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Children's Health Coverage Shrank In Utah Last Year, Reversing Decade-Long Growth

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For the first time in nearly a decade, fewer kids in Utah have health coverage, according to a new report from Georgetown University. KUER's Erik Neumann spoke with Joan Alker, executive director of the Georgetown University Center for Children and Families about the new report and what's behind this trend. 

 

Erik Neumann: This report was just released that tracked the uninsured rates of children in the U.S. What’s the takeaway from this report?

Joan Alker: What we've seen is that children are losing public coverage. That's primarily coverage through the Medicaid program, to a lesser degree the Children's Health Insurance Program and the Affordable Care Act marketplaces. So, even though the economy is good and more kids are getting covered through their parents' job, this loss of public coverage has unfortunately led the uninsured kids number to go up.

EN: What are the factors behind this rise in uninsured kids?

JA: What we think was going on in 2017 was that this was the year Congress spent a lot of time talking about repealing the Affordable Care Act and cutting Medicaid. That didn't happen but there was a lot of talk about coverage going away. 

Following that, CHIP actually ran out of funding at the end of September. Utah was one of the states that did put up a notice that it might have to stop enrolling kids in the CHIP program even though ultimately Congress restored that funding a few months later. But [there were] a lot of confusing messages going out to families about coverage going away.

At the same time, the Trump administration was cutting funding for community-based navigators [as well as] advertising for the Affordable Care Act marketplace. The combination of those two factors, all of these messages about coverage going away, as well as a decrease in advertising and assistance to families to help them figure out their options, we think contributed to this rise in uninsured kids.

EN: Looking at the graph that you have in your report, it's a pretty stark decline [of uninsured] over the past decade. And then, there's this increase between 2016 and [2017]. It seems like an uncommon shift.

JA: That's absolutely right. I mean this is really a red flag. It would be great if this was just a blip but I fear that next year when we do this report that number will still be going in the wrong direction.

EN: It seems like it's one thing to talk about this in sort of an abstract way through a report and trends that you're seeing. Can you tell me anything about what this might actually mean for the state of Utah?

JA: When you think about kids, they really need health coverage to succeed. For children who are uninsured, we know there's a lot of research [that] they have less access to well-child care, they have less access to needed medications.

So, think about a kid who has asthma. This is a condition we can treat but the kids got to be able to go to the doctor and be able to get the inhaler and other medications that he or she needs. We know that uninsured kids are less likely to succeed in school, they miss more days of school, and that leads to lower high school graduation rates. So, this issue really has ripple effects across the economy and the future economy if Utah.

EN: Utah did just expand Medicaid. Do you think this could reverse the trend that we're seeing?

JA: I do. I have to say, of the nine states nationally where we saw the biggest increase in insured children, Utah is the one I am most hopeful will be able to turn this around next year because you did expand Medicaid in the election. So, this is probably the only surefire way that a state can bring down its uninsured kids rate. That's good news for Utah.

EN: Is there anything else states should do to try to reverse this trend? I ask only because we're also approaching our legislative session. So I was trying to think if there's anything that has been done in other states that's proven successful in terms of increasing insured rates with children.

JA: There are a couple of things to note. One thing which Utah could do would be to assure 12-month continuous coverage, regardless of any small changes in a family's income. The other, just to flag this issue, which is not a huge issue in Utah but one of the factors that we think may continue to contribute to an increase in uninsured children, is a climate of hostility towards immigrant families and families who have a citizen kid but that parent is an immigrant and they're scared to interact with the government right now.

For those families it can be really important to have a welcoming climate and make sure that they feel comfortable enrolling their kids in public coverage options.

Questions and responses have been edited for length and clarity.

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