THE AFFORDABLE CARE ACT: EFFECT OF NEW MEDICAID ELIGIBILITY LEVELS ON SPECIAL NEEDS CHILDREN’S ACCESS TO HEALTH CARE PROVIDERS

Abstract

The Affordable Care Act, design to provide expanded insurance coverage for many Americans, will increase the number of individuals enrolled in Medicaid. In April 2014, the Centers for Medicare and Medicaid Services reported that more than 3 million individuals were determined to be eligible for Medicaid. This influx of newly enrolled Medicaid patients could strain the capacity of and intensify the demand for the limited number of health care providers who currently treat and counsel Medicaid patients. Limited access to health care providers has the potential to disproportionally impact children with special health care needs due to this group’s variable, complex and chronic conditions that require numerous types of primary care providers, specialists, social and therapeutic services. Data from the National Survey of Children with Special Health Care Needs will be used to provide a profile of socio economic and demographic information of children with special health care needs over a ten year period. Review of insurance coverage from 2001-2010 shows that although nearly 90% percent of special needs children were insured, parents reported that the insurance coverage was inadequate. Using survey data from the Centers for Disease Control and Prevention’s National Health Interview Survey, this paper conducts a regression analysis to understand children’s ability to access specialists after health care reform. Four variables—0-year-old to 19- year-old Medicaid enrollees; 19-year-old to 26-year-old Medicaid enrollees; 0-year-old to 19-year-old Children’s Health Insurance Program enrollees; and 19-year-old to 26-yearold Children’s Health Insurance Program enrollees—were used to show that regardless of insurance type (Medicaid and Children’s Health Insurance Program), special needs young adults (19-26 years old) are more likely to see a health care provider than special needs children under 19 years old. In addition, special needs young adults that are covered under Children’s Health Insurance Program are more likely to see a health care provider than those covered under Medicaid. Overall, regardless of age, children covered under Children’s Health Insurance Program are more likely to see a health professional than children covered under Medicaid, particularly those age 19-26 years old. These results show that there is a need to consider the consequences of children transferring from Children’s Health Insurance Program to Medicaid and the potential impact on supply of health care specialists as demand increases.