Uninsured state youth rate increases

More enrollment education needed, advocates say

The percentage of Arkansas children and 18-year-olds who lack health insurance increased last year for the second year in a row, although the increase wasn’t big enough to be considered statistically significant, according to U.S. Census Bureau estimates released this week.

Last year, more than 33,700 children and 18-yearolds in the state lacked health insurance, an increase of about 3,800 people compared with 2017, according to estimates from the bureau’s American Community Survey.

The number of uninsured represented 4.5% of people in that age group, an increase from 4.4% in 2017 and 4% in 2016.

State-level advocates said more education on how to enroll for health care is needed to bring the number of uninsured back down.

Nationally, the percentage of children and 18-yearolds who lacked coverage increased from 4.7% in 2016 to 5% in 2017 and 5.2% in 2018.

The national increases in both 2017 and 2018 were considered statistically significant, although the Arkansas increases weren’t in either year or when comparing 2016 with 2018.

The survey, sent to more than 3.5 million households across the country each year, asks about a participant’s current health coverage status, among other topics.

The percentage of Arkansas children and adults who lacked coverage increased from 7.9% in 2017 to 8.2% in 2018, community survey figures show. That increase was also not considered statistically significant.

The percentage of children and adults nationwide who lacked coverage increased from 8.7% to 8.9%, which is statistically significant, according to the American Community Survey estimates.

Figures released earlier this month from a different Census Bureau survey showed the overall national rate increased from 7.9% in 2017 to 8.5% in 2018. That survey, the Current Population Survey, asks respondents about their coverage throughout the previous year instead of just at the time of the survey.

Joan Alker, director of the Georgetown University Center for Children and Families, said a reduction in funding under President Donald Trump’s administration for health coverage outreach and education as well as delays by Congress in providing money for the Children’s Health Insurance Program have contributed to the national rise in uninsured children.

Last year for instance, outreach grants for the Children’s Health Insurance Program weren’t awarded until after the start of the 2018-19 school year for the first time in several years due to a delay in Congressional approval

for the funding, she said.

Other factors include the Trump administration’s crackdown on illegal immigration, which discourages migrants from seeking coverage for their children, even when the children are citizens, and stricter state policies for renewing children’s Medicaid coverage, she said.

“It’s an unwelcoming climate in a lot of respects, and that’s a real change from a few years ago,” Alker said.

More than half of Arkansas children are covered by Medicaid and the Children’s Health Insurance Program.

The programs’ average enrollment among children at the end of each month increased from 426,651 in 2016 to 428,490 in 2017 and 429,506 last year, according to state records.

“We do ARKids outreach and education continuously and have for as many years as the program has existed,” said Amy Webb, a spokeswoman for the state Department of Human Services, referring to the state’s Children’s Health Insurance Program and Medicaid for children.

The percentage of uninsured Arkansans fell by half after the state expanded its Medicaid program to include more low-income adults in 2014, the same year other coverage assistance under the 2010 Patient Protection

and Affordable Care Act became available.

Although the percentage has remained relatively flat over the past few years, the state still has a large number of people who lack insurance even though their incomes would qualify them for subsidized coverage, said Craig Wilson, health policy director for the Arkansas Center for Health Improvement.

The American Community Survey estimated that almost 244,000 of the state’s residents lack coverage.

Most of those people are likely eligible for Medicaid or tax credit subsidies offered through healthcare. gov, Wilson said.

“I think there’s a lot more that we could be doing” to educate people about their options, Wilson said. “It’s really critical that we enhance those efforts, particularly for our rural communities where a larger proportion of the population remains uninsured and our rural hospitals, our safety net, are struggling.”

Since 2014, language attached to appropriation bills has prevented the state departments of Health and Human Services from promoting enrollment in the state’s expanded Medicaid program, known as Arkansas Works, or plans offered through healthcare.gov.

The state Insurance Department

had the same restrictions until this year, when it absorbed the Arkansas Health Insurance Marketplace, an independent agency responsible for promoting enrollment in healthcare.gov plans.

The department is now allowed to promote enrollment in healthcare.gov plans but not in Arkansas Works.

Wilson added incomes in the state haven’t kept pace with rises in premiums and other health care costs. With many plans requiring enrollees to meet large deductibles, some people may “forgo coverage knowing that they’ll have to spend $10,000 out of pocket before they see any value,” he said.

Loretta Alexander, health policy director for Arkansas Advocates for Children and Families, said she’d also like to see the state do more to let people know about the assistance that’s available.

“Our goal for Arkansas is to get 100% insured,” she said.