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 four million children were uninsured in 2018, the highest level since the Affordable Care Act’s major coverage expansions first took effect in 2014.
In Tennessee, an estimated 83,000 children were uninsured in 2018, an increase of approximately 43% since 2016. This alarming trend took place during a period of economic growth when children should be gaining health coverage. Overall, Tennessee saw the nation’s largest increase in rate of uninsured children, moving from 3.7% in 2016 to 5.2% in 2018.
“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.”
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.
“This data shows that the declines in children’s enrollment we’ve seen this year have contributed to the country’s largest increase in uninsured kids. This should be a wake-up call for our state leaders to stop promoting policies like block grants and work reporting requirements that threaten even more coverage losses,” said Kinika Young, director of children’s health at the Tennessee Justice Center. “We need to focus on solutions to reverse these troubling trends, like expanding Medicaid. We know when parents are insured, their children are more likely to be insured and the whole family is better protected from medical debt and financial insecurity.”
The report found that children in states that have not expanded Medicaid 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% to 5.2% between 2016 and 2018, according to data from the Census Bureau’s American Community Survey. Coverage losses were widespread, with Tennessee 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.”