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After years of steady decline, the number of American children without health insurance has increased by 276,000 in 2017, according to a report from Georgetown University released Thursday.
Although statistically, the share of uninsured children is not very large, it was 5.7% in 2017, compared to 4.7% a year earlier – but it remains striking. The uninsured rate generally remains stable or decreases during periods of economic growth. In September, the US unemployment rate reached its lowest level since 1969.
"The country is backing up to insure the children and the situation is likely to worsen," said Joan Alker, co-author of the study and executive director of the Georgetown Center for Children and Families.
Alker and other child health advocates attribute responsibility for this change to the Trump administration and the Republican-controlled Congress, saying Republican policies and actions have put a damper on registration in health plans.
In the United States, the number of children without coverage has increased from 3.6 million a year earlier to 3.9 million in 2017, according to census data analyzed by the Alker team in Georgetown.
The overall uninsured rate for people of all ages – who dropped from 2013 to 2016 following the implementation of the Health Act – remained unchanged at 8.8% last year.
The proportion of children receiving employer-sponsored health coverage has increased slightly in 2017, says Alker, but not enough to offset the drop in the number of children enrolled in Medicaid or benefiting from the coverage Obamacare insurance scholarships.
Although no state has made significant progress in reducing the percentage of uninsured children, nine states have seen their numbers deteriorate. The largest negative changes occurred in South Dakota (where the rate of uninsured children increased from 4.7% to 6.2%), Utah (from 6% to 7.3%) and Texas (from 9.8% to 10.7%).
More than one in five uninsured national children live in Texas – approximately 835,000 children – by far the largest number of any state.
Florida had 325,000 uninsured children last year, with its uninsured insurance rate for this age group increasing by 0.7 percentage points to 7.3%. California had 301,000 uninsured children – its number remained virtually unchanged from the previous year.
Georgia, South Carolina, Ohio, Tennessee and Massachusetts also experienced a significant increase.
Uninsured rates for children have almost tripled compared to those states that have not expanded their Medicaid business under the Affordable Care Act, according to the report. Studies have shown that children whose parents are insured are more likely to be in good health blanket.
Georgetown has been tracking these numbers since 2008, when 7.6 million children – about 10 percent of children – did not have a health care system.
Since almost all low-income children are eligible for Medicaid or the federal child health insurance program, the challenge is to ensure that parents are aware of these programs, says Alker, and to that the children are enrolled and that they remain enrolled as long as they are eligible. .
Congress allowed CHIP funding to expire for several months in 2017, putting states in a position of having to warn families that registrations would soon be frozen. Congress reinstated federal funding early in 2018.
In addition, low-income families were bombed last year with reports that the Congress was threatening to repeal the health bill, which extended coverage to millions of people. And, in the past two years, the Trump administration has slashed funding for the browsers of Obamacare who help people sign up for coverage.
Alker points out that the Trump government's September proposal, known as the "public office" rule, is another factor that could have led to a decrease in the number of children receiving health insurance. The rule could make it more difficult to obtain a green card for immigrants in good standing if they have received certain types of public assistance, including Medicaid, food vouchers and other housing subsidies. Green cards allow these legal migrants to live and work permanently in the United States.
OLE Health, a leading Napa Valley, Calif.-based healthcare provider serving many immigrants, said it has seen patients drop out of Medicaid lists in the last year. CEO Alicia Hardy says that many have dropped the coverage because they feared that help would jeopardize their immigrant status.
"They are afraid to be deported" she says.
All these events may have deterred families from protecting their children.
"The welcome mat has been removed," says Alker, "and so we see more uninsured children."
She says the easiest way to change the trend would be for more states to develop Medicaid under the Health Act. Fourteen states have not yet done so. Although the expansion mainly concerns adults, their children will likely follow as parents enroll.
Kaiser Health News, a non-profit news service, is an independent editorial program of the Kaiser Family Foundation, and is not affiliated with Kaiser Permanente. The coverage of child health problems by KHN is supported in part by a grant from the Heising-Simons Foundation.