For low-income families with special needs kids, where you live matters

December 04, 2009

In the United States, caring for a child with special health care needs usually means higher medical expenses for a family -- particularly for low-income families, who spend a disproportionally large share of their income on their child's care. Yet the amount of financial burden for these families also depends on their state of residence, says Paul T. Shattuck, Ph.D., professor of social work at Washington University in St. Louis.

"The percentage of low-income families in a given state with out-of-pocket expenses that exceeded 3 percent of their income varied considerably according to state and ranged from 5 percent to 25. 8 percent (District of Columbia and Montana, respectively). Families living in states with more generous Medicaid and State Children's Health Insurance Program (SCHIP) benefits report less financial burden," Shattuck says.

Research has shown that families raising children with disabilities face exceptionally high rates of financial hardship, which can have a negative effect on the children's well-being.

"Policy makers should consider ways to strengthen Medicaid and the State Children's Health Insurance Program (SCHIP) to reduce the financial burdens these families shoulder," Shattuck says.

In a recent study published in the journal Pediatrics, Shattuck and lead author Susan Parish, Ph.D., professor of social work at the University of North Carolina at Chapel Hill, also found that:

This data can help clinicians and policy makers understand the challenges that low-income families caring for children with special health care needs face.

"State Medicaid and SCHIP policy decisions are modifiable," Shattuck says. "States have considerable leeway in determining program funding and eligibility levels, and there is an opportunity for policy makers to adequately fund the health insurance programs.

"Projected cuts due to budget shortfalls may have a particularly detrimental effect on the financial well-being of low-income families raising children with special needs."
The researchers used data from a national telephone survey of households with children who have special health care needs, including a representative sample from each state and the District of Columbia.

This study grows out of Shattuck's earlier work comparing the cost of raising a child with special needs by state (Cost of raising a child with special needs: Where does your state rank? Includes rankings table:

Washington University in St. Louis

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