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Survey: ACA Hasn't Lowered Child Uninsured Rate


The rate of uninsured children was already falling before the passage of the Affordable Care Act. A new study finds the ACA hasn't changed those numbers significantly.

A new survey finds the Affordable Care Act had little impact on the number of uninsured children in America.

The Urban Institute’s September Health Reform Monitoring Survey shows the uninsured rate among children 17 and younger was 7.3% at the end of June, virtually unchanged from the 7% uninsured rate in 2012.

The study notes only 6% of enrollees in the new health insurance marketplaces were under the age of 18.

The uninsured rate among children had been falling prior to the passage of the Affordable Care Act. And while the rate was already relatively low, the lack of a continued drop seems to be related to inefficiencies in the new system, according to the study.

In fact, the survey found a large majority of uninsured children surveyed in March and June were actually eligible for a government insurance program.


  • 56% were in families with income below 138% of the federal poverty level, which should qualify them for Medicaid.
  • 25% were in families with incomes between 138% and 250% of the federal poverty level, meaning they’re likely eligible for Medicaid or the Children’s Health Insurance Program.
  • 19% were in families with incomes exceeding 250% of the federal poverty level. Some of those families could still be eligible for Medicaid or CHIP, depending on the state where they live. Their families could also be eligible for subsidies if they bought insurance on the federally run marketplaces.

The study blames the above statistics on a lack of data sharing between agencies and a lack of technical infrastructure to facilitate that sharing. That should improve over time, the authors wrote.

“However, the process of developing and deploying new technology and procedures is inherently difficult and further complicated by increased application volume and significant changes to eligibility and annual redetermination policies,” the study notes.

Thus, it’s unclear how quickly those problems might be solved. That said, the uninsured children rate could decline even without technological changes if more states expand Medicaid coverage, the study noted.

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