Parents were asked whether their child's health insurance offered benefits and covered services the child needed; whether the insurance allowed the child to see needed health care providers; and if the costs for deductibles, co-pays and other services not covered were reasonable.
Parents of kids with private insurance were three times more likely to report that the out-of-pocket costs for services not covered were "unreasonable," compared to people with public insurance.
For many parents, that resulted in delaying or forgoing care for their children, according to the study. Children whose parents reported they were "underinsured" were more than 3 times more likely than children with adequate coverage to delay or go without care.
Uninsured kids were more than four times more likely to have delayed or skipped medical care than kids with adequate insurance, although the difference was not statistically significant as compared to kids who were underinsured, Kogan said.
"We found that kids who are underinsured are having some of the same problems with health care access and quality as kids who are uninsured," Kogan said.
While asking parents about their perceived "reasonableness" of costs is not an objective measure of affordability, the study does highlight serious problems of accessing health care for America's children, said Dr. James Perrin, a professor of pediatrics at Harvard Medical School.
"What these researchers have demonstrated is that underinsurance is bad, almost as bad as being uninsured," Perrin said. "What we do know is children are not getting a lot of the services they should be getting."
Recent health reform legislation may help, but not solve, the problem, Perrin said. Although more children will have some sort of insurance, issues with the affordability of co-pays and deductibles, as well as limitations on benefits, will likely continue, h
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