The study population included all Oregon families enrolled in the federal food stamp program at the end of January 2005 with children who were also presumed eligible for publicly funded health insurance. Both programs require a household income of less than 185 percent of the federal poverty level and proof of a child’s U.S. citizenship. Of the 8,636 questionnaires sent, 2,681 were returned. About 25 percent of those responding reported gaps in coverage during the previous year.

The study was designed to the identify barriers low-income parents face when accessing health care for their children and how insurance status affects their reporting of these barriers. DeVoe found three major barriers: lack of insurance coverage, poor access to services and unaffordable costs. Even families with health insurance had trouble affording the co-pays as well as needed medications. Families with public health insurance had trouble getting access to a health care provider. When they did gain access, they reported feeling unwelcome and having to travel long distances to get to these providers. Those without any insurance struggled to obtain publicly-financed or any affordable insurance.

“Incremental health insurance reforms alone are not going to solve these problems. A more comprehensive approach is desperately needed,” said Jennifer DeVoe, M.D., D.Phil., research assistant professor of family medicine, OHSU School of Medicine.