The fresh start of a new decade brings renewed interest in the growing numbers of uninsured children in our nation. Four million children are now uninsured, an increase of than 400,000 between 2016 and 2018, according to the U.S. Census. The new numbers point to a new downward trend after a trajectory of coverage among children the past few years. Now, Medicaid and the Children’s Health Insurance Program (CHIP) coverage has declined (while the number of children with private insurance has not markedly changed). The trend is worse among white and Latino children, young children under age 6, and children in low- and moderate-income families who earn between 138 percent and 250 percent of poverty.
Most notably, states that have not expanded Medicaid to parents and other adults as an option under the Affordable Care Act (ACA) have seen increases in the rate of uninsured children three times as large as states that chose to expand Medicaid. Among the factors contributing to the decline in coverage are efforts to repeal the ACA changes in Medicaid policy, delays in funding CHIP, funding cuts to enrollment outreach and advertising and an increase in state-based eligibility checks for Medicaid. Also, the crackdown in immigration has triggered fears among parents about enrolling eligible children in public programs. Last October Senate Finance Committee Ranking Member Ron Wyden (D-OR) and House Energy Commerce Committee Chairman Frank Pallone, Jr, raised concerns about the “disturbing trend” in the rising ranks of uninsured children in an October letter to Health and Human Services Secretary Alex Azar.
School-based health centers can meet the full range of a child’s health care needs regardless of insurance status. Health centers already serve one in 9 children and 802,630 school-based patients. To learn more about school-based health centers, please visit this link.