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N.C. Health News: Number of uninsured children in North Carolina rises for a second year

Updated: Mar 2

Between 2016 and 2018, the total number of uninsured children in North Carolina rose from 115,000 to 130,000, a recent Georgetown University analysis found.


By Anne Blythe, N.C. Health News


North Carolina is one of 15 states that saw a statistically significant jump over the past two years in the number of children without health insurance, according to a Georgetown University report released this week.


The number of uninsured children grew in North Carolina between 2016 and 2018, pushing the total number of children not covered from 115,000 to 130,000, researchers at Georgetown’s Center for Children and Families found.


Overall, the percent of North Carolina’s children lacking coverage ticked up to 5.3, reversing a decade-long trend of fewer children without coverage.


Only five states — Arizona, California, Florida, Georgia and Texas — have more children without coverage, their research shows.


The report comes at a time when North Carolina Republican lawmakers and the Democratic governor are locked in a budget standoff over the issue of Medicaid expansion.


Gov. Roy Cooper vetoed a $24 billion budget bill in June largely because the Republican-led General Assembly has not agreed to expand Medicaid eligibility to as many as 550,000 low-income adults who could qualify for the federal assistance. That stalemate continued this week as Republican leaders in the state House and Senate wrapped up the month with a series of mini-budgets and a plan to return in November and later in January to complete their legislative work.


The Georgetown researchers found that three-quarters of the 400,000 children across the country who lost coverage during the two-year period live in states that have not expanded Medicaid.


The growth in the number of uninsured children during the past two years reverses an eight-year increase in coverage from 2008 to 2016, two years after the 2014 implementation of the Affordable Care Act. Nationally, there were 7.8 million children without coverage in 2008, when the financial crisis struck. By 2016, the last year of Barack Obama’s presidency, that number had dropped to 3.6 million. But since then, the numbers have begun creeping up.


The Georgetown researchers found that loss of coverage was more prominent for white and Latino children, children younger than 6, and children in families where the household income is between $29,435 to $53,325.


The research showed a slight improvement in coverage during the two-year period for African American children.


“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,” Joan Alker, executive director of the Georgetown University Center for Children and Families and a research professor at the McCourt School of Public Policy, said in a prepared statement.


Michelle Hughes, executive director of NC Child, an advocate for the state’s children, called the upward tick in uninsured children “a concerning trend.”


“One of the big factors for North Carolina and other states is the rate of uninsured is growing three times as fast as other states that have expanded Medicaid,” Hughes said.

The biggest loss of insurance was for children from low- and moderate-income households, Hughes added. Sixty percent of the 130,000 children without insurance coverage in NC are available for assistance, Hughes said, highlighting a need for advocates to get the word out to parents about how to go to county social services departments and sign up for CHIP.

NC Child also encourages parents without insurance to go to Healthcare.gov and explore eligibility options for Affordable Care Act subsidies.


Research has shown that parents without insurance are more likely to have uninsured children than those with insurance. Other studies have found that providing coverage for adults becomes a mechanism to reach their previously uninsured children, gaining them access to care.


“NC Child’s biggest priority and the biggest lever to help insure children is to expand Medicaid,” Hughes said.

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