This study sought to determine whether outcomes for simple horizontal strabismus surgery differed for children with supported medical assistance (MA) compared to children with private healthcare insurance, with an assumption of lower socioeconomic status (SES) in the MA group. This was a retrospective study with 69 patients with MA and 34 with private insurance. Overall, surgical success was 71% for those with MA and 73.5% for private insurance that was insignificant. This suggests that children of lower SES may not expect a reduced chance of successful surgical alignment. Noncompliance with treatment such as for amblyopia and wearing glasses was similar in both groups. A higher rate of loss to follow-up was, however, seen in the MA group.