PT  - JOURNAL ARTICLE
AU  - Pascoe, John M.
AU  - Stolfi, Adrienne
AU  - Eberhart, Gregory
AU  - Khamis, Harry
TI  - Parents’ Report of Their Children’s Underinsurance Status After the Affordable Care Act
AID  - 10.3122/jabfm.2021.01.200036
DP  - 2021 Jan 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 208--215
VI  - 34
IP  - 1
4099  - http://www.jabfm.org/content/34/1/208.short
4100  - http://www.jabfm.org/content/34/1/208.full
SO  - J Am Board Fam Med2021 Jan 01; 34
AB  - Objective: To determine the prevalence and correlates of children’s underinsurance pre- and post-implementation of the Affordable Care Act (ACA).Study Design: A cross-sectional survey of a convenience sample of 5043 parents of children greater than 6 months old who had health insurance in the previous 12 months. Respondents completed the Medical Expenses for Children Survey. Pre-ACA data were collected in summer/fall of 2009 to 2011 (n = 3966); post-ACA data were collected in summer/fall 2016 (n = 1077). All data were collected within the Southwestern Ohio Ambulatory Research Network (SOAR-Net).Results: Some study parents (16.3%) were unable to follow at least 1 recommendation of their child’s pediatrician due to their inability to pay for it, and 17.3% reported it had become more difficult to obtain “needed health care” in the past 3 years. Factors associated with underinsurance after adjusting for demographic factors did NOT include pre/post-ACA, but did include annual household income < $50,000 (adjusted odds ratio [AOR] = 2.71; 95% CI, 2.15–3.40). Poor child health was also a significant risk factor for underinsurance(AOR = 3.71; 95% CI, 2.61–5.29).Conclusions: About 1 in 6 study children were underinsured. The ACA did not affect the underinsurance rate. Parents continued to report that it had become more difficult to obtain needed health care over the past 3 years post-ACA. About one third of study parents consistently reported that the health of their underinsured child had suffered because they could not afford to pay for their child’s health care.