Number of uninsured kids in Missouri rises by nearly 17% since 2016, study says

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JEFFERSON CITY - The national and local rate of uninsured children has seen an overall increase since 2014, according to a study by Georgetown University. 

It found an estimated 83,000 children in Missouri did not have health insurance in 2018, "an increase of approximately 17 percent since 2016." 

Columbia doctor Adam Wheeler said health insurance allows doctors to intervene early if children have potential health issues or concerns.

"[Early intervention] is pretty expensive if you don't have health insurance," he said. "If it doesn't get caught because you don't get to see the doctor for your regular check-ups, it really makes a lifelong impact."

Traci Gleason, Vice President for External Affairs for the Missouri Budget Project, said, "There are a lot of children that are eligible for health insurance through Medicaid and CHIP."

Medicaid provides medical care for children under 19 years old whose family income falls at or below 148% of the federal poverty line. CHIP, the State Children's Health Insurance Plan, provides medical care for uninsured children whose family's monthly gross income is up to 300% below the federal poverty line. 

The study also listed the following factors that have "contributed to the erosion in children's health coverage nationwide":

  • Efforts to repeal the Affordable Care Act and cut Medicaid
  • Cuts to enrollment outreach and advertising
  • Red tape barriers for families
  • Climate of fear for immigrant families 

Nationwide, more than 4 million children were uninsured in 2018, the highest level since the Affordable Care Act's major coverage expansions first took effect in 2014, according to the study.

Medicaid expansion legislation has never passed in Missouri. According to the National Academy of State Health Policy, Missouri is one of 14 states that has not expanded Medicaid.

The study also found that children in states without Medicaid expansion are nearly twice as likely to be uninsured than those in states that have expanded Medicaid.

Kids Win Missouri is a coalition that focuses on Missouri Children's well-being. 

"We were disappointed but not surprised to see our children’s uninsured rate continue to increase in Missouri," Casey Hanson, Director of Outreach and Engagement for Kids Win Missouri, said in a news release.   

Gleason said some families will mail in documentation to renew their child's enrollment, and the paperwork will not be processed before their children are removed from their health insurance. 

"Even if you do it all right and send it in, you may not hear anything for months," Wheeler said. 

He also said the state needs to find a "streamlined way" to get people enrolled into Medicaid. 

"With policies like 12-month continuous eligibility and increased outreach, we can get more of those kids who are eligible covered for the health insurance they need," Gleason said.

12-month continuous eligibility would allow individuals to enroll in Medicaid or CHIP for a year without changes to their plan despite changes in income. 

Gleason said this policy especially affects families who have influxes in their income, including people working in agriculture. 

But Wheeler said this is not just a problem for individuals. 

"If our citizens and legal immigrants are unable to get care, then we're going to have to deal with the long-term effects of that lack of care as a state, which is really unfortunate for the individuals," Wheeler said. "It's also a really big cost to the state in the long-term."

KOMU 8 reached out to MO HealthNet, the state's agency for health insurance, but has yet to receive a comment.

"Missouri can do better to ensure that eligible children get enrolled – and stay enrolled – in Medicaid and CHIP," Hanson said in a news release. 

She said there are solutions for this issue.

"12 months of continuous coverage when they enroll in Medicaid to increase efficiencies and avoid coverage gaps, using available data and technologies to streamline the eligibility processes and to increase no touch renewals that reduce barriers to enrolling and retaining coverage, addressing staffing shortages and training gaps, and simplifying the enrollment and renewal processes."

Wheeler said the state should have the resources to help resolve the problem. 

"If we are unable, as a state, to take care of the children of the state appropriately, then we have to ask about the legitimacy of the state government," Wheeler said.