Kansas had 5,000 more children without health insurance in 2017 than it did the year before, placing the state slightly above the national average as lawmakers prepare to again debate Medicaid expansion in the coming year.
Supporters of expansion say it would help lower the rate of children without coverage, which dropped to record lows just a few years ago.
Nearly 40,000 Kansas children lacked coverage in 2017, up from 34,000 in 2016, according to a report by Georgetown University’s Health Policy Institute.
The statewide rate of uninsured children -- defined as those under 19 years old -- was 5.2 percent in 2017, up from 4.5 percent in 2016. In Massachusetts, by contrast, just 1.5 percent of children are uninsured.
Growing up without health coverage can alter the path of a child’s life, for the worse. Uninsured children are more likely to have unmet health needs, the Georgetown report says. Untreated medical conditions ultimately lead to missed school days and reduce a child’s chances of educational success.
Cyndy Greenhagen, a patient navigator at Community Health Center of Southeast Kansas in Iola, a town of about 5,300, said she sees children without insurance “quite often.”
Having grown up with insurance, she said coming to work at the center was jolting.
“It was shocking to me to see the number of adults who haven’t been to the doctor in 20 years because they didn’t grow up with regular health care,” said Greenhagen, who helps connect families with health services. “So they didn’t learn that habit of having regular health care and they don’t think they can afford it, they don’t need it – all that.”
While Kansas’ rate of uninsured children might seem relatively small, it is above the national average of 5 percent.
The state’s rise is part of a nationwide uptick in the number of young without insurance. The national rate jumped from 4.7 percent in 2016 to 5 percent in 2017. No state saw saw a decline.
Georgetown researchers found that 2017 marked the first time the rate had risen nationally since collection of comparable data began in 2008. The increase came after the United States set a record low in 2016 for the percentage of uninsured children.
The rise also coincided with a long and ultimately unsuccessful effort by Congressional Republicans to repeal the Affordable Care Act (ACA), as well as a temporary lapse in funding for CHIP, Children’s Health Insurance Program, the report said.
States that expanded Medicaid to adults saw a smaller increase in rates of uninsured children, the report said. Of the 276,000 U.S. children who lost coverage in 2017, 75 percent lived in states that had not expanded Medicaid.
The data is likely to play into the upcoming Kansas debate over expansion of KanCare, state’s Medicaid program.
In 2017, lawmakers expanded eligibility to households with incomes at 138 percent of the federal poverty level ($34,638 for a family of four). But then-Gov. Sam Brownback (R) vetoed the measure and legislators were unable to override his decision.
Democratic Gov.-elect Laura Kelly, who takes office next month, has been a vocal proponent of expansion and has consistently named it as one of her top priorities.
“Expanding Medicaid will increase the number of Kansas children and families that received healthcare coverage significantly. I look forward to working with the legislature to expand Medicaid and find ways to expand health coverage for our children,” Kelly said in a statement.
Rep. Monica Murnan, a Pittsburg Democrat and founding member of the Community Health Center of Southeast Kansas, said Medicaid expansion would provide opportunities to identify uninsured children and guide parents to resources when they apply.
“I believe the combination of the lack of public awareness for (ACA) marketplace enrollment and lack of Medicaid expansion – we’ve created this void,” Murnan said.
Enrollment in the ACA, or Obamacare, was down by almost ten percent this year in Kansas and Missouri.
John Wilson, vice president of advocacy at Kansas Action for Children (KAC), said that when parents have coverage, children are more likely to have it as well. That helps make the whole family more financially secure.
In a June report, KAC noted that newborn children of mothers on Medicaid are automatically enrolled in coverage. But if a mother is not covered, her child is not automatically enrolled, though such children may likely be eligible for Medicaid or CHIP. KAC recommended that Kansas make enrollment in Medicaid easier for children.
The Georgetown report said that nationwide, 56.8 percent of uninsured children are eligible for Medicaid or CHIP.
“We know what would make a difference in the number of insured kids. Expanding KanCare would provide a health coverage option to more parents and that would be good for children too,” Wilson said.
Rep. Dave Baker, a Council Grove Republican who sits on the House Children and Seniors Committee, said that “of course” children should be insured. But if there is a desire for Kansas to require children to be insured, it will cost the state.
“If we’re going to require insurance on these children, the state is going to have to step it up and pay for it, because obviously there’s no other funds available,” Baker said.
A mandate requiring individuals to purchase health coverage was effectively repealed, and the Trump administration also reduced efforts to encourage people to sign up for coverage using the ACA marketplace.
Adding to the confusion this year was a federal court ruling that found the entire ACA unconstitutional. While the ruling will be appealed and the law remains in effect, it was issued just before enrollment wrapped for the year.
The report said that a “constellation of national trends has likely created an ‘unwelcome mat’ effect where families are unaware of their options or deterred from seeking coverage.”