NC Child: Would repeal of the ACA reduce coverage for Anson County children?

May 26--The rate of uninsured children in Anson County has decreased by 28.6 percent since 2011. But Laila Bell, director of research and data at NC Child, worries that many children will lose their insurance if cuts in the American Health Care Act are approved.

Bell credits the smaller rate of uninsured children to an increase in health insurance coverage. According to a release from NC Child, 96 percent of children in the county have insurance primarily through the increased coverage in the Affordable Care Act, Medicaid and NC Health Choice.

"The gains we have made in children's health insurance are largely a result of investing in and strengthening public health insurance programs, like Medicaid and CHIP (Children's Health Insurance Program)," Bell said in the release. "If we want to build on our past progress, the U.S. Senate must reject the cuts to Medicaid and consumer protections in the American Health Care Act."

Newborns in Anson can only expect to live 75 years, 7.7 years less than peers in Chatham County, which leads the state in infant life expectancy rates, according to the release.

"10.4 percent of babies are born at a low birthweight, placing them at greater risk for lifelong health challenges," the release said. "26.2 percent of children live in households that are food insecure and struggle to provide consistent and adequate nutrition. 65.2 (percent) of children live in poor or low-income homes, a significant risk factor for children's academic and health success."

"These health challenges are avoidable," Bell said. "We know that smart public policy decisions can help enhance local efforts to ensure all children in Anson live in homes and communities that support their health and development."

Dr. Fred Thompson, director of the Anson County Health Department, thinks that regardless of what the federal government does, children will likely be covered because of the high percentage of families living at or below the poverty line. According to the release from NC Child, 26.2 percent of children in Anson County live in food-insecure households while 65.2 percent of children are in poor or low-income homes.

"My personal opinion is, relative to health insurance for the kids, I don't look for the federal government to do anything that's going to take the health insurance from our kids," he said. "The truth is, the majority of our children have been covered by Medicaid or CHIP as opposed to a lot of young people getting health insurance as a result of the Affordable Care Act."

If anything, he guesses that children and older adults will be the best-insured populations. With a high percentage of young adults in the county neither employed or in school, coverage options may be limited, and they may not choose to purchase insurance because of the cost or their relatively lower risk if they are young and healthy, Thompson said.

"I do think there's a block of young people 18 to 24 who have been allowed to remain on their parent's health insurance program that are a legitimate area of concern," Thompson said. "The repeal of the Affordable Care Act may or may not allow adults 18 to 24 to remain on their parents' insurance. For cohorts 0 to 5, 5 to 10, etc., because so many of our children are low-income families, they will be covered by Medicaid for a very long time.

"We have had very high insurance rates... I don't look for that to change," he continued. "I really don't think the federal government will do anything that will result in young -- when i say young people, I'm really talking about below 16 -- I haven't seen anything that indicates to me that we're going to end up with a lot of kids in Anson County that are uninsured."

Like everyone else, he is waiting to see what will happen.

"At this point, it's almost impossible to predict what will take the place of the Affordable Care Act," he said, noting the debates about issues such as pre-existing conditions. "I think at the end of the day, we're going to have to see what they come up with, and I think it will change a lot when it goes from the House of Representatives, to the Senate, and back and forth, and end up with some compromise, and we'll see what comes through."

Thompson said that he is more concerned about the lack of primary care providers for residents, including for young children, the high amount of single-parent households, the number of children living in poverty and similar issues.

Reach reporter Imari Scarbrough at 704-994-5471 and follow her on Twitter @ImariScarbrough.

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