Nutrition and Health Sciences, Department of


Document Type


Date of this Version



Medicine (2016) 95:28 (e4262)
doi 10.1097/MD.0000000000004262

PMCID: PMC4956833


Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Children with insurance have better access to care and health outcomes if their parents also have insurance. However, little is known about whether the type of parental insurance matters. This study attempts to determine whether the type of parental insurance affects the access to health care services of children. I used data from the 2009–2013 Medical Expenditure Panel Survey and estimated multivariate logistic regressions (N=26,152). I estimated how family insurance coverage affects the probability that children have a usual source of care, well-child visits in the past year, unmet medical and prescription needs, less than 1 dental visit per year, and unmet dental needs. Children in families with mixed insurance (child publicly insured and parent privately insured) were less likely to have a well-child visit than children in privately insured families (odds ratio=0.86, 95% confidence interval 0.76–0.98). When restricting the sample to publicly insured children, children with privately insured parents were less likely to have a well-child visit (odds ratio=0.82, 95% confidence interval 0.73–0.92), less likely to have a usual source of care (odds ratio=0.79, 95% confidence interval 0.67–0.94), and more likely to have unmet dental needs (odds ratio=1.68, 95% confidence interval 1.10–2.58). Children in families with mixed insurance tend to fare poorly compared to children in publicly insured families. This may indicate that children in these families may be underinsured. Expanding parental eligibility for public insurance or subsidizing private insurance for children would potentially improve their access to preventive care.