By Emily Fetsch
December 11, 2019
With well-baby appointments, routine immunizations for toddlers, and screenings for development milestones with preschoolers, pediatricians recommend that children have 15 check-ups by the time they’re 6 years old. Given the necessity of frequent appointments, it’s alarming that the rate of Kansas children under age 6 without health coverage is growing.
Kansas is one of the 13 states where the rate of uninsured young children has increased significantly in a two-year period. The rate has increased from 3.9 percent in 2016 to 4.9 percent in 2018, according to an analysis by the Georgetown University Center for Children and Families.
Lack of coverage bad for children and families’ education, health, and economic outcomes
The implications are profound for these children and their families. Without access to health coverage, kids could miss the routine and necessary care that will help them thrive. Developmental delays or problems with hearing and vision might go undiagnosed, making it more difficult for them to succeed once they reach school. Research shows that health insurance for children is linked to better health, educational, and economic outcomes well into adulthood.
Regular visits to the pediatrician are also important avenues to support parents and other caregivers in their own health and successful parenting. Positive relationships are the foundation of healthy development for young children. When a parent is sick or suffering from depression, that can have a profound effect on bonding with children.
There’s also a financial concern: An unexpected illness for a baby or toddler or a simple playground accident could lead to significant medical bills for a family that lacks health coverage. When even one family member is uninsured, the whole family is less economically secure.
Why are fewer children being covered?
The Georgetown University report points to a number of policies and government actions that have created barriers for families to enroll in and renew public coverage for children through Medicaid and the Children’s Health Insurance Program (CHIP), which include:
- Cuts and delays in enrollment outreach funding and increased red tape for signing up children and parents.
- Confusion that arose from congressional attempts to gut Medicaid and delay renewing CHIP.
- A climate of fear and hostility toward immigrants that has left many families afraid to sign up their eligible children.
Kansas policymakers can help increase coverage among young children
To turn this around, states need to take a hard look at any unnecessary bureaucratic obstacles to enrolling or retaining young children’s health coverage. Some states have streamlined enrollment and reduced paperwork burdens on families to help ensure children have continuous coverage. Kansas leaders should follow that example and:
- Ensure no newborn leaves the hospital without coverage, by allowing secure Medicaid and CHIP enrollment portals in hospitals across the state.
- Request federal permission to pilot five-year continuous Medicaid eligibility for children under age 6.
Providing health coverage for parents can also improve coverage for children. That’s where the Medicaid expansion comes in. Currently, Kansas offers Medicaid coverage only to parents who earn 38 percent of the federal poverty level, or $8,105 per year for a family of three in 2019.
The rates of uninsured young children grew nearly three times as fast in states that refused to expand Medicaid compared to expansion states between 2016 and 2018.
Uninsured young children in non-expansion states face especially challenging circumstances: Their uninsured parents are more likely to struggle with managing their own health and daily parenting challenges and less likely to access treatment for health conditions such as parental depression or substance use disorder. Left untreated, these conditions can have negative effects on a child’s development, weakening the essential relationships young children need for healthy social and emotional development throughout life.
Research shows that when adults have access to coverage, their children are more likely to be enrolled. The latest example of this “welcome mat” effect came in Virginia, where, since the state began Medicaid expansion enrollment for adults in January 2019, more than 25,000 children gained coverage through Medicaid and CHIP.
This health insurance gives families critical access to preventive care, immunizations and routine screenings that can identify delays early, well before a child enters school. Addressing preventable delays and conditions early is not only important to school readiness, it can serve to set a child on the course to healthy lifelong development. Without coverage to facilitate regular check-ups and screenings, small problems can grow into bigger ones, limiting a child’s ability to be successful in school and life.
To learn more about KAC’s work to improve the health outcomes of Kansas children, please check out the following briefs and blog posts: