400,000 more children are uninsured since Trump took office

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.