Data from the 1980 National Medical Care Utilization and Expenditure Survey are used to assess whether financial burdens incurred in obtaining medical services for children are distributed equitably among families with different incomes. When measured in absolute terms, out-of-pocket charges appear to increase in a progressive fashion with family income. However, when out-of-pocket charges are measured relative to ability to pay, a regressive pattern is demonstrated. Within the poverty population, children with continuous Medicaid coverage have much lower out-of-pocket costs than other children. Extension of Medicaid coverage to additional children below poverty is suggested as one approach toward reducing current inequities.