The 2018 Census data report released on September 10, confirms: fewer children have health insurance than the previous year, 2017. According to the US Census Bureau, 4.3 million children don’t have health insurance. This is an increase of 0.6 percent over the previous year.
The reason for the decline is believed to be multi-faceted. According to the US Census Bureau, the contributing factors stem from policy changes, “The new report highlights that 5.5% of children under the age of 19 were uninsured, largely because of a decline in public coverage.”
Public coverage refers to programs like Medicaid and CHIP (Children’s Health Insurance Program). Medicaid was designed to cover the poorest of children, while CHIP was established in 1997 to bridge the gap for children from lower-income families who don’t qualify for Medicaid. The percentage of children covered by private insurance did not change statistically, but the percentage of children with public health coverage dropped 1.3 percent.
The data also revealed the slip in coverage varies both socioeconomically and geographically. Socioeconomically, the lowest of the low-income groups were most affected. Geographically, it’s believed the Affordable Care Act (ACA) played a part in the latest findings.
Thirty-one states and the District of Columbia expanded Medicaid coverage through the ACA. The states that offered expanded coverage showed an overall decrease in Medicaid and CHIP, while the states that didn’t offer expanded coverage stayed statistically unchanged. However, the number of children without health coverage overall rose in the states that didn’t offer Medicaid expansion and stayed unchanged in the states that did offer expansion.
Many believe there are other factors at play, citing cutbacks in Medicaid outreach, increased difficulty enrolling and re-enrolling in the programs and the recent “public charge rule” as barriers. The “public charge rule” makes it harder for illegal immigrants that have participated in public aid programs to seek legal citizenship. Congruently, Hispanic children showed the highest increase in uninsured rates. NPR reported earlier this year that a growing number of American children are dropping out of Medicaid because their parents are undocumented.
This recent census data shows a decline in health insurance coverage for a second consecutive year. Lower-income children appear to be the most affected. How this will impact the healthcare these children receive and whether or not there will be any significant effects on their long-term health remains unknown.