Anticipated and Actual Effects of Medicaid on the Medical-Care Pattern of Children

As a follow-up to an earlier study of anticipated changes in health behavior after enrollment in the New York Medicaid program, we compared the actual changes with the anticipations of the consumers and the intentions of the legislators. Although the program enrolled over 90 per cent of the eligible child population in the community, this did not lead to a medical-care pattern for the Medicaid-registered families similar to that of other families. Little change in source, frequency and purpose of care was observed. Poor families were still more likely to receive less care, to depend more on public clinics and to have a higher proportion of illness-related rather than preventive medical contacts. Instead of diminishing socioeconomic differentials as intended by the legislators, the better financing of the care of the poor led to a solidification of the old separate two systems.