In reversal of trend, more Nevada children uninsured

A study released Thursday from the Georgetown University Center for Children and Families found the rates of uninsured children increased across the nation. In Nevada, the number of uninsured children increased by 16 percent.

“It had been going down for almost a decade,” says Emma Rodriguez, the Children’s Health Policy Manager with the Children’s Advocacy Alliance. “This is really concerning that we are headed in the wrong direction with the latest increase.”

About 8 percent of Nevada’s children were uninsured in 2017, jumping from 50,000 in 2016 to 58,000 uninsured in 2017. It’s the highest percentage in Nevada since 2014.  

Nationally, the numbers of children who are uninsured increase by about 276,000, and several states had percentage increases much higher than Nevada’s.

“This trend is a warning sign to policymakers,” said Joan Alker, executive director of the Georgetown University research center and a research professor at the McCourt School of Public Policy. “Barring new and serious efforts to get back on track, there is every reason to believe the decline in children’s coverage is likely to continue and may get worse for America’s children.”

According to the study, the Hispanic community in Nevada felt the biggest impact with more than 10 percent of children uninsured. The Children’s Advocacy Alliance estimates about one in three children in Nevada have at least one immigrant parent.

“Though their children are citizens and they can access enrollment for Medicaid or (the Children’s Health Insurance Program), they don’t feel comfortable doing so,” Rodriguez says. That reluctance is heightened in the current political climate toward Hispanic immigrants, she adds.

Asian American and Pacific Islander communities saw the most significant drop of uninsured Nevada children, going from 3 percent uninsured in 2016 to 7 percent uninsured last year.

When it comes to the source of coverage, a declining number of direct-purchase plans through the health insurance marketplace accounted for the biggest decrease, falling from 6.1 percent to 4.6 percent of children with coverage. “This has to do with efforts to sabotage the marketplace and efforts to repeal and replace (the ACA),” Rodriguez says.

Medicaid and CHIP also had about a 2 percent decrease.

Children receiving insurance through employer-sponsored plans had a 1 percent increase to 49 percent. “With the economy doing great and unemployment being low, you’d think this number would be higher,” Rodriguez says.

Just a decade ago, 20 percent of children in Nevada were uninsured. Prior to passage of the Affordable Care Act, Nevada perennially had among the highest rates of uninsured people in the nation. With the expansion of Medicaid through the ACA, it began dropping.

Of states that expanded Medicaid, Nevada has the second highest rate of uninsured children. Rodriguez says it’s hard to say why Nevada has a higher rate, but points to its transient population as a potential reason.

Rodriguez is worried this trend will only worsen.

For one, she says a proposed changes to the public charge rule — the rule denies green cards and visas to anyone who might become dependent on programs like Supplemental Security Income, Temporary Assistance for Needy Families or might be institutionalized for long-term care at the government’s expense — might deter some from enrolling in Medicaid or CHIP.

The proposed change would add public housing subsidies and Supplemental Nutrition Assistance Program to the list. “There is a fear that this would affect their status so many (immigrants) are disenrolling in Medicaid even for children.”

Though she says solutions to fix the rate of uninsured children have to be deployed at a federal level, there are things the state could do, such as increasing the type of outreach done to make sure families are enrolled.

Nevada could also provide 12 months of continuous eligibility for Medicaid, meaning eligible families with children don’t have to report changes in family numbers or income levels during the year so they can keep accessing Medicaid.

“Twenty-four states do this,” Rodriguez says. “If we were to change this in our state, it would help children stay enrolled in health coverage and have consistent access to care.”