More Ill. kids going without health insurance

National trend rises at ‘alarming’ rate as annual Obamacare enrollment period begins

A child turns the tables on a doctor during a medical exam, but a new study finds more children going without health insurance after years of progress spurred by Obamacare. (Shutterstock)

A child turns the tables on a doctor during a medical exam, but a new study finds more children going without health insurance after years of progress spurred by Obamacare. (Shutterstock)

By Ted Cox

The number of children going without health insurance is rising across the nation and in Illinois as annual enrollment begins for programs under the Affordable Care Act.

After years of progress in providing more children with health insurance, spurred over the last decade by Obamacare, a new study by the Georgetown University Center for Children and Families finds that the number of uninsured kids is on the rise and, at more than 4 million last year, is now at the highest level since the ACA’s major coverage expansions first took effect in 2014.

“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, who co-wrote the study. “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 the Children's Health Insurance Program.

Illinois was among 15 states showing “statistically significant” increases in the number or rate of uninsured children, according to the study, with more than 100,000 going without health insurance — a 24 percent increase just in the two years since 2016.

"These numbers are especially alarming, given that our state provides coverage to all children from low-income families without regard to immigration status," said Stephanie Altman, senior director of policy at the Chicago-based Shriver Center for Poverty Law. “The federal government's public-charge rule proposal undoubtedly had a chilling effect on immigrant families enrolling their children in programs they are eligible for.”

The Shriver Center found that “the children who comprise the highest proportion of uninsured are from low-income families of color,” while “enrollment in Medicaid and the Children's Health Insurance Program in Illinois has also declined at twice the rate in the U.S. overall.”

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.
— Joan Alker of the Georgetown University Center for Children and Families

According to the Shriver Center, the report blames many Trump administration initiatives for the declining enrollment, including “efforts to repeal the ACA and cut Medicaid; delays in funding the 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 not yet enacted by the Trump administration, the president’s proposed “public charge” rule, which would weigh the immigration process against applicants who’ve drawn on public aid like food stamps or affordable housing, has had the chilling effect on enrollment Altman referred to. She pointed out the Shriver Center has challenged that proposed law in court and recently won a court injunction blocking it from taking effect in Illinois.

Attorney General Kwame Raoul has also filed suit against the proposal, as has Cook County and the Illinois Coalition for Immigrant and Refugee Rights. The county has charged that the rule has driven aspiring immigrants away from enrolling in Medicaid and into the county’s health system to seek care without benefit of insurance.

The Shriver Center also blamed the state’s backlog in processing Medicaid applications for declining enrollment, as well as the bureaucratic red tape in enrolling. That has been worsened by the Trump administration’s cut in Obamacare outreach programs.

The study found declines in coverage are “most pronounced for white children and Latino children, young children under age 6, and children in low- and moderate-income families.” It found African-American children actually saw their coverage rate rise, even over the last two years.

Overall nationally, the number of uninsured kids increased by 400,000 over the last two years, bringing the total to more than 4 million. The uninsured rate rose from 4.7 to 5.2 percent over that time period.

According to the study, using U.S. Census data, there were 7.6 million uninsured kids in 2008 in the last year of President George W. Bush’s term in office, but that declined to 3.6 million in 2016, the last year of President Obama’s term in office. That rose to 3.9 million in 2017 and again to 4.1 million last year.

The child uninsured rate dropped from 9.7 percent in 2008 to 4.7 percent in 2016, then rose to 5 percent in 2017 and 5.2 percent last year.

The Shriver Center called on state officials to try to turn back the tide on declining insurance enrollment, stating: “As the open enrollment period for the ACA commences this Friday, the Shriver Center urges state leadership to prioritize informing families in Illinois about their rights to coverage and the importance of getting insured, as well as addressing the administrative issues that continue to threaten access for children in our state.”

Most state residents get their health coverage through work, with their own annual enrollment periods, but for those seeking a public health plan through Obamacare the enrollment period for coverage next year runs Nov. 1 through Dec. 15. Formal enrollment, again, begins Friday, but those interested can already preview plans and get price estimates through the healthcare.gov website, which will also handle enrollment online.