Children’s Uninsured Rate Rose 400K, Experts Blame White House

October 31, 2019 - According to a study by the Georgetown Center for Children and Families, the number of uninsured children has increased by over 400,000 in a two year time-span and policymakers and researchers alike are pointing to White House regulatory actions as the culprit behind the rise in the children’s uninsured rate.

“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,” said Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the McCourt School of Public Policy. “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.”

Only three years ago the number of uninsured people dropped to a more than eight-year record low of 3.6 million in 2016, according to Georgetown researchers.

However, since then, the rate steadily began to steadily rise.

In 2018, uninsurance nationwide hit a four-year high. Although children under the age of 19 were most likely to be insured apart from adults 65 and older, the population size of uninsured children swelled. The childhood uninsurance rate climbed from 4.7 to 5.2 in 2016 to 2017 and from 5.0 to 5.5 percent in 2017 to 2018, the Georgetown researchers reported.

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At the state level, Medicaid expansion was a telling factor in whether a state saw childhood uninsurance increase. States that saw the lowest childhood uninsurance rates were also most likely to be states that expanded their Medicaid programs under the ACA. In fact, every state plus the District of Columbia in which the children’s uninsurance rate was under 3.5 percent was an expansion state.

Out of all 50 states and the District of Columbia, only North Dakota, an expansion state, successfully lowered its childhood uninsurance rate.

That being said, having a low uninsurance rate is positive indicator but not a guarantee of a healthy childhood insurance environment. West Virginia had the seventeenth lowest childhood uninsurance rate in 2018 but experienced an increase of 25 percent or more from 2016 to 2018. The Mountaineer State had the fifth most significant childhood uninsurance increase in the nation.

At the individual level, the uninsurance rate among children under six years old is seeing a negative shift. After years of this age group having the lowest uninsurance rates, the rate changed from 3.8 percent to 4.3 percent from 2016 to 2018.

Hispanic and American Indian or Alaskan Native children are seeing the highest increases in uninsurance rates. Among Hispanic children, the uninsurance rate went from 7.0 percent in 2017 to 8.2 percent in 2018. American Indian and Alaskan Native children had an uninsurance rate of 12.9 percent and 13.2 percent in 2017 and 2018, respectively.

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In contrast, Asian, Native Hawaiian, and Pacific Islander children had the lowest uninsurance rates, staying at four percent both years.

Previous research found that legal immigrants who are not yet citizens are among the most likely to be uninsured, including their children. Thirteen percent of the children of noncitizens were citizens themselves and seven percent of those did not have health insurance.

Uninsured children are likely to be in low- or moderate-income families. While most of them fall within Medicaid or CHIP eligibility requirements, they are not enrolled.

The researchers blamed the administration’s policies for this downward trend.

In a letter to the Department of Health and Human Services (HHS), the Senate Committee on Finance and the House Energy and Commerce Committee agreed with the researchers and expressed their concern in regards to the findings of this report.

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“We believe that these historic coverage losses among children are the result of overly burdensome and faulty eligibility and renewal processes, diminished resources for outreach and enrollment assistance, and policies that instill fear and confusion among immigrant and mixed status families, such as the Department of Homeland Security’s public charge rule, that are leaving eligible children without the coverage they need,” the letter said.

The Senate Committee on Finance and the House Energy and Commerce Committee gave HHS a month to respond with materials that show how long HHS has been aware of this uninsurance decline and the departmental response. Lawmakers also called on HHS to submit data proving that children who have been disenrolled from Medicaid and CHIP are covered under another source as the administration has claimed and send the details of CMS’ plan to rectify the situation.