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Raleigh--The number of uninsured children increased nationally by more than 400,000 between 2016 and 2018, reversing a long-standing positive trend according to a new report released by the Georgetown University Center for Children and Families. Nationwide, more than 4 million children were uninsured in 2018, the highest level since the Affordable Care Act’s major coverage provisions took effect in 2014.

In North Carolina, an estimated 130,000 children were uninsured in 2018, an increase of approximately 13% since 2016. This alarming trend took place during a period of economic growth when children should be gaining health coverage.

“Recent policy changes and the failure to make children’s health a priority have undercut bipartisan initiatives and the Affordable Care Act, which had propelled our nation forward on children’s health coverage,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. “This serious erosion of child health coverage is due in large part to the Trump Administration’s actions or inactions that have made health coverage harder to access and have deterred families from enrolling their eligible children in Medicaid and CHIP.”

North Carolina is one of 14 states that have not yet expanded Medicaid. While Medicaid expansion provides coverage to uninsured parents and other adults, it also helps children. States that have expanded Medicaid and have seen large reductions in their child uninsured rates. This trend is known as the “welcome mat” effect: when parents sign up for their own health coverage, they often learn they can enroll their children too.

“This news is deeply troubling,” said Michelle Hughes, executive director of NC Child. “Significant losses in children’s coverage really underscore the need to expand Medicaid. Medicaid expansion would connect more parents and their children with health coverage and help our state turn things around for kids and families. Medicaid expansion would also help children by making the whole family more financially stable. Healthy parents make better parents.”

The child uninsured rate increased nationally from 4.7% to 5.2% between 2016 and 2018, according to data from the Census Bureau’s American Community Survey. Coverage losses were widespread, with North Carolina as one of 15 states showing statistically significant increases in the number and/or rate of uninsured children (Alabama, Arizona, Florida, Georgia, Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Texas, Utah and West Virginia).

“As a pediatrician, I understand first-hand how important health insurance coverage is to my patients; it helps ensure children can receive the care and services they need, when they need them,” said Lanre Falusi, MD, FAAP, American Academy of Pediatrics national spokesperson. “The findings in this report are deeply concerning to me. For children who are uninsured, I worry about the critical services they are missing out on and what it will mean for their short- and long-term health. Our federal leaders must advance policies that ensure children can get the health care they need to grow up healthy and thrive.”

Along with the report, the Georgetown University research center launched a new interactive data hub that provides a more in-depth look at child health care trends in North Carolina and across the country, allowing users to compare a variety of metrics across states.

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