Parents' own use of physician services is known to be a strong predictor of their children's use of such services. This paper contrasts the relationship between parents' and children's use of services among uninsured and privately insured children. Parents' utilization is found to have a larger impact upon service use among privately insured children than among uninsured children. Even if all children were universally insured, parents' health care utilization would remain a key determinant in children's use of services. Policies that integrate financing and delivery systems for all family members deserve attention among efforts to foster better access for children. Neglecting financial access to care for adults may have the unintended effect of diminishing the impact of targeted health insurance programs for children.