Suddenly, Progress on Children’s Health Coverage Reverses

For the past eight years, the Center for Children and Families at the Georgetown University Health Policy Institute has published a report tracking health coverage rates for children across the country. This year, for the first time since they began writing this report, the number and rate of uninsured children in the United States went up.

For many years, that rate has been declining thanks to bipartisan efforts to extend coverage through Medicaid and the Children’s Health Insurance Program (CHIP). But in 2017, approximately 276,000 more children became uninsured, leading to a total of 3.9 million uninsured children nationwide. The rate for children age 18 and under went up from 4.7 percent in 2016 to 5 percent in 2017, according to our analysis of U.S. Census Bureau’s American Community Survey data.

While this may not seem like a huge change, both increases are unprecedented in the past decade. Even more troubling, the number of uninsured children increased during a time of economic strength – in fact, at a time when one would expect the uninsured rate to go down, as more children were covered by employer-sponsored insurance in 2017.

However, coverage for children from public sources, Medicaid and CHIP, and in the individual market – inside and outside the Marketplace – decreased during this time period. That caused the number of uninsured children to go up, despite the strong economy.

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 more likely to have better economic and educational outcomes when they grow up. Think of a child with asthma who needs doctor visits and medications to keep her allergies and asthma under control – and without that help will wind up in an emergency room and missing school. Simply put: Kids need health care to succeed.

It’s also notable that no state, except for the District of Columbia, saw any measurable progress in reducing the number of uninsured children in 2017. This finding underscores that even states with the best of intentions – such as those like Iowa that expanded Medicaid – were unable to overcome the negative national currents that are undermining children’s health coverage.

With an improving economy and low unemployment rate, the fact that the nation is going backwards on children’s health coverage is very troubling. Without serious efforts to get back on track, the decline in coverage is likely to continue in 2018 and may in fact get worse for America’s children.