Four hundred thousand U.S. children lost their health insurance from 2016 to 2018, pushing the total number of uninsured children to over four million, according to a report published by the Georgetown University Health Policy Institute’s Center for Children and Families.

For the second year in a row, the total number of uninsured children increased, according to the CCF’s report, which has been released annually for nine years. CCF Senior Research Associate Lauren Roygardner and CCF Executive Director Joan Alker co-authored the report. 

The increase in uninsured children in 2018 was unsurprising following the previous increase in 2017, according to Roygardner.

“Unfortunately, I was not very surprised by the findings, since our center has been monitoring uninsured rates for many years,” Roygardner said in an interview with The Hoya. “Last year, we saw a national increase in the child uninsured rate, and so this year we were closely monitoring children losing their coverage.”

The report found that uninsured children from low- and moderate-income families who earn between 138% or 250% of the federal poverty threshold suffered the largest rate increase. Losing health insurance was an issue most prevalent for children under the age of 6 and for white and Latino children, according to the report. 

The decrease in children’s healthcare coverage has implications for the growing wealth inequality gap, according to GlobeMed Georgetown Co-President Regina Woolridge (COL ’20). GlobeMed is a network composed of university students who partner with organizations to improve health outcomes for people living in poverty.

“[The report] also says a lot about the wealth gap,” Woolridge said in an interview with The Hoya. “Medical bills are one of the biggest contributors to debt in this country, and so not only does it show that the wealth inequality gap is growing, but also that it continues to grow as people who don’t have health insurance have to go into debt to pay medical bills.”

Health care insurance is not only necessary for medical emergencies, but also for yearly checkup appointments, according to Woolridge. Not attending yearly checkup appointments can have financial and educational impacts, Woolridge said. 

“It’s not only about what it means when they have an accident and their family has to take them to the hospital, but also about them not getting checkups as often, and what that will mean for their education and for their family’s financial security in general,” Woolridge said.

The Affordable Care Act allowed states to expand Medicaid coverage to uninsured adults and children with household incomes at or below 138% of the federal poverty level. The federal poverty level was $21,330 for a family of three in 2019. States that expanded Medicaid coverage are called expansion states. 

The report found that 7.3% of children were uninsured in states that did not expand coverage compared to 3.8% of uninsured children in states that did. The large difference in health insurance coverage of children in nonexpansion versus expansion states was shocking, according to Roygardner. 

“Typically we do understand that the child uninsured rate in nonexpansion states is much higher than in the states that expanded, but I was shocked at the extent to which that disparity was,” Roygardner said.

Approximately half of uninsured children in the United States live in Texas, Florida, California, Georgia, Arizona and Ohio, according to the report. 

“While 39 percent of the nation’s children live in the South, 53 percent of uninsured children do,” the report stated. “No other region of the country has a larger share of uninsured children relative to their overall number of children.”

In order to decrease the number of uninsured children, states must find solutions tailored to their uninsured population’s needs, according to Roygardner.

“Probably a lot would have to happen for things to change, so I do think that if things kind of remain as they are, we are likely to continue to see a lot of uninsured kids,” Roygardner said. “Every state has different nuances, and so given that complexity, in order to change in the right direction and get more kids covered, it’s sort of state-by-state.”

In light of the report’s results, people can be active in their communities to learn about health disparities and support health equity, according to Woolridge.  

“We should all be working towards, in whatever our fields are, an equitable world where people have human rights — and health is a human right,” Woolridge said. “I think getting involved and educating yourself is important. We have this power and we should use it towards making the world a better place.”