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Children on Medicaid have reduced access to specialty care Posted: June 16th, 2011

By Maryalene LaPonsie

A study published this month, in The New England Journal of Medicine, brings to light the disparity in access to specialty care between children with Medicaid and those with private health insurance.

The report finds that children with medical coverage through Medicaid or the state-run Children's Health Insurance Program (CHIP) were more likely to be denied services by specialists. In addition, those who were granted appointments had to wait twice as long to see a doctor.

The research was conducted in Cook County, Illinois from January through May 2010. Research assistants posing as mothers called clinics in eight specialties to make an appointment for a fictitious child. Each mother called twice: once reporting that her child had Medicaid or CHIP medical coverage and once saying that Blue Cross Blue Shield provided their health insurance.

In the majority calls--52 percent--specialty clinics asked about health insurance coverage first. Of those reporting Medicaid or CHIP coverage, 66 percent were denied an appointment compared to 11 percent with private health insurance. Of those granted appointments, children on Medicaid had to wait an average of 42 days to see a specialist, even in emergency situations. Children with private health insurance only waited an average of 20 days for their appointments.