Washington, D.C. -- A new report finds that the number of children without health coverage in the United States increased by about 726,000 between 2016 and 2019, bringing the total to over 4 million uninsured children nationwide reversing years of national progress. Much of the gain in coverage that children made as a consequence of the Affordable Care Act’s major coverage expansions, implemented in 2014, has now been eliminated.
The report found:
• After reaching a historic low of 4.7 percent in 2016, the child uninsured rate began to increase in 2017, and as of 2019 jumped back up to 5.7 percent. This increase of a full percentage point translates to approximately 726,000 more children without health insurance since the beginning of the Trump Administration when the number of uninsured children began to rise. Much of the gain in coverage that children made as a consequence of the Affordable Care Act’s major coverage expansions implemented in 2014 has now been eliminated.
• The number of uninsured children increased every year during the Trump Administration. The largest increase was observed between 2018 and 2019 when, despite a continued strong economy, the number of children without health insurance rose by 320,000. This increase in the number of uninsured children was the largest annual jump seen in more than a decade. Moreover, since this data was collected prior to the pandemic, the number of uninsured children is likely considerably higher in 2020, as families have lost their jobs and employer-sponsored insurance, though it is impossible to know yet by precisely how much.
• One-third of the total increase in the number of uninsured children from 2016 to 2019 live in Texas. The state saw by far the greatest coverage loss over the period with an estimated 243,000 more children living without health coverage. Florida has the next biggest loss, 2 adding about 55,000 children to the uninsured count over the three-year period. As a consequence, 41 percent of children’s coverage losses during the Trump Administration occurred in Texas and Florida. Twenty-nine states experienced an adverse change for children from 2016 to 2019. The only state that bucked national trends and significantly reduced its number of uninsured children during this three-year time period was New York.
• These coverage losses were widespread across income, age, and race/ethnicity, but were largest among White and especially Latino children (who can be of any race).
“For decades, children’s health coverage had been a national success story, but the data show that during the years of the Trump Administration the trend went in the wrong direction,” said Georgetown University Center for Children and Families Executive Director Joan Alker. “What’s worse, the numbers of children losing coverage accelerated from 2018 to 2019 during a time when unemployment was very low. The situation is likely worse today.”
Several factors have contributed to the erosion in children’s health coverage: efforts to repeal the Affordable Care Act and cut Medicaid; 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 the Children’s Health Insurance Program (CHIP), according to the report authors. Along with the report, the Georgetown University research center updated its interactive state data hub that provides a more in-depth look at child health care trends and allows users to compare a variety of metrics across states.
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.
For more information, contact Cathy Hope at 202-687-1058 or catherine.hope@georgetown.edu.
