All ETDs from UAB

Advisory Committee Chair

Julie Preskitt

Advisory Committee Members

David Becker

Justin Blackburn

Bisakha Sen

Martha Wingate

Document Type

Dissertation

Date of Award

2020

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

This dissertation is composed of three papers related to children with special health care needs (CSHCN) who are covered by private health insurance, including employer sponsored health insurance. Over the past couple of decades, researchers and advocates have expressed concern about the impact that widespread changes in private insurance coverage may have on families of CSHCN. These researchers point to the rise in high deductible plans and declining generosity in the form of higher premiums and copayments in more traditional plans offered by employers. Despite this expressed concern, little research has been conducted examining how these changes in employer sponsored insurance are affecting coverage options and affordability for families of CSHCN. To address this gap in the literature, this dissertation provides baseline information on the nature of existing literature on privately insured CSHCN, the types of employer sponsored insurance plans families of CSHCN are covered under, and what their out of pocket costs have been over recent years. The first paper is a scoping literature review that characterizes the existing literature, identifies broad thematic areas and identifies areas for future research concerning CSHCN with private insurance coverage. The second paper examines the types of employer sponsored family coverage insurance plans CSHCN have been covered under in recent years and how this differs from non-CSHCN. The third paper examines out of pocket expenditures for CSHCN with employer sponsored family coverage from 2005 to 2017 and compares these expenditures to non-CSHCN with employer sponsored family coverage during the same time period.

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