OBJECTIVES:  To compare the rate of inpatient admissions of pediatric patients with acute asthma that came through the emergency department (ED) visits and mean charges per ED visit between Medicaid patients and privately insured patients. To identify factors associated with hospital admissions through the ED among pediatric patients with asthma.  METHODS:  A retrospective analysis using 2010-2011 National Emergency Department Sample (NEDS), the largest all-payer hospital based ED database in the United States (US), was conducted. All ED visits with a primary diagnosis of acute asthma for patients aged 2-17 years were identified using ICD-9-CM codes of 493.XX. ED visits with unknown destination were excluded. Multivariable logistic regression and Generalized Linear Mixed Model were used to compare the rate of hospital admissions through the ED and mean ED charges between asthma children with Medicaid vs private insurance. RESULTS:  A total of 110,964 pediatric asthma related ED visits from 1,713 US EDs was identified (Medicaid patients: n=69,410 (63%), mean age= 7yrs, 39.86% female; Private insured patients: n=41,554 (37%), mean age= 7yrs, 39.79% female). Of these occurrences, 96,307 (87%) were discharged and 14,657 (13%) were admitted to hospital after ED visits. After adjusting for demographic and clinical factors, privately insurance patients were 12% more likely to be admitted to hospital after ED visits compared to Medicaid patients. (Odds ratio= 1.12, [95% confidence interval: 1.13-1.32]). The mean charge per ED visit for Medicaid insured patients was $1,330, compared to $1,380 among private insured patients (p<0.01). Other factors associated with hospital admissions through ED were younger age, severity, weekday visits, and urban-rural location of patient’s residence. CONCLUSIONS:  Compared to asthma children with Medicaid, privately insured pediatric patients had increased hospital admissions through ED and ED charges. In addition to insurance type, factors relating to severity and hospital characteristics were related to hospital admissions through the ED.