The rate of children without health insurance declined during the COVID-19 pandemic, likely the result of a provision passed by Congress that barred states from dropping anyone from Medicaid during the public health emergency.
According to an analysis of new U.S. Census Bureau data by Georgetown University’s Center for Children and Families, the child uninsurance rate in 2021 was 5.4%, compared with 5.7% in 2019, the year before the pandemic took hold.
The center described that change as a “small but significant decline,” equating to 200,000 more children with health insurance in 2021 than in 2019. Overall, about 4.2 million children were uninsured in 2021, according to the analysis.
The data comes from the Census Bureau’s American Community Survey, which provides annual estimates of income, education, employment, health insurance coverage and housing costs and conditions for U.S. residents. The Census Bureau did not release standard results in 2020 because of difficulties in data collection in the pandemic’s first year.
The Georgetown analysis speculated that the downward trend in child uninsurance was the result of Congress’s provision in the Families First Coronavirus Response Act, passed in March 2020, that prohibited states from involuntarily dropping anyone from Medicaid, the health plan covering lower-income Americans.
The center’s blog, written by Executive Director Joan Alker, speculated that states such as Florida, Georgia and Texas, which make it hardest for people to enroll or stay enrolled in Medicaid, probably saw the biggest declines in the children’s uninsurance rate as a result of the Medicaid pandemic requirement. Texas has the largest amount of children without health insurance.
More than half the children in the United States are enrolled in Medicaid or its companion program, the Children’s Health Insurance Program. Between February 2020 and May 2022, enrollment in Medicaid and CHIP grew by 5.6 million.
The downturn in the rate among uninsured children may be temporary, Alker warned. The Medicaid continuous coverage provision will remain in effect only until shortly after the end of the public health emergency, which is now set to run at least through the end of January.
After that, the Georgetown center estimates that as many as 6.7 million children could lose coverage, at least temporarily, even though three-quarters of them are projected to be eligible for coverage in Medicaid or CHIP. Advocates fear that many of those kids will be dropped because of administrative hurdles parents will face to keep their children enrolled after the public health emergency is lifted.
Although the children’s uninsurance rate dropped between 2019 and 2021, it still remains higher than previous years. In 2016, the rate was 4.7% and then steadily rose until it reached 5.7% in 2019.