consistency of the recent research findings is striking. As would be expected, health insurance is clearly most beneficial for adults who need medical attention, particularly for adults with common chronic conditions or acute conditions for which effective treatments are available. Furthermore, national studies assessing the effects of near-universal Medicare coverage after age 65 suggest that uninsured near-elderly adults who are acutely or chronically ill substantially benefit from gaining health insurance coverage.
Finding: With health insurance, children receive more timely diagnosis of serious health conditions, experience fewer avoidable hospitalizations, have improved asthma outcomes, and miss fewer days of school.
There are 13 recent studies on the health effects of health insurance coverage for children, including 5 studies that used quasi-experimental methods (Aizer, 2007; Bermudez and Baker, 2005; Cousineau et al., 2008; Currie et al., 2008; Howell et al., 2008a). These studies suggest that health insurance is beneficial for children in several ways, resulting in more timely diagnosis of serious health conditions, fewer avoidable hospitalizations, better asthma outcomes, and fewer missed school days (Aizer, 2007; Bermudez and Baker, 2005; Cousineau et al., 2008; Currie et al., 2008; Damiano et al., 2003; Fox et al., 2003; Froehlich et al., 2007; Howell and Trenholm, 2007; Howell et al., 2008a,b; Maniatis et al., 2005; Szilagyi et al., 2004, 2006).
The study by Maniatis and colleagues, for example, assessed children when first diagnosed with diabetes (Maniatis et al., 2005). They found that uninsured children were less likely to have their conditions diagnosed as early as insured children. Among the children diagnosed with diabetes, the uninsured children were more likely to present with severe and life-threatening diabetic ketoacidosis.
Three quasi-experimental studies found significant reductions in hospitalizations related to ambulatory care sensitive conditions (ACSC) for children enrolled in Medicaid or SCHIP (Aizer, 2007; Bermudez and Baker, 2005) or county-based health insurance programs (Cousineau et al., 2008). Aizer, in a quasi-experimental analysis of state hospital discharge files, Medicaid enrollment, and U.S. Census data, found that a 10-percentage-point increase in Medicaid enrollment led to about a 3-percentage-point reduction in ACSC admissions. Similarly, Szilagyi and colleagues reported improvements in asthma-related outcomes for New York children after they enrolled in SCHIP: the rate of asthma-related hospital stays for these children dropped from 11 percent to just 3 percent (Szilagyi et al., 2006). These