCH Digital Library; Michelle Schladant, Ph.D., University of Miami Leadership Education in Neurodevelopmental Disabilities (LEND); Maria Toro, B.A., University of Miami Leadership Education in Neurodevelopmental Disabilities (LEND).
Editor: Ruth Barzel, M.A., MCH Digital Library.