Health Insurance Coverage of Special Needs Children

Statement of the Problem: Health insurance coverage plays a critical role in ensuring appropriate access to care for children with special health care needs (CSHCN). Insured CSHCN are much more likely than their uninsured counterparts to have a usual source of care and to obtain needed medical care, dental care, mental health services, and prescription medications. Adequate health insurance coverage for all children, and CSHCN in particular is a major goal of Healthy People 2010. The most recent available national estimates of health insurance for CSHCN, based on data from 1994, suggest relatively high rates of enrollment in Medicaid, and relatively low rates of uninsurance. However, 11 percent of all CSHCN, and 17 percent of poor CSHCN remained without insurance coverage. Since that period, there have been several important federal and state policy initiatives, including welfare reform and the State Children’s Health Insurance Program (SCHIP) that likely affect eligibility for, and participation in insurance programs for all children. These policy initiatives may have had unique effects on CSHCN due to differences in their underlying characteristics and possible differences in their families ’ responses to changin