National Rate of Uninsured Children

The number of uninsured children increased nationally by more than 400,000 between 2016 and 2018, reversing a long-standing positive trend according to a new report released by the Georgetown University Center for Children and Families. Nationwide, more than 4 million children were uninsured in 2018, the highest level since the Affordable Care Act’s major coverage expansions first took effect in 2014.

In Missouri, an estimated 83,000 children were uninsured in 2018, an increase of approximately 17 percent since 2016. This alarming trend took place during a period of economic growth when children should be gaining health coverage.

“This trend is troubling, especially when combined with the 100,000 children who have fallen off Medicaid and CHIP in Missouri over the past two years,” said Traci Gleason, vice president of External Affairs for the Missouri Budget Project. “We must do all we can to get and keep kids covered, which means embracing solutions like 12-month continuous coverage and boosting outreach to turn this trend around.”

Gov. Mike Parson did not respond to a request for comment.

The report finds the following factors have contributed to the erosion in children’s health coverage nationwide: efforts 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; and the creation of a climate of fear and confusion for immigrant families that discourages them from enrolling eligible children in Medicaid or CHIP.

“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.”

Expanding Medicaid to more parents and adults would also help as studies show that when parents are covered, kids are more likely to be covered too. The report found that children in states that have not expanded Medicaid, like Missouri, are nearly twice as likely to be uninsured than those in states that have expanded Medicaid.

The child uninsured rate increased nationally from 4.7 percent to 5.2 percent between 2016 and 2018, according to data from the Census Bureau’s American Community Survey. Coverage losses were widespread, with Missouri as one of 15 states showing statistically significant increases in the number and/or rate of uninsured children (Alabama, Arizona, Florida, Georgia, Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Texas, Utah and West Virginia).

“As a pediatrician, I understand first-hand how important health insurance coverage is to my patients; it helps ensure children can receive the care and services they need, when they need them,” said Lanre Falusi, MD, FAAP, American Academy of Pediatrics national spokesperson.

“The findings in this report are deeply concerning to me. For children who are uninsured, I worry about the critical services they are missing out on and what it will mean for their short- and long-term health. Our federal leaders must advance policies that ensure children can get the health care they need to grow up healthy and thrive.”

Along with the report, the Georgetown University research center launched a new interactive data hub that provides a more in-depth look at child health care trends in Missouri and across the country, allowing users to compare a variety of metrics across states.

This is the ninth annual report on uninsured children published by the Georgetown University Center for Children and Families, an independent, nonpartisan policy and research center founded in 2005 with a mission to expand and improve high-quality, affordable coverage for America’s children and families. CCF is based at the McCourt School of Public Policy at Georgetown University in Washington, D.C.

Access the report and the data hub at https://kidshealthcarereport.ccf.georgetown.edu/.

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