Georgetown Report: Number of Uninsured TX Kids Up 16%

For Immediate Release
Contact: Peter Clark, 512-417-9262

Analysis shows Texas has the highest number and rate of uninsured children in the nation

The number of uninsured children increased nationally by more than 400,000 between 2016 and 2018, reversing a long-standing positive trend according to a new report released today 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 Texas, an estimated 873,000 children were uninsured in 2018, an increase of approximately 16 percent since 2016. This alarming trend took place during a period of economic growth when children should be gaining health coverage. Overall, Texas has the highest number and rate of uninsured children in the nation, with 11.2 percent of children uninsured.

“Recent policy changes and the failure to make children’s health a priority have undercut bipartisan initiatives and the Affordable Care Act, which had propelled our nation forward on children’s health coverage,” said Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the McCourt School of Public Policy. “This serious erosion of child health coverage is due in large part to the Trump Administration’s actions or inactions that have made health coverage harder to access and have deterred families from enrolling their eligible children in Medicaid and CHIP.”

The report finds the following factors have contributed to the erosion in children’s health coverage nationwide: efforts to repeal the Affordable Care Act and cut Medicaid; delays in funding the Children’s Health Insurance Program (CHIP); elimination of the individual mandate penalty; cuts to enrollment outreach and advertising; inadequate oversight over state Medicaid programs that have created more red tape barriers; and the creation of a climate of fear and confusion for immigrant families that discourages them from enrolling eligible children in Medicaid or CHIP.

While there has been a great deal of fear and confusion about the administration’s new Public Charge rule for visa applicants, it is important for families to know that if they are applying for a green card from within the United States — whether the Public Charge rule is ultimately approved by the courts or not — it is safe to apply for benefits for children and family members who are U.S. citizens or lawfully present immigrants.

“If you want to make sure kids can go to check-ups, do well in school, and quickly see a doctor for anything from strep throat to cancer, then this report is very concerning. This is a problem for kids of all backgrounds in communities throughout Texas, with huge uninsured rates in communities from Amarillo to Brownsville, Odessa to Longview, and Houston to Dallas,” said Adriana Kohler, Senior Health Policy Associate at Texans Care for Children, a member of the Cover Texas Now coalition. “This report should be a wake-up call for the Texas Legislature. State leaders need to make health coverage a priority for the next legislative session and reduce the extra rounds of red tape that have knocked eligible children off of Medicaid."

During the recent Texas legislative session, lawmakers passed no bills to reduce the uninsured rate. Legislators did file a number of bills aimed to reduce the uninsured rate, including bills to reduce red tape for eligible children enrolled in Medicaid; bills to provide health coverage to new mothers for 12 months following childbirth; and bills to accept federal Medicaid expansion funding to cover uninsured child care teachers, janitors, sales clerks, and other low-wage workers.

The Georgetown University report found that children in states that have not expanded Medicaid, such as Texas, are nearly twice as likely to be uninsured than those in states that have expanded Medicaid.

The child uninsured rate increased nationally from 4.7 percent to 5.2 percent between 2016 and 2018, according to data from the Census Bureau’s American Community Survey. Coverage losses were widespread, with Texas as one of 15 states showing statistically significant increases in the number and/or rate of uninsured children (The others are Alabama, Arizona, Florida, Georgia, Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Utah and West Virginia).

“As a pediatrician, I understand first-hand how important health insurance coverage is to my patients; it helps ensure children can receive the care and services they need, when they need them,” said Lanre Falusi, MD, FAAP, American Academy of Pediatrics national spokesperson. “The findings in this report are deeply concerning to me. For children who are uninsured, I worry about the critical services they are missing out on and what it will mean for their short- and long-term health. Our federal leaders must advance policies that ensure children can get the health care they need to grow up healthy and thrive.”

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 Texas and across the country, allowing users to compare a variety of metrics across states.

Starting Friday, November 1 and ending December 15, Texas families who need health coverage or want to explore options that better fit their needs and their budget can sign up for health insurance for next year on healthcare.gov. The vast majority of shoppers will receive financial assistance to reduce the costs of their plan. Experts at local organizations will be standing by in communities throughout Texas to help consumers understand their options and sign up for a plan. If the Texas Attorney General’s health care repeal lawsuit eliminates health coverage provided under the Affordable Care Act, experts believe it would take effect in 2021 at the earliest, leaving coverage intact next year.

During open enrollment for the Affordable Care Act, eligible families will be referred to low- or no-cost health coverage options for their children through CHIP and Children's Medicaid. Families can also sign up for these programs year-round.

This is the ninth annual report on uninsured children published by the Georgetown University Center for Children and Families, an independent, nonpartisan policy and research center founded in 2005 with a mission to expand and improve high-quality, affordable coverage for America’s children and families. CCF is based at the McCourt School of Public Policy at Georgetown University in Washington, D.C.

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