The Youngest Children Are Falling Out of Health Insurance

This story was updated Feb. 19 to clarify the significance of the decrease in uninsured young children in Minnesota and to include a comment from the Texas Health and Human Services Commission and March 3 to correct a reference to states that expanded Medicaid. Kentucky and West Virginia are expansion states.

The first years of life play an outsize role in human health. They are foundational to the development of the brain and the cardiovascular, immune and metabolic systems. Early childhood is when medical interventions to correct problems in any of those areas are most likely to succeed.

So, for many health experts, the most troubling aspect of a recent increase in the number of children without health insurance is a spike in the number of uninsured kids under 6. That figure has climbed above a million for the first time since most of the Affordable Care Act was implemented in 2014, according to a recent analysis of census data by researchers at Georgetown University’s Center for Children and Families.

“Those years set up the trajectory for health into adulthood,” said Dr. Olanrewaju Falusi, an assistant director at the Children’s National Hospital in Washington, D.C., and a spokeswoman for the American Academy of Pediatrics. “This is very alarming to me, to say that young children are becoming uninsured at a higher rate.”

The American Academy of Pediatrics recommends that children visit the doctor at least 14 times before they turn 6 years old. During those visits, they should receive speech, hearing and vision tests, as well as screenings for genetic disorders and the possible effects of trauma or toxic exposure.

The U.S. Centers for Disease Control and Prevention recommends that children under 6 receive numerous vaccinations, including for hepatitis A and B, diphtheria, whooping cough, polio, chicken pox, and measles, mumps and rubella.

Al Race, deputy director at the Center on the Developing Child at Harvard University, said a lack of coverage often leads to a lack of health care. Without it, health problems that might have been corrected can persist into adulthood.

“It’s never too late to address problems,” Race said, “but the earlier you can catch them, the easier it is and the better results you’ll have to put things back on track.”

The Georgetown researchers found that the rate of children under 6 without health insurance climbed from 3.8% in 2016 to 4.3% in 2018. Thirteen states had statistically significant increases in either the rate or number of young kids without insurance. Eleven states — Alabama, Florida, Georgia, Illinois, Kentucky, Missouri, Ohio, Tennessee, Texas, Washington and West Virginia — had significant increases in both.