19 Years and Counting, Children’s Health Insurance Is a Big Winner
Policy + Politics

19 Years and Counting, Children’s Health Insurance Is a Big Winner

REUTERS/Lucy Nicholson

Evidence continues to pile up that federal health care programs are working to reduce dramatically the number of uninsured Americans -- especially children and low-income families.

Earlier this month, a Gallup-Healthways survey showed that the uninsured rate had fallen from 18 percent to 11 percent among adults between 2013 and the first quarter of 2016, a drop of nearly 40 percent.

That was the lowest uninsured rate in eight years, according to Gallup, and was due in large measure to Obamacare, including its provisions for expanding Medicare, and employer provider insurance due to job growth.

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A new study released this week confirms that the federal Children’s Health Insurance Program (CHIP) -- which matches state funds for health insurance for families with children --  expanded Medicaid in 26 states, and Obamacare are having a profound impact on the share of children and the lower middle class who are still struggling without health care insurance.

The report, issued by the Urban Institute, found that the uninsured rate among children 18 years and younger fell 68 percent between 1997 – the year CHIP was introduced -- and 2015. The study showed that the decline was relatively steady over much of the past 18 years, and picked up steam during the first two full years of Obamacare, in 2014 and 2015.

Children and Obamacare

Particularly notable is that the uninsurance rate fell during the Great Recession years ... a time when uninsurance rates for nonelderly adults increased,” the study noted. “This demonstrates the countercyclical role that Medicaid and CHIP played in offsetting the loss of private coverage for children as the economy worsened.”

CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers parents and pregnant women. The 2014 cost to the Federal government was $9.2 billion, while the states kicked in $3.9 billion.

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The Urban Institute study was based on data from the National Health Interview Survey and other research. It showed that the federal programs helped to slash the uninsured rate by as much as 75 percent for children five years old and younger and by 61 percent for those 13 to 18 years of age.

Roughly 4.4 million children lacked health care insurance in 2014, down substantially from 10.7 million in 1997. During that period, the number of uninsured children aged five and under plunged from 2.9 million to  just one million, according to the findings.

“I’ve been studying health insurance coverage for decades, with a focus on kids,” said Genevieve Kenney, a senior fellow at the Urban Institute and a co-author of the study. “I don’t think there is any other way to look at these findings than being pretty remarkable. The decline [in the uninsured rate] is large, and it is shared across different income groups.”

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As for the children who were still going without health insurance in 2013 and 2014, most of them were minorities or from families with parents of limited education or who were living illegally in the country. The study described them as “disproportionately likely to be uninsured” and faced “large gaps in health care access, affordability, and service use compared with their insured peers.”

About 44 percent of the uninsured children were Hispanic, 39 percent were non-Hispanic whites, and 9 percent were non-Hispanic blacks. Nearly a sixth of the uninsured children were not citizens of the U.S. and a third lived in a family with at least one person who lacked citizenship. On a geographic basis, half of all the uninsured children lived in southern states, while another quarter of the children resided in the West.