While US presidential candidates’ debate over health care is making headlines all over the world, millions of children in the US are lacking insurance regardless of whether their parents are insured. This phenomenon translates in fewer visits to the doctor when needed, in parents administering their children drugs without having a clear diagnosis, which could further jeopardize their lives.

A study published this week in the Journal of the American Medical Association found that of the 9 million children and adolescents in the US who have no health insurance coverage, 28 percent have an insured parent. The number doubles if you include children who have gaps in coverage during the year.

These children have parents who earn too much for government programs but on the other hand, they can’t afford private coverage. Other families do qualify for help, but choose not to sign up for numerous reasons, including because the enrollment process can be confusing.

For the study, Jennifer DeVoe, MD, DPhil, from Oregon Health and Science University and colleagues looked at records of 39,588 children and teenagers. The data came from the Medical Expenditure Panel Survey, which is nationally representative. Researchers pooled data from 2002 to 2005.

The study authors estimate that more than 1 million children had no coverage for the entire year, while 3 million children had some lack of coverage despite having one parent with full coverage. Also, children with parents having public health coverage were 36 percent less likely to be uninsured compared to children who parents had private insurance.

“Discontinuities in children’s health insurance coverage, even for only a few months, are associated with significant unmet health care needs. In this study, the private system did not do a good job of providing coverage for entire families. It is time to think beyond health insurance models to achieve a sustainable health care system and the best possible health outcomes for all families,” the researchers wrote.

According to the findings, uninsured children are more likely to be from low-and middle-income families rather than from among the nation’s poor. These insured parents are more likely to have low levels of education, are more likely to be of Hispanic origin, leading a single parent household and living in the geographic South or the West of the country.

“The largest predictor of children being uninsured with an insured parent was being in the middle income, earning somewhere between about $25,000 and $75,000 a year for a family of four,” DeVoe said.

Commenting over the findings of the study, Sen. Ron Wyden, a Democrat from Oregon and Ezekiel Emanuel, chair of the bioethics department at the National Institutes of Health in Bethesda, Maryland, said states and the federal government should work together in order to make health insurance more affordable and available.