Idaho has the fifth-highest rate of uninsured young kids, report finds

The rate of Idaho babies, toddlers and preschoolers who don’t have health insurance rose 36 percent in recent years, leaving the state with the fifth-highest rate of uninsured young children, according to a new report.

The report comes years after Idaho state health officials removed tens of thousands of children from Medicaid shortly after the COVID pandemic ended, a public assistance program that covers more than a third of Idaho kids in rural areas. And as Idaho Medicaid braces for a big slate of changes — like pay cuts for doctors and disability care providers — one local health policy advocate says access to health care will get even harder for kids.

“All it takes is one broken arm on the school playground to financially devastate a family already struggling to make ends meet,” Idaho Voices for Children Policy Associate Ivy Walker said in a statement. “This should be a wake-up call for Idaho policymakers because the unfortunate truth is that children’s access to health care is about to get much worse.”

The report, released Monday by Georgetown University’s Center for Children and Families, found that nearly 8 percent of Idaho children under age 6 are uninsured, according to the latest data from 2024. That meant Idaho had the fifth-highest young children’s uninsured rate.

Researchers with the center say they focused on young children’s health insurance coverage rates in the latest reports because access to health care is important during their formative years.

“Their coverage is really important during a critical time of their development. When they don’t have access to the care that they need in those early years, they’re at higher risk of falling behind developmentally,” said Elisabeth Burak, a senior fellow at the center.

Nearly 8 percent of Idaho young kids don’t have health insurance

Idaho’s rise in uninsured rates for children means that 10,700 young Idaho kids were uninsured in 2024, a number that grew by 2,800 kids between 2022 and 2024. In 2022, 5.8 percent of young Idaho kids were uninsured, compared to 7.9 percent in 2024, the report found.

Accounting for race and ethnicity, American Indian and Alaskan Native young children had the highest uninsured rates, at 10.5 percent in 2024, along with Hispanic and Latino young kids, who had a 7.2 percent uninsured rate in 2024, according to the report.

Three large states — Texas, Florida and Georgia — accounted for more than half of the national increase of 220,000 more young children being uninsured, which was a 23 percent increase between 2022 and 2024, the report found.

Georgetown University’s Center for Children and Families Executive Director Joan Alker said she expects to get new data about health insurance coverage rates for 2025 this fall.

In a separate report released last fall, Georgetown’s center found that the rate of Idaho children without health insurance rose the second fastest in the country.

Why did Idaho’s rate of uninsured young kids rise so much?

The data analyzed in the report covers the years in which Idaho state health officials were reviewing the eligibility of all Idahoans on Medicaid. Pandemic-era protections that barred states from removing people from Medicaid had ended, and Idaho sought to complete the eligibility reviews fast.

Most Idahoans who lost Medicaid through the process, commonly called unwinding, were removed for not replying to the state’s renewal paperwork. Almost three-quarters of the nearly 50,000 kids who lost Medicaid were removed from the health insurance public assistance program for non-responses, Idaho Voices for Children said last year.

Walker, a policy associate for the nonprofit, said the latest report’s results confirm what she and other experts feared.

A spokesperson for the Idaho Department of Health and Welfare, the state agency that runs Medicaid, pointed to several checks in Idaho’s handling of unwinding, saying the state “followed all requirements.” That includes starting first with automatic renewals before sending out paperwork, finding updated addresses using the Postal Service, and sending three notices.

“Idaho was one of the first in the nation to begin and finish the required Medicaid Unwinding process so numbers for some states show less closures because they started and finished the process after we did,” agency spokesperson AJ McWhorter said in a statement.

In the past, Idaho Department of Health and Welfare officials defended the agency’s handling of Medicaid unwinding, saying they rushed to meet a legislative request to quickly finish the process and that state officials “went above and beyond” to reach out to people on Medicaid, the Idaho Capital Sun previously reported.

Walker said there are several other issues at play in the recent rise in young Idaho children being uninsured, like the state ending the practice of using other government data to automatically review Medicaid enrollee’s eligibility to stay on the program and what she described as confusing renewal paperwork notifications during the unwinding process.

“It’s just, I think, a lot of confusion in a very complex system,” she said in an interview on Monday. “The Department of Health and Welfare really needs to improve their outreach for enrollment, especially around children.”

Walker said the crunch to access care is likely going to worsen under recent Medicaid provider pay cuts of 4 percent — recently extended by the Legislature.

“The budget and these lower payment rates have also unfortunately affected how providers are going to move forward, under their own business models,” she said. “Meaning they may have to limit the number of Medicaid patients they see, or just be unable to continue offering their services altogether.”