Medicaid and Access to Child Health Care in Chicago

Abstract

In this article we examine how increasing the reimbursement of physicians and expanding Medicaid eligibility affect access to care for children in Cook County, Illinois, which overlies Chicago. Using Medicaid claims and other data at the zip-code level, we compare the places where Medicaid children live with the places where all the physicians who treat children and those who accept Medicaid patients have their practices. Our findings suggest that the recent changes in legislation are unlikely to benefit extremely poor children, who are more likely to live in depressed inner-city areas, where there are few physicians. "Near-poor" children whose homes are dispersed throughout the county, who are now eligible for Medicaid as a result of the recent changes, are likely to see improvements in their access to care. Further changes in policy, aimed at enhancing the capacity of institutions providing care, could improve access for the children of the inner city.

Neighborhood effects on primary care access in Los Angeles

“…The types of industries in a community affect healthcare resources since certain types of employers are more likely to provide private health insurance coverage, which has higher reimbursement rates than public insurance (Brown, Ponce, & Rice, 2001;Cunningham & Ginsburg, 2001;Komaromy, Lurie, & Bindman, 1995). Thus, the spatial distribution of healthcare resources is far from equitable with severely disadvantaged neighborhoods, such as inner cities, having fewer healthcare resources (Fossett, Perloff, Kletke, & Peterson, 1992;Grumbach, Coffman, Young, Vranizan, & Blick, 1998). Also, populations with a greater percentage of the very young or elderly may demand more healthcare since these ages have greater healthcare needs, bringing more providers to an area (Cunningham & Kemper, 1998;Jiang & Begun, 2002).…”

Mental health services for youths in foster care and disabled youths

“…1,2 The welfare and mental health of children from low-income families has been a public health issue for many years, largely because developmental and psychosocial problems are more prevalent and of greater severity among poor children. [3][4][5][6] Furthermore, low-income families and their children face greater barriers to care and receive less health and mental health care. 3,7,8 During the 1990s, policy and legislative changes expanded the conditions under which children are eligible for Medicaid benefits.…”

“…[3][4][5][6] Furthermore, low-income families and their children face greater barriers to care and receive less health and mental health care. 3,7,8 During the 1990s, policy and legislative changes expanded the conditions under which children are eligible for Medicaid benefits. In 1998, Title XXI of the Social Security Act made federal grants available through the State Children's Health Insurance Plan, so that states could finance insurance for children in families not previously qualified for Medicaid.…”

The Health Effects of Medicare for the Near-Elderly Uninsured

“…By exploiting a natural experiment from a change in the eligibility of pregnant women for Medicaid benefits, a few quasi-experimental studies have provided evidence of a causal relation between health insurance and health of newborns (Joyce, 1998;Epstein and Newhouse, 1998;Baldwin et al, 1998;Ray et al, 1997;Currie and Gruber, 1996a, 1996b, 1997Reichman and Florio, 1995;Haas et al, 1993;Fossett et al, 1992;Buescher et al, 1991;Piper et al, 1990). The findings generally suggest that health insurance does result in modest reductions in infant mortality.…”