Study: Number of uninsured children rises in Arkansas, nation

The number of uninsured children increased from 2016 to 2017 in Arkansas and the United States. In Arkansas, it increased from 30,000 to 33,000, and from 4% of the population to 4.4%.

According to a report by the Georgetown University Center for Children and Families, the number of uninsured children under age 19 nationally rose an estimated 276,000 to 3.92 million. The report said the rate increased from a “historic low” of 4.7% in 2016 to 5% in 2017. It relied on U.S. Census Bureau data.

The report, “Nation’s Progress on Children’s Health Coverage Reverses Course,” said 2017 was the first year since 2008 that the number of uninsured children had increased. That year, 9.7% of children, or 7.6 million, were uninsured.

The report found that no state saw a decline in uninsured children from 2016 to 2017, though the District of Columbia did. Arkansas did move up one spot in state rankings from 26th to 25th.

Three-fourths of the 276,000 children who lost coverage between those two years, or 206,000, lived in states that did not expand Medicaid coverage to lower-income adults under the Affordable Care Act, otherwise known as Obamacare. The uninsured children rate increased almost three times as much in those non-expansion states (.6% versus .2%).

Arkansas expanded its Medicaid population by purchasing insurance for lower-income adults through the program now known as Arkansas Works.

Among the nine states that saw statistically significant increases in uninsured children were two neighboring Arkansas — Texas and Tennessee. Twenty-one percent of uninsured children live in Texas, a non-expansion state that has 8.6% of the nation’s population. There, the rate of uninsured children is 10.7%, the nation’s highest. In 2016, it was 9.8%.

Percentages of uninsured children rose across all family income levels. Related to the federal poverty level, they increased as follows:

• Under 100% of FPL, the rate of uninsured increased from 6% to 6.6%
• 100-137%, from 6.7% to 7%
• 138-199%, from 6.8% to 7%
• 200-299%, from 5.8% to 6.3%
• 300% and above, from 2.5% to 2.8%

Related to race, the percentages changed as follows:

• Black, from 3.9% to 4.6%
• White, from 4.7% to 4.9%
• Asian/Native Hawaiian/Pacific Islander, from 3.5% to 4.1%
• American Indian/Alaska native, from 12.8% to 12.6%
• Hispanic (referring to ethnicity, not race), from 7.7% to 7.8%

The report said that 47.5% of children were covered by employer-sponsored health plans in 2017, an increase from 46.7% in 2016. The percentage of children covered by government plans, Medicaid and the Children’s Health Insurance Program, or CHIP, fell from 35% to 34.3%. The percentage of children covered through directly purchased health insurance dropped from 5.8% to 5.5%. The other 7.8% were covered through Medicare, the military’s TRICARE program, the Veteran’s Administration, or two or more types of coverage.

The report tied the increase in uninsured children to “strong national currents,” including Congress’ attempt to repeal the Affordable Care Act and cap Medicaid funding, and a delay that resulted in CHIP funding temporarily lapsing. Congress did repeal the ACA’s individual mandate to purchase health insurance, while the Trump administration reduced the enrollment period and reduced grants for outreach programs.

The report said one-fourth of children under 18 are living with a parent who is an immigrant. National policies regarding immigrant communities could be discouraging parents from enrolling their children in federal health programs, the report theorized. The report also said changes in state Medicaid information technology systems may have “tightened verification procedures.”