Guest post by Michelle Hughes at NC Child
The number of uninsured children increased nationally by more than 400,000 between 2016 and 2018, reversing a long-standing positive trend. The data come from a new report released by the Georgetown University Center for Children and Families. Nationwide, more than 4 million children were uninsured in 2018, the highest level since the Affordable Care Act’s major coverage provisions took effect in 2014.
In North Carolina, an estimated 130,000 children were uninsured in 2018, an increase of approximately 13 percent since 2016. This alarming trend took place during a period of economic growth when children should be gaining health coverage.
Every child needs access to basic health care. Without health coverage, children can miss important screenings. Many have to go without the treatments they need to thrive, like inhalers, diabetes maintenance, and physical therapy. We know from our own history that good access to health care sets kids up for better grades in school, a richer childhood, and ultimately higher earnings and much better economic stability as adults.
What is behind this trend?
The child uninsurance rate is growing fastest in states like North Carolina that have not expanded Medicaid. The state legislature could roll out the welcome mat to enroll the whole family in coverage, but so far they have not. This is perhaps the biggest factor behind the numbers of children falling off the insured rolls in North Carolina.
The House Health Committee twice passed HB655, a conservative compromise sponsored by Rep. Donny Lambeth (R-Forsyth), but that bill has yet to be allowed a vote by the full House of Representatives.
While expanding Medicaid, or taking an approach like H655 would provide coverage to uninsured parents and other adults, it also helps children. States that have expanded Medicaid have seen large reductions in their child uninsured rates. This trend is known as the “welcome mat” effect: when parents sign up for their own health coverage, they often learn they can enroll their children too.
Along with the report, the Georgetown University research center launched a new interactive data hub that provides a more in-depth look at child health care trends in North Carolina and across the country, allowing users to compare a variety of metrics across states.
Michelle Hughes is the executive director of NC Child. Learn more at ncchild.org.