U.S. reaches historical milestone in number of uninsured children

The nation saw the sharpest two-year decline in the uninsured rate for children's health care between 2013 and 2015 – with 95 percent of children having health coverage in 2015, according to a just-released study.

“This is a testament to what can be achieved when national and state leaders work together to confront intolerable problems such as children going without health coverage in our country,” said Georgetown University CCF Executive Director Joan Alker.

The positive trend in children’s health coverage started with the expansion of Medicaid to more children, the creation of the Children’s Health Insurance Program (CHIP) in 1997 and subsequent improvements to both programs aimed at providing health care coverage to children in low-income families. The Affordable Care Act, which maintained and built on Medicaid and CHIP coverage for children, accelerated these trends, according to the report.

Medicaid and CHIP are funded by a combination of state and federal matching tax dollars. In Florida, the federal government pays 60 cents of every dollar and the state pays the remaining 40 cents for the Medicaid program. CHIP provides health coverage options for children whose families earn too much to qualify for Medicaid but too little to afford other coverage.

Forty-one states saw improvements in coverage rates.

California saw the largest decline in the number of uninsured children.

Vermont tops the list, while Texas has the greatest number of uninsured children.

Four states, including Florida, saw a decline of around 4 percentage points.

In 2013, 11.1 percent of Florida children were uninsured. That number dropped to 6.9 percent in 2015. The report indicates Florida ranks 42 nationwide in the percent of uninsured children.

More than half of the nation’s uninsured reside in six states, including Florida.
The South is home to 38 percent of the nation’s children, but half of all uninsured children.

One in five uninsured kids live in Texas.

Florida is among the states where Medicaid has not been expanded. Although the Florida Senate approved a Medicaid expansion plan in 2015, it was rejected by Gov. Rick Scott and the state House.

Why the decline in uninsured children?

While largely targeted at addressing the higher rate of uninsurance among adults, the Affordable Care Act built on Medicaid and CHIP to bring uninsured rates lower for kids.

The “maintenance of effort” provision, driven by ACA’s strategy, requires states to maintain their current eligibility levels for children’s coverage in Medicaid and CHIP.

Other contributors to the decline in uninsured children include:

■ The “welcome mat” effect: As parents learned and signed up for newly available Medicaid or marketplace coverage, many Floridians found out they or their children were eligible for Medicaid when they signed up for health insurance.

■ Eligibility was aligned across families: Eighteen states were required by the Affordable Care Act to move children ages 6 to18 with family incomes between 100 to 138 percent of the federal poverty level from their separate CHIP programs to Medicaid. This eliminated premiums for some children, increasing their chances of enrollment.

■ Subsidies on the marketplace: Premium tax credits help subsidize the cost of coverage on the newly available marketplaces. Approximately 790,500 children enrolled in marketplace coverage in 2015, according to the report.