A health safety net for undocumented children works, according to a study


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For some low-income, undocumented children, they may not see a doctor or nurse when they are sick.

Going through childhood without health coverage and fear of interacting with the it means less access to vaccines, asthma treatment, dental care and vision.

A study at San Diego State University School of Public Health, however, shows a California expanding public health programs to undocumented immigrant children significantly reduces disparities in coverage rates.

“These are some of the biggest coverage disparities that still exist,” said Brandy Lipton, assistant professor and health economist in the health management and policy division. He noted that the Agreementable Care Act, which reformed health insurance in the U.S. and expanded Medicaid to many states, is not open to undocumented children or adults.

“We’ve had these big expansions in public coverage for most children dating back to the 1980s, but they’ve generally excluded undocumented children,” Lipton said. “Most states do not offer public coverage options for undocumented children.”

The research team, however, found a 34% reduction in the rate of uninsured noncitizens in California after the implementation of Health for All Kids in May 2016. Health for All Kids allowed children under 19-year-olds in families with qualified income levels enroll in Medi-Cal (Child and Medicaid Health Insurance Program or CHIP in California) regardless of immigration status.

The team looked at changes in coverage rates through 2018, before Health for All Kids extended to young adults up to 26 years old.

“Five other states had expanded Medicaid coverage to undocumented children before they did in California,” Lipton said, “but there is really limited evidence of what these policies do.”

The results were published on July 6 in the July issue of Health issues, a top-level peer-reviewed journal on health policy.

For the purposes of the study, researchers examined coverage rates of noncitizen children, a state easier to determine than whether they are documented or not.

Prior to the expansion, the uninsured rate among noncitizen children in California “was quite high,” Lipton said, at about 26% compared to only 7% of citizen citizens from low-income families to qualify. for Medi-Cal coverage. That figure dropped to 10% in California in late 2018 after up to 130,000 undocumented children enrolled in health coverage.

Medi-Cal coverage only increased 21% compared to rates of noncitizen children in California before the expansion.

“This is an example of a policy that really did a pretty good job of closing this gap, not completely, but of closing a good portion of this gap.”

Nationwide, approximately three out of ten children receive coverage through public programs such as Medicaid and CHIP.

Lipton noted there is plenty of evidence on the benefits of expanding Medicaid children in general, and increased access to health care services, both in the short and long term. “Getting Medicaid coverage from childhood has long-term effects in terms of adult socioeconomic status, educational attainment, and adult health as well,” he said.

The researchers validated the health effects for all children through a variety of comparisons with the changes observed in low-income citizen children during the same period and in states without similar programs. The study also reported on previously adopted child health initiatives that provide coverage for undocumented children locally (some of which have enrollment limits and age limits) and examined differences between areas with different rates. of available through a from the program to the Kaiser Permanente service areas.

Jefferson Nguyen, co-author of the study and graduate of the May master’s degree program, he said he hopes his findings will lead to debates in other states about expanding health, viability, and the peace of mind it would bring to underprivileged, low-income families.

Melody K. Schiaffino, co-author of the study and assistant professor at the School of Public Health, said she believes this study will be important in demonstrating the potential of state and local programs to improve coverage of our most vulnerable sectors. population. , which represents a critical investment in equity.

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More information:
Brandy J. Lipton et al, Expansion of California Health4All Kids and Health Insurance Coverage Among Children Without Low-Income Citizens, Health issues (2021). DOI: 10.1377 / hlthaff.2021.00096

Citation: Healthcare Network for Undocumented Children Works, Study Findings (2021, July 6) Retrieved July 6, 2021 at https://medicalxpress.com/news/2021-07-health-safety -net-undocumented-kids.html

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