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• <br />• <br />10 <br />28 <br />CHILD HEALTH <br />► Indicator 10: Percent of Eligible Chil- <br />dren Enrolled in Medicaid <br />The state's Medicaid program grew substan- <br />tially after new income eligibility levels were <br />established in October 1990 and during in- <br />creased unemployment in 1991 and 1992.11 As <br />a result, the percentage of all children (under <br />age 18) enrolled in Medicaid rose 42 percent <br />between 1988 -90 and 1990 -92 to 21, the same <br />percentage as the nation's. <br />Unfortunately, the state's Medicaid program <br />still enrolled in 1990 -92 a significantly lower <br />percentage of eligible children (68.7) than did <br />programs nationwide (75.4)? <br />Effective July 1, 1994, Medicaid was ex- <br />panded to cover children aged 10 -18 whose <br />family incomes are under 100 percent of pov- <br />erty. The state's Health Planning Commission <br />has recommended that Medicaid benefits be <br />further expanded to cover a) infants (under I <br />year) whose family incomes are below 200 per- <br />cent of poverty, b) children aged 1 -5 with fam- <br />ily incomes below 185 percent of poverty, and <br />c) children aged 6 -18 with family incomes be- <br />low 133 percent of poverty. The Health Plan- <br />ning Commission also recommends eventual <br />Access to Health Care in North Carolina <br />coverage of all children whose family incomes <br />are below 200 percent of poverty as well as, for <br />two years, postpartum women whose family <br />incomes are below 200 percent of poverty. 10 <br />Data from the 1995 North Carolina Health <br />Profile telephone survey show that more than <br />one out of three minority children and 14 per- <br />cent of white children were covered by Medic- <br />aid. Overall, 21 percent were in the program, <br />according to the children's caregivers. Once <br />again, households without telephones were not <br />included in the survey. <br />Even when poor children are enrolled in <br />Medicaid, access to private physicians may -be <br />limited due to physicians' unwillingness to par- <br />ticipate in the program. A recent North Caro- <br />lina study found that, in 89 reporting counties, <br />38 percent of general and family practitioners <br />did not accept Medicaid children under age 5 <br />in 1994. In 74 reporting counties, 27 percent of <br />pediatricians did not accept Medicaid children <br />under age 5.19 <br />Data on physician participation in Medicaid are <br />not routinely collected. The feasibility of obtain- <br />ing this information should be investigated. <br />107 <br />