Why fewer children have health insurance now

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By Elizabeth Chuck

Raquel Cruz has a lot of stress in her life. A single mother of three daughters, she is the manager of a small health clinic and is going to school full-time for an education degree.

But her biggest stressor is worrying about health insurance.

Cruz, 47, of Pharr, Texas, makes about $30,000 a year and cannot afford the insurance offered by the pain management office where she works.

Her oldest daughters, college students, also have no insurance. Her youngest daughter, Korrie Cantu, is 17, young enough to receive coverage through the Children’s Health Insurance Program, or CHIP, a federal program for low-income families who make too much to qualify for Medicaid.

But even that is not guaranteed: Last year, as Cruz was preparing to apply for CHIP renewal, Korrie’s coverage was suddenly yanked for more than a month.

“I was walking on eggshells,” Cruz said. “Even driving, because you always think, ‘Oh, what if I get into a car accident?’ Or Korrie would say, ‘I’m going to go ice skating,’ and I would think, ‘No, that’s not a good idea.'”

Raquel Cruz, bottom left, with her daughters Kellie Cantu, 23; Korrie Cantu, 17; and Kerrie Cantu, 19. Cruz and her two oldest daughters do not have health insurance; her youngest is covered by CHIP, but briefly lost insurance last year.Courtesy of Raquel Cruz

Korrie is far from the only child who lost insurance in 2017, and not all were fortunate enough to get it back like she eventually did. Last year, the number of U.S. children without health insurance jumped by 276,000 — to 3.9 million, up from a low of 3.6 million in 2016 — according to a report published last week by Georgetown University.

It was the first increase in the number of uninsured children in America since 2008, when Joan Alker, the executive director of Georgetown’s Center for Children and Families and lead author of the study, started keeping track of the data.

“What was really disturbing was that the number went up even though the economy is doing so well. We would expect the number to go down,” Alker said. “Kids are falling off.”

“What was really disturbing was that the number went up even though the economy is doing so well. We would expect the number to go down.”

Alker said employer-sponsored health insurance coverage went up last year, an expected result of a good economy. Yet losses in public insurance coverage, including CHIP, Medicaid and direct coverage through the Affordable Care Act marketplace, declined enough to push the overall number of uninsured children up.

Multiple factors led to that: states’ refusing to expand Medicaid under the Affordable Care Act, creating a gap in affordable coverage options for low-income families; federal budget cuts to outreach programs for the Affordable Care Act; and federal policies targeting immigrants that discourage people from other countries, even if they are legal U.S. citizens, from signing up for federal health insurance.

The government’s delay over renewing funding for CHIP, with some families not reapplying because they were uncertain whether the program had run out of money, also contributed to the chaos, experts say.

Cruz believes the blip in Korrie’s coverage was due to an administrative misunderstanding on the government’s part regarding her renewal application and does not know if it was connected to Congress’ failure to meet a September deadline to allocate funding for the program.

University of Chicago medical students host rally to call on Congress to reauthorize funding for the Children’s Health Insurance Program (CHIP) in Chicago on December 14, 2017.Scott Olson / Getty Images file

She still worries it could happen again and is not sure what she will do once Korrie ages out of the program next year.

“If you don’t have insurance, what if something happens?” Cruz said. “I would still take her to the emergency room, but I know it’s going to be out of pocket.”