US children and youth rely on insurance to access health care. Families living in or near poverty may qualify for public coverage with income thresholds for eligibility varying from 138% to 325% of the federal poverty level (FPL) across states. Other families may have commercial insurance through an employer or direct purchase. Families lacking insurance pay out-of-pocket for health care. The adequacy of insurance varies across insurance types, with some providing better coverage and access to care than others.5,6  Households with children and youth with special health care needs (CYSHCN) with low-to-middle income (ie, 200% to 399% of FPL) may be particularly sensitive to insurance variations, yet little is known about family perceptions of insurance adequacy.1,3  We compared these perceptions across insurance types for CYSHCN living in low-to-middle income families.

We performed a retrospective analysis of 4321 responses of parents...

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