BEYOND THE NUMBERS
The uninsured rate among children fell to a historic low of 6 percent in 2014 as health reform’s major coverage expansions took effect, the Georgetown University Center for Children and Families’ annual report on children’s health coverage finds. That’s down from 7.1 percent in 2013 and marks the largest single-year decline on record in data going back to 2008.
While the coverage expansions mainly target low-income adults, children benefit as well, the report shows:
- States that expanded Medicaid as part of health reform had much larger declines in the children’s uninsured rate than non-expansion states in 2014, even though they had lower uninsured rates to start with. The uninsured rate among children dropped from 5.9 percent to 4.6 percent in expansion states and from 8.5 percent to 7.5 percent in non-expansion states.
- That’s likely because research shows that expanding Medicaid coverage to parents boosts participation by their children who are already eligible for Medicaid and the Children’s Health Insurance Program (CHIP). Parents are more likely to sign up their children for coverage when the whole family can get coverage.
- Similarly, outreach efforts to sign adults up for subsidized coverage through health reform’s marketplaces likely encouraged more parents to enroll uninsured-but-eligible children in Medicaid and CHIP.
- Also, health reform bars states from cutting children’s eligibility for Medicaid or CHIP (or making it harder for eligible children to enroll) until 2019. That prevented states from scaling back children’s coverage to close budget deficits.
Some 68 percent of uninsured children were eligible for Medicaid or CHIP before health reform’s coverage expansions took effect, according to the Urban Institute. To make further historic progress in cutting the number of uninsured children, the 20 states that haven’t expanded Medicaid should adopt the option and all states should intensify outreach to enroll more eligible children.