BEYOND THE NUMBERS
Children are much likelier to receive preventive care when their parents enroll in health coverage, new research published in the American Academy of Pediatrics’ journal finds. Low-income children with parents enrolled in Medicaid are 29 percentage points likelier to get an annual well-child visit. This new finding supplements previous research identifying other ways in which expanding health coverage to parents helps children, such as by increasing Medicaid enrollment among eligible children, increasing insured children’s use of other health services, and reducing child poverty.
Well-child visits are recommended annually for children ages 3 and up, more frequently for infants and toddlers. They include screening for problems in a child’s growth and development, immunizations, and guidance for parents. Previous research shows that children receiving well-child visits are likelier to complete immunization schedules and less likely to have avoidable hospitalizations.
The new study capitalizes on a natural experiment afforded by several states’ decisions in the early 2000s to expand Medicaid eligibility for low-income parents. Between 2001 and 2013, the average Medicaid eligibility threshold for parents rose from roughly 74 percent to 108 percent of the federal poverty line (from $15,110 in annual income for a family of three to $22,050, in 2017 dollars). Over that period, the share of low-income children receiving an annual well-child visit rose from one-third to nearly half. The new study sought to isolate and estimate the impact of Medicaid expansion and enrollment among parents on children’s increased use of preventive services.
The study’s authors offer several reasons why parents’ enrollment in Medicaid could increase their children’s use of preventive services, though this issue lay beyond the scope of their analysis. By gaining coverage themselves, for instance, parents may become more adept and comfortable in the health care system.
There’s still considerable room for progress in ensuring that children get regular well-child visits, particularly among those in low-income families or rural areas. Recent legislative and administrative actions, however, threaten Medicaid coverage for low-income parents. Bills to repeal the Affordable Care Act (ACA) would eliminate its Medicaid expansion for low-income adults and cap federal funding per beneficiary for all of Medicaid, likely prompting states to make significant cuts to parents’ (and children’s) eligibility. More recently, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma said that CMS will let states impose work requirements as a condition of Medicaid eligibility and make other changes that would erect barriers to Medicaid enrollment for parents. The findings of this study suggest that restricting parents’ Medicaid coverage would reduce children’s use of preventive services.