Report: Number of uninsured children in U.S. grows

The number of uninsured children in the U.S. ballooned by more than 400,000 between 2016 and 2018 despite it being a period of economic growth, according to a new state-by-state analysis by the Georgetown University Health Policy Institute Center for Children and Families.      

This increase brings to more than 4 million the number of uninsured children in the country and raises the uninsured child rate from 4.7 percent to 5.2 percent. The researchers say this brings both the number of uninsured children and the child uninsured rate to the highest level they’ve been at since 2014 when many of the Affordable Care Act’s major coverage expansions took effect.

The researchers lay the blame for this explosion in uninsured children at the feet of recent policy changes which have the U.S. “now reverting backward on children’s health coverage.”

“Recent policy changes and the failure to make children’s health a priority have undercut bipartisan initiatives and the Affordable Care Act, which had propelled our nation forward on children’s health coverage,” Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the McCourt School of Public Policy, says in a statement. “This serious erosion of child health coverage is due in large part to the Trump Administration’s actions or inactions that have made health coverage harder to access and have deterred families from enrolling their eligible children in Medicaid and CHIP.”

The specific actions the report identifies as causing these increases are:

·      Attempts to repeal the Affordable Care Act and cut Medicaid

·      Delays in funding the Children’s Health Insurance Program (CHIP)

·      Elimination of the individual mandate penalty

·      Cuts to enrollment outreach and advertising

·      Inadequate oversight over state Medicaid programs that have created more red tape barriers to coverage

·      Creating a climate of fear and confusion for immigrant families that discourages them from enrolling eligible children in Medicaid or CHIP

Losses of coverage were spread across the country, with 15 states having a statistically significant drop.  The report shows heavy concentration of these states in the south. It says seven states in particular had an especially sharp drop in insured children. These seven states, in order of severity, are:

·      Tennessee 1.5 percent

·      Georgia 1.4 percent

·      Texas 1.4 percent

·      Utah 1.4 percent

·      West Virginia 1.1 percent

·      Florida one percent

·      Ohio one percent

Texas has the largest proportion of uninsured children as 20 percent of all children within the state lack health insurance.

The loss of health insurance most impacted white and Latinx children, children under the age of six, and the children of families with low to moderate incomes. The majority of these children are eligible for Medicaid or CHIP but are currently not enrolled, according to the report.

“This is a very troubling trend and mainly due to the fact that children are losing Medicaid and CHIP coverage,” Alker says in the statement. “The decline in health coverage occurred at a time when children should have been gaining coverage in the private market and is a red flag for policymakers as even more children would likely lose coverage in an economic downturn.”

In addition to the report and statement, Georgetown produced a data hub which gives a greater breakdown of all the numbers. It is available here.