Editorial: Strong economy not responsible for increase in uninsured children

More than 1 million children around the country were taken off the two main health programs for low-income children, Medicaid and the Children’s Health Insurance Program, between December 2017 and June of this year.

That’s a lot of children who no longer have health insurance. While some state and federal officials treat this statistic as a positive effect of lowering unemployment and a better economy, a closer look at the situation suggests that immigration policy as well as state and federal actions aimed at reducing fraud have pushed these children out of health care coverage. This is the opposite of what should be happening regarding children’s health care — efforts should be made to get more children covered.

The New York Times analyzed census data and found that between 2016 and 2018, the number of children in the United States without insurance rose by more than 400,000, which is a huge decrease following decades of steadily increasing enrollment. States that had the highest numbers of uninsured children were often those that had stricter eligibility rules. They also often had obtained new computer systems that updated their lists of those eligible for insurance. It seems that in cracking down on eligibility requirements for insurance, more children are becoming uninsured.

To put a positive spin on this phenomenon, many government officials interpret the falling Medicaid enrollment as a byproduct of recent economic growth. While this might account for some families who have gained jobs with private insurance, it’s unlikely that this accounts for all families with children who have been dropped from Medicaid and CHIP.

Similarly, officials from Texas and Missouri — states with large enrollment declines — cite lower levels of unemployment as a positive reason for the decline. However, in these states and others with decreases in enrollment, those declines also coincide with increases in the number of uninsured children. So there are many children who are removed from these lists not because they’ve found other forms of insurance but because they don’t have any insurance at all.

In states with large immigrant populations, like Texas and Florida, health care providers report a concern among immigrant parents that signing their citizen children up for health insurance could hurt their chances of getting a green card or put them at risk for deportation. This isn’t a choice that a parent should have to make, but the growing fear surrounding stricter enforcement of immigration laws due to President Trump’s immigration policy has forced many parents to not sign their children up for health care.

Texas also has stricter policies regarding how often it checks for insurance eligibility. Most states check on a yearly basis, but Texas enrolls children for six months and checks eligibility four months in a row to ensure a family’s income still qualifies. If income goes over the limit for eligibility, families receive a letter saying they have 10 days to prove they still qualify for coverage, which is not a long time considering the family’s health may be at stake. Other states with higher numbers of uninsured children also have been checking their databases more often for eligibility.

The concerning trends in falling Medicaid enrollment isn’t solely the result of a better economy. It’s also the result of fear within immigrant communities and an unfairly strict enforcement of eligibility. Instead of touting a stronger economy, officials should be making it less intimidating for more families to enroll their children in health insurance.