More Kids Are Getting Health Insurance…

“¦ And it’s not because of Obamacare.

Physician's Assistant Kim Gracey checks the throat of sick child Joselyn Mejia, age 4, at a low-cost clinic run by the Rocky Mountain Youth Clinics on July 28, 2009 in Aurora, Colorado. Her mother Jessica Mejia (C) said she has health insurance through her employer, but finds the clinic cheaper than paying the deductible to have her children cared for by a family practitioner. Funded primarily through donations and grants, Rocky Mountain Youth Clinics treats mostly children of uninsured parents, those on Medicaid and others whose parents cannot afford to pay the high deductibles charged by many health insurance policies.
National Journal
Clara Ritger
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Clara Ritger
April 9, 2014, 8:05 p.m.

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.

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