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New report: Progress on children’s health coverage reverses course

The good people at the Georgetown University Health Policy Institute Center for Children and Families are out with some sobering news on the health coverage provided to children in the U.S.

Here are the key findings from their new report:

  • For the first time in nearly a decade, the number of uninsured children in the United States increased. Recently released data shows an estimated 276,000 more children were uninsured in 2017 than in 2016. No state (except for the District of Columbia) experienced a significant decline in the number of uninsured children in 2017.
  • Three-quarters of the children who lost coverage between 2016 and 2017 live in states that have not expanded Medicaid coverage to parents and other low-income adults. The uninsured rates for children increased at almost triple the rate in non-expansion states than in states that have expanded Medicaid.
  • The share of children without health insurance nationally increased from 4.7 percent in 2016 to 5 percent in 2017. Nine states experienced statistically significant increases in their rate of uninsured children (SD, UT, TX, GA, SC, FL, OH, TN, MA).
  • Texas has the largest share of children without health coverage with more than one in five uninsured children in the U.S. residing in the state.
  • States with larger American Indian/ Alaska Native populations tend to have higher uninsured rates for children than the national average

In 2017, the number of uninsured kids in North Carolina climbed to 120,000 and the failure to expand Medicaid is almost certainly to blame.

What’s perhaps most disturbing about the new findings, says author Joan Alker, is that this has happened during a time of economic growth. So why is this happening? Alker put it this way yesterday in a blog post:

We can’t know for sure, but here are some of our best guesses:

The majority of uninsured children are already eligible for Medicaid or CHIP but are not currently enrolled. The name of the game here is to make sure that families are aware that their child has a path to coverage and that these kids get enrolled and stay enrolled. For these families, 2017 was a year of constant news about the President and Congress wanting to take coverage away – first with the attempt to repeal the Affordable Care Act and make drastic cuts to Medicaid, all of which continued with a last gasp effort in September 2017.

Then on September 30, funding for CHIP expired and, in an unprecedented delay, Congress did not extend funding until early 2018 – again with families hearing that their state might have to close its CHIP program. At the same time, the Trump Administration began efforts to sabotage the ACA’s Marketplace including cuts to advertising, outreach and enrollment funding for navigators – who were playing an important role connecting families with public coverage, with the repeal efforts raising insurer uncertainty and driving up premiums.

The Trump Administration also began a series of actions hostile toward immigrant families. One quarter of children living in the United States has a parent who is an immigrant. For these “mixed status” families, there is likely a heightened fear of interacting with the government and this may be deterring them from signing their eligible children up for government sponsored health coverage.

As a result, the “welcome mat” for coverage has been pulled back and we see the results – more uninsured children.

With an improving economy and low unemployment rate, the fact that our nation is going backwards on children’s health coverage is very troubling. Without serious efforts to get back on track, the decline in coverage is likely to continue in 2018 and may in fact get worse for America’s children.

The bottom line: After years of progress, America is losing ground in the battle to provide health coverage to its children and it seems almost certain that conservative, anti-government policy choices are to blame. Click here to read the full report.

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