(CNN)The
number of uninsured children ballooned by more than 400,000 between
2016 and 2018, an unprecedented decline in health coverage for the
youngest Americans, a new study has found.
Roughly
4.1 million children were uninsured in 2018, up from a low of 3.6
million in 2016, according to the Georgetown University Center for
Children and Families, citing US Census Bureau data. Their uninsured
rate jumped to 5.2% last year, up from 4.7% in 2016.
Another
Census study shows a similar increase, with the uninsured rate for kids
increasing to 5.5% last year, up from 5.0% two years earlier.
The
trend is particularly troubling because it comes during a period of
economic growth when more Americans are gaining employment, said Joan
Alker, the center's executive director. She fears even more children
will lose coverage if the economy falters.
"Much
of the gains in children's coverage that came about as a result of the
Affordable Care Act have now been reversed," Alker said.
The national uninsured rate for all Americans also
rose last year for the first time in nearly a decade, according to the
Census Bureau. It increased to 8.5% in 2018, up half a percentage point a
year earlier. Some 27.5 million people were uninsured last year, a jump
of 1.9 million.
Several factors have contributed to the bump in uninsured rates for children, the center says. They include: efforts to repeal the Affordable Care Act and cut Medicaid, delays in funding the Children's Health Insurance Plan, the effective elimination of the individual mandate penalty, cuts to Affordable Care Act enrollment outreach and advertising and an increase in state-based eligibility checks for Medicaid.
Also, the Trump administration's crackdown on immigration
has discouraged parents from enrolling eligible children in public
programs, leading to a rise in uninsured Latino children in particular.
The
Affordable Care Act helped improve children's coverage rates by
increasing the likelihood that children would be enrolled in Medicaid or
CHIP when their parents obtained insurance, simplifying enrollment,
funding outreach efforts and establishing the individual mandate, which
required most Americans to be insured or pay a penalty. Congress set the
penalty to $0 starting this year.
Health
insurance is vital for children, particularly young ones, experts say.
They need immunizations and developmental screenings, as well as routine
and preventative care.
"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," said Lanre Falusi, American Academy of Pediatrics national
spokesperson.
In addition to
declines in Medicaid coverage for children, fewer were enrolled in the
individual market -- which includes the Obamacare exchanges -- between
2017 and 2018, likely a result of higher premiums. Insurers hiked rates
that year in part because of uncertainty created by efforts by President
Donald Trump and congressional Republicans to repeal the landmark
health reform law.
The coverage
loss was greatest among white children and Latino children, some of whom
may fall into both categories, and for kids under age 6. Also, children
in families between 138% and 250% of the federal poverty level -- or
about $29,000 to $50,000 for a family of three -- saw big declines. The
majority of uninsured children qualify for either Medicaid or CHIP but
are not enrolled.
A larger share of higher-income children are also uninsured, likely because of rising premiums in employer-sponsored coverage, Alker said.
Fifteen states, led by Tennessee, Georgia and Texas, saw the number and/or rate of uninsured children increase.
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