Children's Health Insurance Coverage: Progress, Problems, And Priorities For 2021 And Beyond
Children's Health Insurance Coverage: Progress, Problems, And Priorities For 2021 And Beyond
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DOI：
10.1377/hlthaff.2020.00785
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发表时间：
2020-10-01
期刊：
影响因子：
9.7
通讯作者：
Rosenbaum, Sara
中科院分区：
文献类型：
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作者：
Alker, Joan C.;Kenney, Genevieve M.;Rosenbaum, Sara
医疗补助计划的扩大和儿童健康保险计划（CHIP）的建立代表了国家努力保障儿童健康保险的重大成功。这一成功反映在儿童，包括低收入家庭儿童的高覆盖率和获得保健服务的机会上。但仍然存在重大的覆盖差距——自2016年以来，这一差距一直在扩大，并可能随着2019年冠状病毒病（COVID-19）的大流行和相关的经济衰退而加速。根据全国健康访谈调查数据，我们发现2018年未参保儿童的比例为5.5%。儿童继续面临保险中断，拉丁裔、青少年和非公民儿童继续面临更高的无保险风险。尽管我们注意到全民、联邦政府资助、单一支付方式覆盖的好处，但我们也提出了两种可能的改革途径，可以在当前的多支付系统中进行，旨在确保覆盖面、可及性、连续性和全面性，使国家更接近为儿童提供充分发挥其潜力所需的医疗保健的目标，并减少种族和经济不平等。
Expansion of Medicaid and establishment of the Children's Health Insurance Program (CHIP) represent a significant success story in the national effort to guarantee health insurance for children. That success is reflected in the high rates of coverage and health care access achieved for children, including those in low-income families. But significant coverage gaps remain-gaps that have been increasing since 2016 and are likely to accelerate with the coronavirus disease 2019 (COVID-19) pandemic and the associated recession. Using National Health Interview Survey data, we found that the proportion of uninsured children was 5.5 percent in 2018. Children continue to face coverage interruptions, and Latino, adolescent, and noncitizen children continue to face elevated risks of being uninsured. Although we note the benefits of a universal, federally financed, single-payer approach to coverage, we also offer two possible reform pathways that can take place within the current multipayer system, aimed at ensuring coverage, access, continuity, and comprehensiveness to move the nation closer to the goal of providing the health care that children need to reach their full potential and to reduce racial and economic inequalities.