Number of Uninsured Children Rising Since 2016

“The Number of Uninsured Children Is On the Rise

Key Findings

The number of uninsured children in the United States increased by more than 400,000 between 2016 and 2018 bringing the total to over 4 million uninsured children in the nation. Bipartisan initiatives and the Affordable Care Act that successfully reduced the child uninsured rate for many years have been undercut by recent policy changes, and the U.S. is now reverting
backward on children’s health coverage. The number of uninsured children and the child uninsured rate are now at the highest levels since 2014, when the ACA’s major coverage expansions first took effect. This trend is particularly troubling as it occurred during a period of economic growth when children should be gaining health coverage. The child uninsured rate may increase more rapidly should an economic downturn occur.

These coverage losses are widespread with 15 states showing statistically significant increases in the number and/or rate of uninsured children (Alabama, Arizona, Florida, Georgia, Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Texas, Utah, West Virginia), and only one state (North Dakota) moving in the right direction. States where the uninsured rate for children has increased most sharply are Tennessee, Georgia, Texas, Utah, West Virginia, Florida, and Ohio. With respect to the number of uninsured children, West Virginia, Tennessee, Idaho, Alabama, Ohio, and Montana saw increases of 25 percent or more between 2016 and 2018.

Loss of coverage is most pronounced for white children and Latino children (some of which may fall into both categories), young children under age 6, and children in low- and moderate income families who earn between 138 percent and 250 percent of poverty ($29,435 – $53,325 annually for a family of three). Children whose families are in this income range also have the
highest uninsured rates. American Indian/Alaska Native children continue to have the highest uninsured rates by race. African American children saw a slight improvement in their coverage rates during the period examined.

States that have not expanded Medicaid to parents and other adults under the Affordable Care Act have seen increases in their rate of uninsured children three times as large as states that have. Children in non-expansion states are nearly twice as likely to be uninsured as those in states that have expanded Medicaid. ..”

Georgetown University Health Policy Institute, “The number of uninsured children is on the rise,” Joan Alker and Lauren Roygardner, October 2019

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