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Medical assistant Daisi Minor, left, gives a vaccine to Kristian Richard, 1, being held by his mother, Natasha, in 2015 at the Medical Arts Pediatric Med Group in Los Angeles.

Despite Wisconsin’s low unemployment rate, the state isn’t making headway on reducing the number of kids without health insurance, according to a recent report from the Georgetown University Center for Children and Families.

And the problems are bigger than Wisconsin. Even with a healthy economy, the number and percentage of uninsured children increased nationwide for the first time in years, the report says.

The Georgetown center describes itself as an “independent, nonpartisan policy and research center,” and this is its eighth annual report on uninsured kids.

In 2016, there were 50,000 Wisconsin children under 19 without insurance, or about 3.7 percent of kids. In 2017, that slightly increased to 53,000 kids, or about 3.9 percent of the children in the state.

That’s not a statistically significant increase, but the fact the number is not decreasing is worrying, said William Parke-Sutherland, health policy engagement coordinator at Kids Forward.

“Since 2015, we’ve made no progress on lowering the number of uninsured kids,” Parke-Sutherland said.

In 2010, Wisconsin had about 67,000 uninsured kids. That decreased to about 46,000 uninsured children in 2015, but since then, the numbers have gone up. (To note: until this year’s report on 2016 and 2017 data, the Georgetown reports tracked kids under 18. It now tracks kids under 19.)

The report says kids with health insurance are less likely to miss school and more likely to experience “better economic and educational outcomes” as adults. With insurance, kids can access preventative care that can shelter them from more serious health issues or the emergency room.

“These programs help keep all of us healthier,” Parke-Sutherland said. “From a policy perspective, having more kids insured is a win-win.”

One of the best ways to increase Medicaid enrollment of kids is to expand Badgercare for adults, Parke-Sutherland said, because “if parents have coverage, their kids are far more likely to have coverage.”

The study shows Michigan, Illinois and Minnesota all have lower percentages of uninsured kids (at 3.0, 2.9 and 3.4 percent respectively compared to Wisconsin’s 3.9 percent), Parke-Sutherland said. All three states have expanded Medicaid eligibility to households below 133 percent of the federal poverty level.

Gov. Scott Walker refused federal funds to expand the program, but partially expanded Medicaid in the state in 2014 through an alternate plan. Governor-elect Tony Evers has promised to propose expanding Medicaid eligibility.

As in most other measures of health and wellness in Wisconsin, there are racial disparities in rates of uninsured children, with much higher rates for American Indian and Alaskan Native children, Parke-Sutherland said.

To combat this, the state needs to create “policies, enrollment and outreach that specifically addresses the kids who are in those communities,” Parke-Sutherland said, and talk with the communities themselves to “figure out what's useful and what’s missing.”

NATIONWIDE

Nationwide, the percentage of uninsured kids increased from 4.7 percent in 2016 to 5 percent in 2017. That’s about 276,000 additional uninsured children, for a total of 3.9 million uninsured kids.

That’s the first time the number of uninsured kids across the nation has increased since Georgetown started collecting data in 2008. The report finds this “troubling” given the generally healthy economy and the fact that the percentage of kids covered under their parent’s employer-sponsored insurance increased in 2017.

Only the District of Columbia saw a statistically significant decrease in the rate of uninsured kids from 2016 to 2017, the report said, but nine states saw statistically significant increases. Rates of uninsured kids grew "at almost triple the rate" in states that had not expanded Medicaid as those that did. 

“Never before have we seen such uniformity in state behavior,” the report said. “This finding underscores that even states with the best of intentions were not able to overcome the negative national currents that are affecting children’s health coverage.”

SOLUTIONS

More than half of uninsured kids are eligible for Medicaid or Children’s Health Insurance Program (CHIP), the report said; families need to know these options exist and feel comfortable enough to claim coverage.

The report speculated that news coverage about potential changes and cuts to the Affordable Care Act, as well as anti-immigrant rhetoric, could have discouraged Medicaid-eligible families from seeking coverage.

Policy changes like the end of the individual mandate from the Affordable Care Act may also have had an effect, the report said.

“The ACA is still the law of the land but … President Trump is saying Obamacare is dead. There's all of this rhetoric around either the fate of the ACA or the uncertainty of the ACA,” Parke-Sutherland said. “I think people just don’t know what to do.”

The report concludes that without major changes, “there is every reason to believe” things will continue or get worse in the future. It suggests statewide efforts like expanding Medicaid to adults, increasing eligible income levels, and funding outreach.

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