HEALTH CARE NEEDS OF THE "HIDDEN" UNINSURED: CHILDREN WITH GAPS IN COVERAGE Beth Yudkowsky, Lynn Olson, Suk-fong Tang, Paul Newacheck. Practice and Research, American Academy of Pediatrics, Elk Grove Village, IL; Practice and Research, American Academy of Pediatrics, Elk Grove Village, IL; Practice and Research, American Academy of Pediatrics, Elk Grove Village, IL; Institute for Health Policy Studies School of Medicine, University of California San Francisco, San Francisco, CA.

BACKGROUND: Official counts of the uninsured usually focus on who is uninsured a full year, but as many children experience gaps in insurance coverage. Little is known about the relative health care needs of children uninsured part year.

OBJECTIVE: To compare the unmet health care needs of children who are: uninsured part year, uninsured a full year, and insured a full year.

DESIGN/METHODS: Analysis of 2000 National Health Interview Survey (NHIS) data examining duration of health insurance coverage by delay in receiving medical care and not receiving medical care because of cost. Duration of health insurance coverage is defined as: 1) publicly insured for all of the last 12 months (either Medicaid, Medicare, SCHIP, other state government programs excluding VA and CHAMPUS, and Indian Health Services), 2) uninsured for the last 12 months, 3) insured for part of the last 12 months, and 4) privately insured for all of the last 12 months.

RESULTS: Children who were uninsured for part of the year experienced similar delays in receiving medical care as did children who were uninsured for 12 months or longer (18.7%, 15.6% respectively) compared to children who were either publicly or privately insured for 12 months (2.5%, 1.3% respectively). Children who were uninsured for part of the year and children who were uninsured for 12 months or longer reported that cost was a factor in not receiving medical care (11.5%, 13.0%, respectively) compared to children who were either publicly or privately insured for 12 months (1.6%, 0.6% respectively).

CONCLUSIONS: In terms of children's experiences with delayed health care and unmet health care needs due to cost concerns, our analysis suggests that children uninsured for part of the year are far more similar to the full year uninsured than the full year privately or publicly insured. These comparisons highlight the importance of health insurance retention, and informs policy initiatives regarding continuous Medicaid/SCHIP eligibility and reduction of waiting periods.