Thousands more of Ohio's youngest children have no health insurance coverage, reversing a multi-year trend of declining uninsured rates for those under age 6.
The Buckeye State's uninsured rate for infants, toddlers and preschoolers climbed to 5% in 2018, up from 3.6% in 2016, a 40% jump that ranked as third highest in the nation.
That totals 41,642 children without health coverage, an increase of nearly 12,000 in two years, according to a recent study from the Georgetown University Center for Children and Families.
"This trend is deeply disturbing because we know children experience rapid brain development during the earliest years of life, before they start kindergarten," said Shannon Jones, executive director of Groundwork Ohio, a leading child advocacy group.
"We have a critical and narrow window of time to build a healthy foundation for development, intervene to address any delays and health conditions and prevent greater challenges later in life."
Uninsured children who are injured or ill can get care at hospitals that are required by law to provide emergency treatment to anyone with or without coverage, but they likely are foregoing regular visits to the pediatrician and dentist.
"These well-child visits and other preventive care are the first and best opportunity we have to engage parents and caregivers as partners in their child's health and well-being before school begins," said Melissa Wervey Arnold, chief executive officer of the Ohio chapter of the American Academy of Pediatrics.
The academy recommends 15 well-child visits before age 6, with most in the child's first two years.
With nearly half of Ohio children insured through the state's Medicaid and Children's Health Insurance Program, advocates are urging Gov. Mike DeWine's administration to improve and promote access to the tax-funded coverage.
"We have to hold all stakeholders, including health plans, accountable to our shared vision for young children in this state," Jones said.
DeWine said Friday he had asked Medicaid Director Maureen Corcoran "to see what steps that we can take to deal with this."
"I've asked her to see if there is some way to make re-enrollment easier and that it is not a hurdle ... We should make it as easy as possible to keep a child in," DeWine said.
"It's very important," the governor said. "Making sure every child in Ohio has good medical care is just absolutely essential."
Medicaid officials, including Corcoran, were unavailable last week for comment.
In an interview last July, Corcoran said declining Medicaid enrollment was due to an improving economy and rising incomes causing many to no longer qualify for coverage, and an annual renewal process which critics say is time-consuming and cumbersome and leads to many eligible beneficiaries being dropped from the rolls.
According to the Georgetown study, the number of children under age 6 without health coverage nationwide surpassed 1 million in 2018 for the first time since implementation of the Affordable Care Act, with the uninsured rate climbing to 4.3%, up from 3.8% in 2016.
The 2014 law, credited for large drops in the uninsured rate, allowed states to expand Medicaid coverage to poor families and provided government subsidies for low- and middle-income families to purchase private insurance.
"Recent increases in uninsurance for the nation's youngest children happened during a time of economic growth when more children should be gaining health care coverage," the report found. "A number of factors may be contributing to this coverage reversal, likely driven by declines in Medicaid and CHIP among children--many of whom are likely eligible."
The report said declines were likely caused by efforts by Congress to repeal the Affordable Care Act and delays in extending funding for the Children's Health Insurance Program, federal cuts to outreach and enrollment assistance and less focus in many states on enrolling and retaining eligible children.
More than half the nation's uninsured infants, toddlers and preschoolers lived in seven states: Texas, with the highest share, followed by Florida, California, Georgia, Pennsylvania, Ohio and Arizona.
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