Report: TX Kids Losing Health Insurance Since 2016 Fueled Spike in National Kids’ Uninsured Rate
For Immediate Release
As Texas Faces the Highest Children’s Uninsured Rate in the Nation, Advocates Urge Texas Policymakers to Take Steps to Prevent Kids from Losing Health Coverage
Austin - The uninsured rate for Texas kids rose from 9.8 percent in 2016 to 12.7 percent in 2019, an increase that helped fuel an alarming spike in the national uninsured rate for kids during the last three years, according to a new report released by the Georgetown University Center for Children and Families. The report also found that Texas had by far the worst children’s uninsured rate in the nation at 12.7 percent, with Wyoming coming in next at 10.6 percent.
The picture would be even worse if the data included 2020, given the significant number of families who have lost insurance during the pandemic, but precise children’s uninsured numbers for 2020 are not available at this time.
“Way too many Texas children lost their health insurance over the last three years because of state and federal policy decisions,” since Patrick Bresette, Executive Director of Children’s Defense Fund-Texas. “There are several steps the Legislature and other state leaders should take to ensure more Texas kids have the insurance they need so they can see their doctor, go to their check-ups, stay healthy for school, and get their immunizations. Let’s roll up our sleeves and make sure that eligible kids are getting enrolled and staying enrolled in Medicaid and CHIP instead of missing the health care they need.”
More than any other state, Texas is pushing the national children’s uninsured rate higher as eligible Texas children face obstacles to enrolling and staying enrolled in Medicaid and Children’s Health Insurance Program (CHIP). According to the report, Texas is responsible for one-third of the total increase in the number of uninsured children from 2016-2019. The national uninsured rate for children rose from 4.7 percent in 2016 to 5.7 percent in 2019.
The particularly high children’s uninsured rate in Texas is due to a number of factors that state leaders can address during the next legislative session. To reduce the Texas uninsured rate — and counteract the nationwide trends pushing the uninsured rate even higher — state leaders should:
Allow children to remain continuously enrolled in Medicaid for 12 months at a time rather than conducting inaccurate mid-year eligibility reviews that mistakenly remove eligible children from health coverage;
Boost outreach efforts to help families sign up eligible children for Medicaid and CHIP, including efforts to address mixed-status families’ concerns and fears about enrolling their U.S. citizen children in insurance programs;
Commit to the recent request from 22 Texas health organizations not to go forward with proposed state cuts to the HHSC workforce that enrolls children in Medicaid, CHIP, and other programs; and
Implement Medicaid expansion to provide a health insurance option to low-wage working adults, a proven method for indirectly increasing eligible children’s enrollment in health insurance programs.
The report notes that the children’s uninsured rate for Medicaid expansion states (4.2 percent) is much lower than the rate for non-expansion states (8.1 percent).
Because Texas has not implemented these policies yet, the state has higher uninsured rates for every racial/ethnic group compared to national averages — as well as significant racial disparities. In fact, (non-Hispanic) White children in Texas are almost twice as likely to be uninsured compared to (non-Hispanic) White children nationwide (8.3 percent and 4.3 percent, respectively). Amid inadequate state policies, Hispanic children in Texas have a higher uninsured rate (17.5 percent) compared to the national rate for Hispanic kids (9.2 percent) and compared to (non-Hispanic) White children in Texas (8.3 percent).
The report cites a number of reasons for the nationwide increase in the children’s uninsured rate — factors that Texas leaders could counteract by taking the steps outlined above. Those reasons include federal cuts to Affordable Care Act outreach and enrollment assistance; confusion and fear among mixed-status families due to the Trump Administration’s Public Charge rule; and state policies that mistakenly remove eligible children from Children’s Medicaid due to inaccurate mid-year eligibility checks and red tape.
“For decades, children’s health coverage had been a national success story that we could point to with pride, but the data shows the trend is now going in the wrong direction,” said Georgetown University Center for Children and Families Executive Director Joan Alker. “What’s worse, the number of children losing coverage accelerated from 2018 to 2019 during a time when unemployment was very low. The situation is likely worse today.”
This is the 10th 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. The report analyzes single-year estimates of summary data from the U.S. Census Bureau’s American Community Survey (ACS) from 2016 through 2019. For more information about the report, visit ccf.georgetown.edu.
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