How Medicaid and the state children's health insurance program can do a better job of insuring uninsured children: The perspectives of parents of uninsured Latino children
How Medicaid and the state children's health insurance program can do a better job of insuring uninsured children: The perspectives of parents of uninsured Latino children
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DOI：
10.1367/a04-067r2.1
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发表时间：
2005-11-01
期刊：
影响因子：
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通讯作者：
Tomany-Korman, SC
中科院分区：
文献类型：
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作者：
Flores, G;Abreu, M;Tomany-Korman, SC
背景。- 850万美国儿童没有保险，尽管1997年颁布的国家儿童健康保险计划（SCHIP）有390亿美元的资金，拉丁美洲人仍然是最没有保险的种族/族裔群体，有24%（300万）没有保险。为什么SCHIP和医疗补助没有更成功地为没有保险的儿童提供保险尚不清楚。为了确定原因为什么父母无法在一个所有低收入儿童都有资格获得保险的国家投保未投保的拉丁裔儿童。来自波士顿社区的未投保拉丁裔儿童的父母双语焦点小组，未投保拉丁裔儿童的比例最高。在6个焦点小组中采访的30名父母的平均年龄为39岁; 63%从未高中毕业，33%是美国公民。他们孩子的平均年龄为12岁，家庭年收入中位数为9120美元。父母报告了52个障碍，以确保儿童。主要障碍包括对申请程序和资格缺乏了解（特别是对工作，福利和移民的误解），语言障碍，移民问题，收入，麻烦，悬而未决的决定，家庭流动性，保险代表的错误信息（被告知保险太贵，父母必须工作），以及系统问题（包括丢失申请，歧视和过度等待）。父母普遍同意的情况下经理将有助于投保未投保的儿童。即使在一个所有低收入儿童都有资格获得医疗保险的州，目前的SCHIP和医疗补助计划的推广和登记也没有有效地覆盖到没有保险的拉丁裔儿童。家长需要更好地了解项目、资格和申请程序，以及更有效、用户友好的系统。
Background.-Eight and a half million US children are uninsured, despite the 1997 enactment of the State Children's Health Insurance Program (SCHIP) with $39 billion in funding, and Latinos continue to be the most uninsured racial/ethnic group, with 24% (3 million) uninsured. Why SCHIP and Medicaid have not been more successful insuring uninsured children is unclear.Objective.-To identify reasons why parents are unable to insure uninsured Latino children in a state where all low-income children are eligible for insurance.Methods.-Bilingual focus groups of parents of uninsured Latino children from Boston communities with the highest proportion of uninsured Latino children.Results.-The 30 parents interviewed in 6 focus groups had a mean age of 39 years; 63% never graduated high school and 33% were US citizens. The mean age of their children was 12 years, and the median annual family income was $9120. Parents reported 52 barriers, to insuring children. Major obstacles included lack of knowledge about the application process and eligibility (especially misconceptions about work, welfare, and immigration), language barriers, immigration issues, income, hassles, pending decisions, family mobility, misinformation from insurance representatives (being told insurance is too expensive and parents must work), and system problems (including lost applications, discrimination, and excessive waits). Parents universally agreed case managers would be helpful in insuring uninsured children.Conclusions.-Even in a state where all low-income children are eligible for health insurance, current SCHIP and Medicaid outreach and enrollment are not effectively reaching uninsured Latino children. Parents need better information about programs, eligibility, and the application process, and a more efficient, user-friendly system.