Unfinished business: Inadequate health coverage for privately insured seriously ill children

During the 1980s and 1990s there were great increases in health insurance c overage for poor children through the Children's Health Insurance Program ( CHIP) and extended Medicaid eligibility. Problems remain for the small numb er of children with serious medical conditions whose care is a high proport ion of total health care expenditures on children. We report on the adequac y of health insurance coverage for a sample of children with serious and ra re illnesses treated at the single tertiary care pediatric hospital in Indi ana. One third of privately insured children in our data had inadequate ins urance. Compared to families with inadequate health insurance, families wit h adequate insurance were 50% less likely to delay care for themselves and 67% less likely to delay care for a child. Our research identifies policy-r elevant deficiencies in private health coverage for seriously ill children ineligible for either Medicaid or CHIP.