A publication of the Kentucky Center for Public Service Journalism

More children in state, nation lack health insurance; Kentucky uninsured rate rose to 3.8 percent in 2017

By Melissa Patrick
Kentucky Health News

For the first time in nearly a decade, the number of uninsured children in the United States and Kentucky increased, according to a report from Georgetown University in Washington, D.C.

From 2016 to 2017, the number of uninsured U.S. children rose by 276,000, to nearly 4 million. About 5 percent of the nation’s children were uninsured in 2017, up from 4.7 percent in 2016.

In Kentucky, 6,000 fewer children had health insurance in 2017, for a total of 41,000. That’s an increase to 3.8 percent, up from 3.3 percent in 2016.

The report, based on Census Bureau data, found that no state saw its number of uninsured children decline from 2016 to 2017. The rate did drop in the District of Columbia.

In six of the previous seven years, the percentage of U.S. children with health insurance increased, first due to the Children’s Health Insurance Program (K-CHIP in Kentucky), then with the 2014 implementation of the Patient Protection and Affordable Care Act.

“Having health insurance is important for children because it improves their access to needed preventive and primary care such as well-child visits, immunizations, and prescription drugs. Insured children are also less likely to miss school, and they are more likely to have better economic and educational outcomes when they grow up,” Joan Alker, co-author of the study and executive director of Georgetown’s Center for Children and Families, says in the news release.

The report says the declines are likely the result of influences that have created an “unwelcome mat” effect, including: efforts to repeal the ACA; an “unprecedented delay” by Congress to fund CHIP; repeal of the law that required most peoples to have health insurance or pay a fine; huge cuts in outreach and enrollment programs for ACA insurance; a shorter open enrollment period for that insurance; and changes in state Medicaid systems that may have tightened verification procedures.

In addition, the report says that several new Trump administration policies deter parents who are immigrants from enrolling their children, even if the child is a U.S. citizen. One-quarter of all children under 18 living in the U.S. have a parent who is an immigrant.

“Declines in child coverage rates occurred in 2017 despite an improving economy and low unemployment rate, strongly suggesting that federal actions contributed to a perception that publicly funded health coverage options are no longer available or, in the case of an immigrant parent, created concern about enrolling their child in public coverage for fear of reprisal,” says the report.

The report adds that while the largest source of coverage for children in 2017 was through employer-sponsored insurance, the increases made in this market were not enough to compensate for the decline in publicly-funded coverage.

The report also shows that states that expanded Medicaid to people with incomes up to 138 percent of the federal poverty level, as Kentucky did, had fewer uninsured children. For example, of the 276,000 children who lost coverage in 2017, three-fourths, or 206,000, lived in non-expansion states.

Research shows that children whose parents are insured have considerably higher rates of coverage than those whose parents are not.

“We’ve made so much progress in Kentucky since 2014,” Emily Beauregard, executive director of Kentucky Voices for Health, said in a KVH blog post. “By getting parents covered under our Medicaid expansion and health insurance marketplace, we’ve seen a dramatic decrease in the number of children who were uninsured. It would be a shame to allow all that we’ve achieved for Kentucky’s children fall by the wayside.”

The report concluded with a dire warning: “Barring new and serious efforts to get back on track, there is every reason to believe the decline in coverage is likely to continue and may get worse in 2018.”

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