The Affordable Care Act helped significantly lower the number of uninsured Americans from 2013 through 2016, particularly because it expanded Medicaid eligibility to more families.
But the trend line is heading back in the other direction as Obamacare withers; more individuals move into the private market as incomes rise and eligibility changes; and access to health care becomes more challenging for immigrant families.
In Georgia alone, Medicaid and the Children’s Health Insurance Program, which in Georgia is called PeachCare for Kids, covered 20,000 fewer children at the end of 2018 than the year before, according to a new report from the Georgetown University Center for Children and Families.
“That 1.6 percent drop is less than an overall 2.2 percent decline in enrollment nationally,” the report states.
Nationwide, about 828,000 fewer children were enrolled in Medicaid last year, with declines in 38 states.
A decline in enrollment in Medicaid and CHIP is unusual, the report states, with it occurring in just one year between 2000 and 2016.
“While enrollment growth slows during periods of economic growth, it is uncommon for there to be an actual decline in enrollment,” the report states. “The decline in children’s enrollment in Medicaid and CHIP reinforces serious concerns that this alarming trend could continue—and perhaps even worsen.”
The report concludes that it’s critical to decipher the precise explanations for this increase in the uninsured children population, but that it’s a question without a definitive answer until new U.S. census data is released this fall.
Between 2013 and 2016, the number of uninsured Americans fell from more than 44 million to less than 27 million, bringing the uninsured rate to 10% from 16.8%.
The rate of uninsured children, meanwhile, fell to just 4.7% in 2016.
According to Kaiser Family Foundation, “The Affordable Care Act led to historic gains in health insurance coverage by extending Medicaid coverage to many low-income individuals and providing ‘marketplace’ subsidies” for individuals below 400% of the poverty line.
“However, in 2017, the number of uninsured people increased by nearly 700,000 people, the first increase since implementation of the ACA,” the report continues. “Ongoing efforts to alter the ACA or to make receipt of Medicaid contingent on work may further erode coverage gains seen under the ACA.”
Laura Colbert, executive director of Georgians for a Healthy Future, said her nonprofit is asking the same question she and her staff are asking.
They knew children in the state were losing coverage, mostly those in low-income households, but the reasons remained unclear.
“Our job now is to figure out why kids are falling off coverage,” she said. “Certainly, a jump that much is concerning.”
In addition to funding cuts to the Affordable Care Act, immigrant families also may be leaving the insured rolls, even though citizen children of undocumented immigrants are eligible for coverage.
And there may be some local or state contributing factors that need to be unearthed, Colbert added.
In Georgia, 190,000 people under the age of 18 are already uninsured.
Locally, The Longstreet Clinic is seeing health insurance challenges among its own patients, according to CEO Mimi Collins.
“I can say yes, we are seeing more patients without traditional insurance coverage and more challenges with maintaining coverage,” she told The Times in an email.