The number of children covered by Medicaid declined in Florida and other states for the first time in more than a decade.
With the unemployment rate at historic lows, that could mean that more children are being covered by their parents’ employers. But some experts say something else is at play.
“It’s true that Medicaid is sensitive to changes in the economy,” said Tricia Brooks, lead author of a report from the Georgetown University Center for Children and Families that examines the drop. “But while enrollment growth historically slows during favorable economic times, it’s really unusual for there to be a decline in enrollment.”
Nearly 70,000 fewer children in Florida enrolled in Medicaid and the Children's Health Insurance Program, known as CHIP during 2018, according to the report. Those programs had seen enrollment increase or stay the same in all but one year since 2000. The growth coincided with historic drops in the nation’s uninsured rate for children.
The report attributes the drop in enrollment to steps taken by the Trump administration, including cuts to programs that help people sign up for health insurance and immigration policies that discourage parents from enrolling their children. Also, in September 2017, funding for CHIP expired and congress delayed an extension until early 2018. Many families were told during the delay that their states may have to shut down their CHIP programs. In Florida, CHIP is known as KidCare.
Critics fear that an increase in the uninsured rate among children could follow the enrollment drop.
“We wrote this report because we are extremely concerned by what we are seeing and what it portends for the uninsured numbers this fall,” said Joan Alker, director of the Center for Children and Families.
The uninsured rate for 2018 will be released around November. In 2017, Florida saw the number of children without health insurance increase for the first time in nearly a decade.
Between 2016 and 2017, the rate of uninsured children in Florida rose from 6.6 percent to 7.3 percent. The increase of roughly 37,000 children, brought the total number of children in the state without insurance to 325,000.
“Florida already has a growing number of children becoming uninsured, and these declining enrollments in children’s Medicaid and KidCare is a sign that it is getting worse,” said Sadaf Knight, CEO of the nonpartisan Florida Policy Institute.
The report found that the enrollment declines were concentrated in seven states – California, Florida, Illinois, Missouri, Ohio, Tennessee and Texas. Across 38 states, the number of children enrolled in CHIP and Medicaid dropped by 912,000.
Stricter enrollment policies and more frequent reviews of eligibility in states, such as Florida, may have contributed to the declines, the report found.
“When kids lose health coverage, they lose critical access to health care,” Alison Yager, director of policy advocacy for Florida Health Justice Project, said in a release. “Yet health care is an essential ingredient in a child’s ability to thrive. We know from the research that Medicaid and CHIP coverage contribute to long-term positive outcomes not just in health, but also in school performance, educational attainment, and economic success.”