The percentage of Texas' youngest children without health insurance has increased since 2016, according to a report released Wednesday.
In 2018, 8.3% of Texas children under the age of 6 -- a total of 198,014 -- were uninsured. The rate has grown by one percentage point, or about 23,000 more children, since 2016, according to a report by Georgetown University Health Policy Institute. The data mirrors growth seen in the uninsured rates among all Texans.
Texas has the second highest rate of uninsured young children, behind Alaska. The overall U.S. uninsured rate of young children since 2016 to 4.3%, or more than 1 million children. About 19% of the country's uninsured young children are in Texas, even though Texas' share of the total U.S. population of young children is about half that percentage.
"Nobody is even close to that," Anne Dunkelberg with the liberal policy think tank Centers for Public Policy Priorities. "We have a particularly extreme problem in Texas and the time seems ripe to pay attention to it."
Georgetown researchers say the increases are likely caused by decline in Medicaid and Children's Health Insurance Program (CHIP) coverage of eligible children. Since 2016, Congress has tried to repeal the Affordable Care Act, cut Medicaid and delayed the reauthorization of CHIP. The Trump administration has decreased outreach and programs that help people sign up for Obamacare.
"The health system is one of the few places that can reach young children and their families before the child gets to kindergarten," said Elisabeth Wright Burak, one of the authors of the Georgetown report. "It's not just a place to check the child's health and development but it's also a way to connect families to resources."
The American Academy of Pediatrics recommends 15 preventive checkups before a child turns six.
Also, with the Trump administration's attempt at barring legal status for immigrants who use certain government programs, some families whose children are Medicaid eligible may have stopped using the benefits, Burak said. The problem has touched the border state of Texas, but that's not the sole reason the uninsured rate is so low, Dunkelberg said.
New Mexico, for example, has an uninsured rate of young children that was half of Texas' in 2018.
New Mexico also has expanded Medicaid eligibility.
"Texas is of course one of the states that hasn't expanded Medicaid, and it's the most effective way to turn the tide," Burak said.
Expansion of the federal and state-subsidized health insurance program could cover 686,000 Texans who make too much to qualify for Medicaid yet earn too little to qualify for tax credits to purchase Obamacare, according to the Kaiser Family Foundation, a policy research organization. Thirteen other states have not expanded Medicaid, rejecting extra federal funding that would come with it. Republicans have resisted the move, calling the effectiveness of Medicaid into question and saying they don't trust the federal government to offer enough funding.
Dunkelberg, who also supports Medicaid expansion, said health insurance rates could be improved if Congress patched holes in the Affordable Care Act that has prevented people from obtaining coverage. She said the Texas Legislature in particular could prevent children -- about 50,000 a year -- from being kicked off Medicaid due to paperwork problems. A bill to address this issue this year failed in the Senate.
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