Sunday, December 15, 2019

Study shows Ky. had the nation's third largest increase in 2016-18 in the percentage of young children without health insurance

By Melissa Patrick
Kentucky Health News

Over the past two years, Kentucky saw the third largest increase in the nation for the percentage of children under 6 years of age with no health insurance, says a Georgetown University study.

The university's Center for Children and Families' analysis of the most recent census data found the rate of uninsured children under the age of 6 in Kentucky rose from 2.7 percent to 4% between 2016 and 2018. The national rate increased from 3.8% to 4.3% respectively.

The state's rate had been trending down since 2014, which coincides with the full implementation of the Patient Protection and Affordable Care Act, or Obamacare.

In 2013 the rate was 5.2%, in 2014 it was 4.1%, in 2015 it was 3.5%, dropping to its lowest rate of 2.7% in 2016, before increasing in 2017 to 3.5% and again to 4.0% in 2018.

The number of uninsured young children in Kentucky went from 8,608 in 2016 to 12,973 in 2018, meaning that 4,365 more young children in Kentucky didn't have coverage in 2018, a 50.7% change.

Kentucky was one of 11 states that showed a significant increase in both the rate and number of uninsured young children, says the report.

In a blog-post about the report, the liberal-leaning Kentucky Center for Economic Policy reports that this finding is in line with the broader coverage losses experienced in Kentucky between 2016 and 2018.

"But the increase in the number of uninsured young children (50.7%) far outpaced the increase in the number of uninsured Kentuckians as a whole (10.9%)," Dustin Pugel, policy analyst for KCEP, writes.

The report stresses that it is critical for this age group to have health insurance, not only for medical care during a time in life that includes rapid brain development and physical growth, but also because it protects families from financial risk that can come from an unexpected injury or illness. Further, it points to research that shows health insurance for children is linked to better health, educational, and economic outcomes well into adulthood.

The American Academy of Pediatrics recommends 15 checkups before age 6. These early visits include not only vaccinations and preventive care, but screenings that can detect developmental delays to allow for early intervention.

The report does not specify if the recent increase in uninsured young children is specific to any one type of coverage.

It also points out that these increases have happened during a time of economic growth, "when children should be gaining health care coverage."

The report notes that a number of factors could be contributing to this coverage reversal, including declines in Medicaid and in the Children Health Insurance Program.

It adds that these declines have likely been influenced by the Trump Administration's "policies and rhetoric targeting immigrant families," which has reportedly deterred many parents from signing up eligible citizen children in available Medicaid and CHIP coverage.

It also points to ongoing national policy debates and decisions that it says have "undoubtedly sowed confusion among parents and caregivers about whether coverage would be available to their children."

Specifically, the report points to the 2017 efforts in Congress to repeal the ACA and severely cut Medicaid, along with months-long delay in extending the children's insurance program funding, as well as cuts to national outreach grants.

Added to Kentuckians confusion, Pugel notes that in addition to these other issues, Kentuckians have also had to keep up with the status of the state's new Medicaid program, which was instigated under then-Gov. Matt Bevin. The new program includes, among other things, work and community engagement requirements. The proposal has been blocked by a federal judge and an appeal has been argued. Gov. Andy Beshear has said he plans to rescind the proposal.

Kentucky's numbers would likely be higher if it had not expanded Medicaid to adults who have earnings just above the poverty line. The report shows that young children were more likely to be uninsured in states that did not expand Medicaid.

"Research shows that when adults have access to coverage, they are more likely to enroll their eligible children," says the report. This is often called the "welcome mat."

The report adds that young children tend to be uninsured at lower rates than their school-aged peers. However, Kentucky along with six other states, has shown an opposite trend with 4% of its young children uninsured, compared to 3.7% of its school-aged children.

"For these states, the inversion serves as a potential warning sign that more could be done to reach uninsured young children," says the report.

A health cabinet spokesperson said Friday they would need time to review the report before offering comment.

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