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Florida's Rate Of Uninsured Children Continues To Increase

Nurse smiling with a child patient
The Florida Channel

The number and rate of uninsured children continued to increase in Florida and across the nation in 2018, according to a report released today by Georgetown University’s Center for Children and Families. 

The report finds that the number of uninsured children is now at the highest levels since major provisions of the Affordable Care Act took effect.

The number of uninsured children increased by more than 400,000 between 2016 and 2018, an increase from the child uninsured rate increased from 4.7 percent to 5.2 percent. Nationwide, more than 4 million children were uninsured in 2018.

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Florida’s rate of uninsured children exceeded the national average, increasing from 6.6 percent to 7.6 percent between 2017 and 2018. The state was one of 15 to show statistically significant increases in the number and or rate of uninsured children.

States where the uninsured rate for children has increased most sharply, in order or magnitude, are: Tennessee, Georgia, Texas, Utah, West Virginia, Florida, and Ohio.

“Another important finding is that states that have not expanded Medicaid to parents and other adults under the ACA saw an increase in the rate of uninsured kids that was three times as large as states that have,” said the center’s director Joan Alker.

“Children in these states that haven't expanded are nearly twice as likely to be uninsured as those living in states that have expanded Medicaid.”

The U.S. Census Bureau says the main cause is the loss of public coverage like Medicaid and the Children's Health Insurance Program (CHIP).

The highest uninsured rates are not for the poorest kids, but for those living just above the poverty line between 138 percent and 250 percent of the federal poverty line. These are families working a low and moderate wage job with incomes between roughly $30,000 and $53,000 a year for a family of three.

Many these children are eligible for Medicaid or CHIP but aren't currently enrolled, possibly because families don’t know they’re eligible for benefits, or because they’ve wrongly been denied benefits.

Tamico Spears, a community outreach coordinators for the Players Center for Child Health at Wolfson Children’s Hospital in Jacksonville, said red tape barriers have prevented many children in Florida from getting benefits, or having their benefits renewed.

She said all children in Florida are eligible for either Medicaid, or Florida KidCare - paying on sliding scale basis, but applications are often denied for small mistakes or missing information, without giving families adequate time to provide details or fix errors.

She said Department of Children and Families processors are also cherry-picking the information they require from family to family, and are inconsistent in enforcing eligibility requirements.

“I had one incident where DCF was counting alimony as income (for Medicaid) and KidCare was not counting alimony as income,” Spears said. “So this family was being pushed between both programs. In the meantime, we had a child that was not covered that had medical issues that needed to be addressed.”

She’s says DCF is understaffed and underfunded, and it’s leading to a lot of paperwork errors that shouldn’t be happening.

“And in a perfect world, when you do a Medicaid application and you get denied, Medicaid is supposed to automatically send it over to KidCare. That does not always happen. And those that have families that were missing."

Marivi Wright, another community outreach coordinator for the hospital, said some U.S. citizens, children with immigrant parents, are also being pulled from public insurance programs by their parents, who fear public charge rule enforcement could get them deported.

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Last year was the first year that the rate in every state increased since the center began tracking uninsured children in 2008, Alker said. This year, every state saw an increase, except North Dakota.

Daylina Miller is a multimedia reporter for WUSF and Health News Florida, covering health in the Tampa Bay area and across the state.