Texas Leads Nation In Number Of Uninsured Children: Report

AUSTIN, TEXAS — Texas leads the nation in the number of children without health insurance, according to a newly released study.

In a report by the Center for Children and Families at the Georgetown University Health Policy Institute released this week, researchers found that Texas had roughly 835,000 uninsured children last year, an increase of 83,000 kids from 2016. Even amid a national increase of uninsured kids, statistics from Texas stood out in showing the state had the greatest share with 1 in 5 children without insurance living in the Lone Star State in 2017.

Drawing on 2017 U.S. Census Bureau data, researchers found that 10.7 percent (835,000 children) lacked health insurance in Texas. That's an increase from 9.8 percent in 2016, according to the study.

While Texas again gained the dubious distinction of topping the list, increases in benefits-bereft children isn't endemic to the state. For the first time in nearly ten years, the rest of the nation posted increases in the number of uninsured youth — from 3.6 million to 3.9 million children without health insurance, a increase from 4.7 percent in 2016 to 5 percent last year, researchers found.

"While no state saw meaningful movement in the right direction, nine states had the worst possible outcome and saw statistically significant increases in their rate of uninsured children," researchers wrote. "These states are (in order of magnitude) South Dakota, Utah, Texas, Georgia, South Carolina, Florida, Ohio, Tennessee, and Massachusetts."

Some reasons for the hike of uninsured children in Texas appear to be politically driven. Given Republican control of the state by conservatives loathe to avail themselves of social programs anathema to their ideology, Texas is among those states declining to expand Medicaid coverage to parents and other adults.

Access to social programs has long been a hallmark of the Democratic Party, and thus a source of political fodder for conservative ideology against such programs.

The upshot: "Three quarters of the children who lost coverage in 2017 live in states that have not expanded Medicaid coverage to parents and other adults," Georgetown University researchers noted in their report. "Three big states that jump out in this vein are Texas, Florida and Georgia — all of whom saw sizable increases in their child uninsured rate."

Why is the rate of uninsured children growing? Researchers can't say for sure, but offer a couple of informed guesses:

• "The majority of uninsured children are already eligible for Medicaid or CHIP but are not currently enrolled," analysts wrote, noting the rate of children insured through Medicaid and CHIP fell 2 percentage points in 2017. "The name of the game here is to make sure that families are aware that their child has a path to coverage and that these kids get enrolled and stay enrolled. For these families, 2017 was a year of constant news about the president and Congress wanting to take coverage away — first with the attempt to repeal the Affordable Care Act and make drastic cuts to Medicaid, all of which continued with a last gasp effort in September 2017."
• "Then on September 30, funding for CHIP expired and, in an unprecedented delay, Congress did not extend funding until early 2018 — again with families hearing that their state might have to close its CHIP program."
• "At the same time, the Trump Administration began efforts to sabotage the ACA’s Marketplace including cuts to advertising, outreach and enrollment funding for navigators — who were playing an important role connecting families with public coverage, with the repeal efforts raising insurer uncertainty and driving up premiums." The net effect of that drumbeat of ACA animus is a broad, but mistaken, perception that government-subsidized health insurance programs are no longer available.
• "The Trump Administration also began a series of actions hostile toward immigrant families. One quarter of children living in the United States has a parent who is an immigrant. For these “mixed status” families, there is likely a heightened fear of interacting with the government and this may be deterring them from signing their eligible children up for government sponsored health coverage. As a result, the “welcome mat” for coverage has been pulled back and we see the results – more uninsured children."

Ironically and incongruously, hikes in the rate of uninsured children come amid highly touted economic growth. Donald Trump often boasts of the robust economy and low unemployment rate in gaining political capital, and conservative lawmakers in Texas often cite the "Texas Miracle" of the state economy, shielded from economic woes afflicting others states given its diversified economic base.

"With an improving economy and low unemployment rate, the fact that our nation is going backwards on children’s health coverage is very troubling," the study's authors wrote. "Without serious efforts to get back on track, the decline in coverage is likely to continue in 2018 and may in fact get worse for America’s children."

In January, Georgetown University wrote a related report titled "Research Update: How Medicaid Coverage for Parents Benefits Children." Yet by September, researchers followed up with a sobering assessment in a report titled "Nation’s Progress on Children’s Health Coverage Reverses Course." This week's report continues the corrosive trend of uninsured rates as illustrated by researchers' September 2017 report "Nationwide Rate of Uninsured Children Reaches Historic Low."

To read the full Georgetown University report, click here.

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