Purpose of review: This article reviews the impact of the Medicaid program, including the proportion of children in America insured by Medicaid; the extent to which Medicaid-enrolled children have access to care; the use of services and the quality of care received by Medicaid enrollees, including evidence for disease reduction; and family satisfaction with the program.
Recent findings: More than a quarter of all children in the United States were insured through public programs, primarily Medicaid, in 2002. Public insurance programs are even more critical for low-income children: 69.5% of children in families with incomes below 100% of the federal poverty level are covered by public programs. The reach of Medicaid is extensive, although substantial numbers of eligible children remain uninsured. Although Medicaid-insured children still face access barriers, particularly for certain types of specialty care, parents of children with public insurance report high levels of satisfaction with their experience with well-child care. While the study findings are mixed, several recent studies show very favorable comparisons between the experience of privately insured children and that of publicly insured children.
Summary: Medicaid plays a critical role in providing health insurance coverage for children, particularly for very low-income families. Additional efforts are needed to fully enroll all eligible families and to assure full access to high-quality care.