MACPAC analyses of national household survey data have shown that in comparison with similarly situated uninsured non-elderly adults, people enrolled in Medicaid reported substantially better access to care for almost every measure analyzed. Compared to uninsured non-elderly adults, Medicaid enrollees reported they were:
- more likely to have a usual source of care;
- more likely to have had a visit to a general doctor in the past year;
- more likely to have had a specialist visit in the past year; and
- less likely to have delayed medical care in the past year.
However, privately-insured non-elderly adults report less access barriers than Medicaid enrollees. For example, adults with Medicaid are more likely to report delayed medical care because of concerns about out-of-pocket costs, difficulty obtaining appointments, or because they do not have transportation.
With regard to children, Medicaid offers access to health care that is on par with private insurance in many cases, but lags in others. Analyses based on data from the National Health Interview Survey, the principal source of information on the health of the civilian noninstitutionalized population of the United States, and the Household Component of the Medical Expenditures Panel Survey, large-scale survey data on specific health services that Americans use, show:
- Children with Medicaid or CHIP coverage are as likely to have a usual source of medical care as privately insured children even when controlling for age, race and ethnicity, income level, and special health care needs.
- Children with Medicaid or CHIP, who are disproportionately affected by behavioral health disorders, are more likely to see a mental health professional for an emotional or behavioral problem as their privately insured counterparts.
- Children with Medicaid or CHIP have more difficulty than children with private insurance when it comes to finding a doctor who accepts their health insurance, making an appointment (or other provider-related reasons), and obtaining specialist care.
- Children with Medicaid or CHIP visit the emergency room more often than children who are privately insured—their families are more likely to report that that their usual medical providers were not open or that they did not have another place to obtain care.
- Although dental coverage is required for children on Medicaid and CHIP and the gap between their rate of dental visits and that of children with private medical insurance is narrowing, they still see the dentist less often than children with private coverage.
For every indicator, children with Medicaid or CHIP have better access to medical care than if they were uninsured.
MACPAC also routinely monitors access to care using a variety of measures and data sources. Learn more by reviewing these MACStats tables:
- Measures of Access to Care among Non-Institutionalized Individuals Age 0–18 by Primary Source of Health Coverage
- Measures of Access to Care among Non-Institutionalized Individuals Age 19–64 by Primary Source of Health Coverage
- Provider availability measures of access to care
Learn more about children’s access to care:
- Access in Brief: Children’s Difficulties in Obtaining Medical Care
- Access in Brief: Children’s Use of Behavioral Health Services
- Access in Brief: Use of Emergency Departments by Children
- Access in Brief: Children’s Dental Services
- The Effect of Premiums and Cost Sharing on Access and Outcomes for Low-Income Children
Learn more about non-elderly adults’ access to care:
- Access to Care for Non-Elderly Adults
- Access to Care for Persons with Disabilities
- Medicaid Access in Brief: Adults’ Experiences in Obtaining Medical Care
- Medicaid Access in Brief: Adults’ Use of Oral Health Services
- Access in Brief: Use of Cervical, Breast, and Colon Caner Tests among Adult Medicaid Enrollees
Learn more by reading these report chapters and briefs:
- Access and Quality in Managed Care
- Access and Value: Issues for Medicaid and CHIP as Purchasers
- Effects of Medicaid Coverage of Medicare Cost Sharing on Access to Care
- Data Book: Beneficiaries Dually Eligible for Medicare and Medicaid (jointly produced with MedPAC)
- Revisiting Emergency Department Use in Medicaid
- Data Sources for Monitoring Access to Care in Medicaid and CHIP