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The questions to ask when assessing the impact of coverage expansion proposals on children
The questions to ask when assessing the impact of coverage expansion proposals on children
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Future of children's health care coverage
- Author(s):
- Park, Edwin, author
Alker, Joan, author - Contributor(s):
- Georgetown University. Center for Children and Families issuing body.
- Publication:
- Washington, DC : Georgetown University Health Policy Institute, Center for Children and Families, March 2019
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Insurance Coverage
Child
Medicaid
United States
State Children's Health Insurance Program (U.S.) - Genre(s):
- Technical Report
- Abstract:
- With the outcome of the November midterm elections, the risk of federal legislation to repeal and replace the Affordable Care Act (ACA) and impose a cap on federal Medicaid funding has receded. Instead, there is renewed attention by some policymakers on how to once again make substantial progress toward the goal of universal coverage. This has become more urgent with recent survey data showing that the ranks of the uninsured are increasing. For example, data from the Census Bureau's American Community Survey (ACS) show that in 2017, the uninsured rate among children increased for the first time since at least 2008 when the ACS first asked a health insurance question. The share of children without health insurance rose from 4.7 percent to 5 percent between 2016 and 2017 and the number of uninsured children increased by 276,000. While the number of children with health insurance has reversed modestly, this troubling sign comes on the heels of extraordinary progress as a result of efforts at the federal and state levels to address children's health needs. Following decades of coverage expansions and eligibility simplifications through Medicaid and the Children's Health Insurance Program (CHIP), the percent of insured children reached a historically high level of 95.5 percent in 2016. Children are also at risk when their parents and caregivers lack health insurance. The latest results from the Gallup National Health and Well-Being Index, for example, find that the uninsured rate among adults has increased by 2.8 percentage points since 2016 (from a low of 10.9 percent in the third quarter of 2016 to 13.7 percent in the fourth quarter of 2018), which translates to an increase of about 7 million people. According to Gallup, this is the highest uninsured rate among adults since the ACA's major coverage expansions were implemented in 2014. The health coverage expansion plans being proposed not only by members of Congress but also by think tanks and health advocacy organizations vary considerably in their approach and scope. Some proposals would establish new universal coverage programs (often under the rubric of "Medicare for All") that may or may not replace current coverage sources like employer-sponsored insurance and public programs such as Medicare, Medicaid and the ACA marketplaces. Some proposals would expand coverage to targeted populations (such as by lowering the age of Medicare eligibility or allowing a buy-in to Medicare or Medicaid for those not currently eligible). Others would provide a public health insurance plan option for the ACA's marketplaces. There is a wide diversity among these coverage expansion proposals. This issue brief asks a number of key design questions to help assess the relative merits of expansion proposals from the perspective of children, especially the tens of millions of low-income children who rely on Medicaid and the CHIP today.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (9 pages)).
- NLM Unique ID:
- 101770652 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101770652