New administrations bring about changes: some good, some not so good. Take for instance the Trump administration.
Per a recent Georgetown University report on children’s health coverage, for the first time in this decade the number of uninsured children rose by 276,000 kids in 2017. There were 3,925,000 children uninsured in 2017, as compared to 3,649,000 in 2016. Though statistically, the rise is small, the upward trend is still shocking when typically uninsured rates for children drop during periods of economic growth.
Health coverage for children is important for numerous reasons, such as improving immunization rates, providing needed services such as well-child checks, and improving public health in general. Children who are healthy are also more likely to miss fewer days of school, which impacts future educational and economic opportunities.
Children with conditions such as asthma need regular medical care and consistent access to medications. It is also well-recognized that poor children may have limited access to care even if they are insured. Therefore, adding a lack of insurance hurdle only further complicates the situation.
It is not surprising that three-fourths of the children who lost coverage between 2016 and 2017 were from states that did not expand Medicaid. Interestingly enough, eight of the nine states with the most statistically significant increases were in states that voted for President Trump (Florida, Georgia, Massachusetts, Tennessee, Texas, Ohio, South Carolina, South Dakota, Utah). One in five uninsured children in the U.S. lives in Texas, making it the state with the largest share of children without coverage.
Only the District of Columbia saw a decline in the number of uninsured children.
As a reminder, this current body of congressional legislators unsuccessfully tried to repeal the Affordable Care Act (ACA, otherwise demonized as “Obamacare”) and cap Medicaid funding and caused a temporary delay of funding for the Children Health Insurance Program (CHIP). Furthermore, the individual mandate to purchase health insurance was repealed by this Congress. The individual mandate was originally put in the legislation so that the risk pool would include healthy as well as sick people. Reducing the open enrollment period and cutting outreach and enrollment grants were additional efforts by the Trump administration to weaken the ACA.
Per the Georgetown study, certain policies by the Trump Administration are deterring immigrant parents from enrolling their children in Medicaid or CHIP even though these kids are U.S. citizens. Parents, quite frankly, are afraid of being deported.Â
When comparing years 2016 and 2017, American Indian and Native Alaskans had the highest rates of uninsured children, followed by Hispanics. The uninsured rate of black children rose from 3.9 percent in 2016 to 4.8 percent in 2017.
Therefore, without the proper checks and balances, the authors of this study concluded that rates of uninsured children will continue to rise. The ACA Marketplace will also continue to struggle and show declining enrollment due to perception (the belief that ACA no longer exists) and infrastructure problems.
Ensuring the well-being of our most vulnerable populations is a responsibility of us all. The current trend of health insurance coverage for our children is concerning and will have negative effects on our communities if our voices are not heard.
Denise Hooks-Anderson, M.D., is assistant professor at SLUCare Family Medicine and medical accuracy editor for The St. Louis American. Email her at yourhealthmatters@stlamerican.com.
