Report: State’s number of uninsured children rising

A report released Wednesday (June 26) said the percentage of uninsured Arkansas children is rising. To reverse the trend, an advocacy group said the state should determine eligibility for all ARKids First recipients annually and not monthly, and increase its outreach efforts with immigrant families.

Those were some of the findings in an Arkansas Advocates for Children & Families report, “Removing the Hurdles to the Finish Line.” The “finish line” would be 100% coverage.

The report said Arkansas has reduced its uninsured rate through efforts such as the ARKids First program covering lower-income children, and the adult program now known as Arkansas Works. Fifty-two percent of all Arkansas children are covered by Medicaid and ARKids First.

However, the trend in 2017 began moving in the opposite direction. The percentage of uninsured children fell from 7.3% in 2010 to 4% in 2016, but it increased to 4.8% in 2017. The percentage of uninsured adults in 2017 increased from 11% to 13%.

Moreover, monthly state Department of Human Services reports showed a decline in ARKids First enrollment from 435,431 at the beginning of 2018 to 418,542 by the year’s end. The report said school-aged children are more likely to be uninsured than younger children.

The uninsured rate for children under age 19 in households with incomes between 100% and 200% of the federal poverty level increased from 4.4% in 2016 to 6.2% in 2017. That was the most likely group of children to be uninsured in 2017. The percentage of uninsured children increased at all other income levels except those below 100% of the poverty line. In those households, it fell from 5.7% to 5.1% in 2017.

At the same, the percentage of children under age 18 living in poverty fell that year from 23.5% to 21.3%.

For children covered by ARKids A, which serves the lowest-income children, the report recommends continuous eligibility on an annual income basis, not a monthly income basis. Doing so would help ensure coverage for families whose incomes may fluctuate. Children covered by ARKids B, which serves higher-income families, already are served on an annual basis.

Cleveland County had the state’s highest rate of uninsured children, 11%. Madison and Carroll counties were second at 9%. Arkansas and Woodruff counties had the lowest percentage at 1%.

In 2016, the Fourth Congressional District covering southern and western Arkansas had the highest percentage of children served by Medicaid or ARKids First, 56%, and the lowest percentage of uninsured children, 2%. The other congressional districts had uninsured rates of 4% but had varying degrees of children covered by those programs: 54% in the First; 43% in the Second; and 42% in the Third.

Broken down by race, the percentage of uninsured white children fell from 4.9% to 3.1% in 2017, but the percentage of uninsured children of other races increased. Among black children, it increased from 1.7% to 3.5%. Among Hispanic children, it increased from 9.2% to 13.6%. Among children described as “other,” it increased from 7.7% to 14%. Seventy-three percent of foreign-born children in Arkansas lack insurance.

The report recommends increasing outreach efforts to immigrant families. About 11% of the state’s children, or 82,000, have a parent who is an immigrant, but more than 90% of those children are U.S. citizens. The report said 69% of children in immigrant families live in low-income households, compared to a statewide average of 52%.

The report pointed to a 2017 legislative resolution allowing the state to waive a five-year waiting period for Medicaid eligibility for lawfully residing immigrant children. The resolution also made eligible children from the Marshall Islands who live in Arkansas as part of an arrangement between the two countries.

It questioned a proposed Trump administration rule making it harder for applicants considered likely to need public assistance to obtain permanent residency or a temporary visa. That rule could discourage immigrants from enrolling in public assistance, the report said.

The report calls for eliminating the current prohibition on using state funds for outreach and enrollment in Arkansas Works. That’s the state program that uses mostly federal dollars to purchase private health insurance for adults with incomes up to 138% of the poverty level. Covering more adults should result in more children being covered, the report said.