Replies

The original report:

Medicaid and CHIP Enrollment Decline Suggests the Child Uninsured Rate May Rise Again

Executive Summary
There is no debate over the fact that children are losing Medicaid and Children’s Health Insurance Program (CHIP) coverage. Overall, more than 828,000, or 2.2 percent, fewer children were enrolled in Medicaid and CHIP, combined, at the end of 2018 than the previous year.1 2 A drop in child enrollment is unusual; between 2000 and 2016, enrollment declined in only one year—2007—by 1.1 percent.3 During this period, the nation achieved historic success in covering children with the rate of uninsured children reaching an all-time low of 4.7 percent in 2016. In 2017, child enrollment in Medicaid and CHIP was basically flat while the uninsured rate for children increased for the first time in a decade to 5 percent despite the strong economy.4

The decline in children’s enrollment in Medicaid and CHIP reinforces serious concerns that this alarming trend could continue—and perhaps even worsen. At a time when the economy is strong, the critical question is whether these children are moving to private coverage or becoming uninsured—a question that will not be answered definitively until the U.S. Census Bureau’s American Community Survey data become available this fall.

Introduction
In 2018, enrollment in Medicaid and CHIP declined by 912,000 children in 38 states while only 13 states experienced gains in enrollment. Despite a strong economy, there is negligible evidence that any significant economic factors have substantially increased access to affordable private or employer-sponsored insurance. It appears that both national and state-specific factors played a role in the decline.

While enrollment growth slows during periods of economic growth, it is uncommon for there to be an actual decline in enrollment. The 2018 decline follows the first year in a decade that the number of uninsured children increased, rising by 276,000 children. The uninsured rate rose from 4.7 percent to 5 percent, both statistically significant increases. If health insurance coverage trends continue, the rate of uninsured children is likely to grow again.

This paper examines the significant decline in children’s combined enrollment in Medicaid and CHIP during 2018 reported in federal/state administrative data; what may be happening to coverage for these children; and why it occurred. Most importantly, we describe what can be done to regain the country’s momentum in providing health coverage to children and ensure that eligible children are not losing access to the health care they need to succeed in school and in life.

Full Report and Executive Summary
Read the full report and executive summary.

https://ccf.georgetown.edu/2019/05/28/medicaid-and-chip-enrollment-decline/

I can’t post the full report link from my tablet but it is easily accessible here.

The nearly 1 million decline is actually 912,000 in 38 states and a 84,000 increase in 13 states for a total decline of only 828,000, significantly less than the 1 million cited.