HealthZette

Insured Kids Still Don’t Get Care

Even with coverage, our youngest citizens are not receiving medical attention

Few would argue that rising health care costs make it tough for many families to seek care. They may have insurance coverage with an employer, under Obamacare, or through any number of government programs — but they can’t afford the copays, and meeting deductibles has essentially gotten out of reach.

A new report from the Children’s Health Fund outlines that even with the development and expansions of Medicaid, the founding and reauthorization of the State Children’s Health Insurance Program (CHIP) and the Affordable Care Act (ACA), there are still 20.3 million children in the U.S. who lack access to essential health care.

One in four children still does not have access to essential health care, reportedly.

So one in four children still reportedly does not have access to essential health care, despite young people now having health insurance. Medicaid is the federal health insurance program specifically designed to support health care for poor children and people with disabilities.

The authors of the report say their findings “should be a call for immediate and focused attention to (a) identify the reasons for persistently poor levels of access to care; and (b) develop strategies that can close the access gaps that have defied existing policies and programs.”

No one wants to see any child go without necessary medical care. But the findings are somewhat misleading, according to Twila Brase, R.N., co-founder of Citizens’ Council for Health Freedom, a national patient-centered health freedom organization in St. Paul, Minnesota.

There is access to care and resources available, Brase told LifeZette. There are sometimes barriers that exist such as transportation challenges, language, and deductibles, she added. But the access is there. Children shouldn’t ever go without.

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Chart: Children’s Health Fund

“As an ER nurse for seven years and a pediatric nurse in a major school system for another seven years, I saw so many Medicaid parents who could have taken their children in for something, but didn’t,” she said.

The biggest challenge, according to Brase, may be that the very system these study authors call upon for help is where the problems arise.

Related: 8 Ways Obama Bends the Truth About Obamacare

“Medicaid pays so poorly that it actually costs doctors to provide services. For the kind of reimbursement a lot of doctors get, the paperwork to get the reimbursement costs more than the reimbursement they receive. This is why doctors choose not to see patients on Medicaid — they don’t want to actually lose money for taking care of this ‘covered’ population,” Brase said.

The government, she added, has essentially offered coverage without care.

“Imagine all the doctors who might take children if it wasn’t through Medicaid — if, for instance, they got a tax deduction or business deduction for providing charity care. There’s a report out now on the lack of dental care, because so many dentists say, ‘I don’t think so.’ It is not worth their time. Every dentist office would be open if they could take it as charity care. Then the parents would know this was charity care — which would mean they would decide to not make an appointment and then not come in, leaving a gaping hole in a doctor’s schedule where he’s just lost money because it’s not important to them. Right now, it’s an entitlement — so patients don’t care.”

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Or perhaps they are starting to care. The new report comes on the heels of another study last week showing fewer U.S. children are missing out on things like physicals and dental exams because so many more do have coverage.

Related: The Mental Health Crisis Facing Our Children

Steep declines in the number of uninsured have been well-documented, largely as a result of growth in Medicaid and CHIP, the study authors noted in the journal Pediatrics. The study offers fresh evidence kids are not only getting insured — they’re becoming more likely to receive the care they need.

“In addition to having improved insurance coverage, we showed that children’s utilization patterns improved, meaning that fewer children lacked well-child visits, or had unmet health needs as their gains in coverage improved,” study co-author Dr. Andrew Racine, a pediatrics researcher and chief medical officer for Montefiore Health System in New York City, told Reuters.