The percent of kids in the United States without health insurance fell more than 2 points in four years, but that has little to do with the Affordable Care Act.
A new study from the Robert Wood Johnson Foundation shows that the percentage of uninsured children dropped to 7.5 percent in 2012 from 9.7 percent in 2008.
Among the groups that saw major gains in coverage are low-income and minority children, the researchers found — two populations that traditionally have higher uninsured rates. Hispanic children, for instance, saw a 6 percent gain in coverage over the four-year period.
Driving both of those changes, the researchers said, was an increase in coverage through Medicaid and the Children’s Health Insurance Program, which is a public coverage option for low-income youth.
Although the uninsured rate fell, so did the number of kids who had private insurance, the researchers found.
“We did see declines in the percentage of kids who had private coverage,” said Julie Sonier, a researcher on the study and deputy director at the State Health Access Data Assistance Center at the University of Minnesota. “In the absence of public coverage, we would have seen those kids go uninsured.”
One factor causing the decline in private insurance, Sonier said, was the recession. More parents were losing jobs, meaning they no longer had access to employer-provided health insurance and were more likely to fall into a lower-income bracket, qualifying their kids for public health programs.
The Affordable Care Act, however, wasn’t much of a factor in the numbers, Sonier said. That’s because in most states that opted to raise the income eligibility for Medicaid — a provision of the Affordable Care Act — children already qualify for CHIP at or above those income levels.
“We may see an effect in the future,” Sonier said, “as total families gain coverage from parents’ becoming newly eligible and realizing their kids are, too.”
The “woodwork effect” is already being seen in some state Medicaid programs, as people who were always eligible for Medicaid are just now signing up due to the heavy marketing of the Affordable Care Act.
Marketing and outreach efforts played a big role in the four-year decline in uninsured children, Sonier said. States also made big gains by improving the application process.
“We do know there have been really significant efforts on the part of states to streamline eligibility processes,” Sonier said. “Historically, we’ve seen really high rates of people falling off programs, even if they continue to be eligible due to the paperwork burden.”
But not all states are created equal, and the national uninsured rate masks some states that are having more trouble covering children than others. In Massachusetts, for instance, roughly 1 percent of children lacked insurance in 2012, compared with Nevada, which has a 17 percent uninsured rate.
The University of Minnesota researchers conducted the study independently of the Robert Wood Johnson Foundation, which funded the project.