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. 2022 Jul 29;11(3):22799036221102492.
doi: 10.1177/22799036221102492. eCollection 2022 Jul.

Children's health insurance coverage and adequacy from 2016 to 2018: Racial/ethnic disparities under the ACA

Yuying Shen  1 , Carlene Buchanan Turner  1 , Robert K Perkins  1 , Ami Moore  2
Affiliations

Children's health insurance coverage and adequacy from 2016 to 2018: Racial/ethnic disparities under the ACA

Yuying Shen et al. J Public Health Res. .

Abstract

Background: This study advances health disparities research by documenting the racial/ethnic disparities in children's health insurance coverage and health insurance adequacy under the implementation and revisions of the Affordable Care Act between 2016 and 2018 in America.

Design and methods: Combining the nation-wide repeated cross-sectional data from 2016 to 2018 Children's Health National Survey (NSCH), we examined the changes and trends of health insurance coverage and health insurance adequacy among children age 0-17 across different racial/ethnic groups from 2016 to 2018. Multivariate logistic regression models stratified by race-ethnicity were further analyzed to examine the association between children's health insurance adequacy, their health insurance coverage, and their socio-demographic background factors.

Results: Our analyses indicate that generally children's enrollment in Medicaid or other government aided health care programs had been increasing whereas children's enrollment in the employer-based had been decreasing from 2016 to 2018. At the same time, the number of children who said that they always had adequate health insurance to meet their health care needs has slightly dropped from 2016 to 2018, except for AIAN children. Our analyses further revealed that the risk of inadequate health insurance appears to be stronger for children in disadvantaged situation, socially and economically.

Conclusions: The ACA has contributed to expanding childhood health insurance coverage. But racial/ethnic disparities continue to exist in children's health insurance coverage and health insurance adequacy. To achieve equity in childhood health care, more outreach and appropriate programs are needed for children who are socially and economically disadvantaged.

Keywords: Affordable Care Act; children; health insurance adequacy; health insurance coverage; race/ethnicity.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Percentage of children uninsured by race/ethnicity, 2016–2018 (NSCH 2016–2018, N = 102,341).
Figure 2.
Figure 2.
Percentage of children with adequate insurance by race/ethnicity, 2016–2018 (NSCH 2016–2018, N = 102,341).
Figure 3.
Figure 3.
Percentage of children’s health insurance coverage by race/ethnicity, 2016–2018 (NSCH 2016–2018, N = 102,341).
See this image and copyright information in PMC

References

    1. Buchmueller TC, Levinson ZM, Levy HG, et al. Effect of the Affordable Care Act on racial and ethnic disparities in health insurance coverage. Am J Public Health 2016; 106(8): 1416–1421. - PMC - PubMed
    1. Cockerham WC. Medical sociology. New York: Routledge, 2017.
    1. Griffith K, Evans L, Bor J. The Affordable Care Act reduced socioeconomic disparities in health care access. Health Aff 2017; 36(8): 1503–1510. - PMC - PubMed
    1. Artiga S, Hill L, Orgera K, et al. Health coverage by race and ethnicity, 2010-2019. San Francisco, CA: Kaiser Family Foundation, 2021.
    1. Martinez ME, Ward BW. Health care access and utilization among adults aged 18-64, by poverty level: United States, 2013-2015. NCHS Data Brief No. 262. Hyattsville, MD: National Center for Health Statistics, 2016. - PubMed

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