The most alarming group in the uninsured population is children under age 6, and that group is increasing according to a new analysis of census data by researchers at Georgetown University’s Center for Children and Families and reported by Stateline. The alarming trend is most pronounced in states that didn't expand Medicaid under the Affordable Care Act, where immigrant families have been intimidated into the shadows, and which have been particularly affected in the opioid crisis. There are now more than one million children under age 6 who are not insured, the highest number since Obamacare was fully implemented in 2014, and it's accelerated under Donald Trump.
"The rate of children under 6 without health insurance climbed from 3.8% in 2016 to 4.3% in 2018," Stateline reports. The states with the highest numbers and largest increase in uninsured children are Alabama, Florida, Georgia, Illinois, Kentucky, Missouri, Ohio, Tennessee, Texas, Washington, and West Virginia. Minnesota is the only state that has increased the number of children with insurance. Children between 6 and 19 have been increasingly uninsured as well, from 4.7% in 2016 to 5.2% in 2018, mostly stemming from a loss in enrollments in Medicaid and the Children's Health Insurance Program (CHIP).
From December 2017 to August 2019 there was a 2.9% decline in the number of children covered by the two programs. The most alarming increases between 2016 and 2018 "occurred in Missouri (up 1.7 percentage points), West Virginia (1.5), Ohio and Tennessee (1.4) and Kentucky (1.3)." Missouri has kicked 60,000 kids out of coverage in the last year as the result of a mistake that the state so far is refusing to rectify.
The award for the worst place for children, though, goes to Texas which had by far the largest number of insured children under 6—198,000—"and the second-highest rate of uninsured kids of that age (8.3%), behind Alaska (9.2%)." Adriana Kohler, policy director of the advocacy group Texans Care for Children, says that the state's "very messy, chaotic system" for Medicaid is partly to blame, as is rampant Trumpism and the increasingly anti-immigrant climate which has made immigrants fearful of interacting with the government to access programs for their families.
Health care in the first six years of life is crucial for children to develop both physically and intellectually. Physicians recommend that children by that age have at least 14 doctor visits, for immunizations, screenings for genetic disorders, and for speech, hearing, and vision tests as well as for checkups and to screen for potential traumas like exposure to toxins or abuse. Al Race, deputy director at the Center on the Developing Child at Harvard University, explained why it's so critical that this care happens in young children. "It's never too late to address problems," Race said, "but the earlier you can catch them, the easier it is and the better results you'll have to put things back on track."