Fearful of deportation
for undocumented household members, an increasing number of immigrant families
in Texas haven't re-enrolled their eligible children into government-sponsored
health coverage. Other eligible youngsters have never been signed up for any
number of reasons, and still others live in "working poor" families
with incomes that don't qualify them for Medicaid or the Children's Health
Insurance Program (CHIP) and yet make it tough to pay family premiums. Some
have parents employed by small businesses that don't offer insurance or offer
only single coverage for workers, not their dependents. Even families turning
to the Affordable Care Act (ACA) exchange may find subsidies won't make
coverage affordable for their children, too.
That's how Ken Janda,
president and CEO of Community Health Choice, sums up a situation recently
gaining national attention amid reports from Georgetown University and
elsewhere. The upshot, he says, is about a 7% decline of children enrolled
through Medicaid or CHIP in his plan since the end of March 2017, in line with
the statewide figure.
The Georgetown report
asserts that national policies on immigration and other factors are creating an
"unwelcome mat effect" in which:
• The number of uninsured children
in the U.S. increased for the first time in nearly a decade, from a historic
low of 4.7% in 2016 to 5% in 2017.
• Between 2016 and 2017, nine states
saw statistically significant increases in their rates of uninsured kids.
• Three-quarters of the children
losing coverage between 2016 and 2017, or 206,000, resided in non-Medicaid
expansion states.
• The percent of uninsured children
increased among all income levels between 2016 and 2017, but was highest among
children living in or near poverty.
Joan Alker, research professor and
executive director of the Georgetown Center for Children and Families, says she
expects to see another decline in children's coverage next year. "To see
no state making progress suggests to me there are strong national currents at
work that led to this unfortunate outcome," she says.
In Houston, it's reached a point
where, Janda says, "We're working with immigration lawyers so children
know what to do if their parents are picked up [by U.S. Immigration and Customs
Enforcement, or ICE, while the children are in school]. That's how bad it is in
Houston right now."
From Health Plan Weekly
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