Summary
The article examines insurance-based disparities in provider-related barriers to care among children in California in the wake of changes to the insurance market resulting from the Affordable Care Act. Data from the 2014-16 California Health Interview Survey (CHIS) were analyzed for 6,514 children ages 0-11 years. Authors examined parent reports in the past year of 1) having trouble finding a general provider for the child, 2) the child not being accepted by a provider as a new patient, 3) the child’s health insurance not being accepted by a provider, and 4) any of the above.
Multivariable models estimated the associations of insurance type (Medi-Cal/Medicaid), employer-sponsored insurance (ESI), and privately purchased coverage) and parent reports of these problems. Approximately 8 percent of parents had encountered at least 1 of the 3 problems. Compared with parents of children with ESI, parents of children with Medi-Cal or privately purchased coverage had more than twice the odds of experiencing at least one of the barriers. Parents of children with Medi-Cal had more than twice the odds of having been told a provider would not accept their children’s coverage or having had trouble finding a general provider and three times the odds of having been told a provider would not accept their children as new patients. Parents of children with privately purchased coverage had over three times the odds of having been told a provider would not accept their children’s coverage.
