Monday numbers: A closer look at what Medicaid expansion for adults can mean for kids

By: - February 22, 2021 6:00 am

More evidence that N.C. is harming children with refusal to expand Medicaid

A new report from the Center for Children and Families at the Georgetown University Health Policy Institute – “Children Are Left Behind When States Fail to Expand Medicaid” – shines a light on the big impact that Medicaid expansion for adults plays in assuring health coverage for children.

As the report executive summary explains:

While Medicaid expansion was designed to help uninsured adults who could not afford private insurance, the policy change also benefits children. When parents gain coverage, they are more likely to access the supports they need to be a healthy and effective parent, more likely to enroll their children in ‘whole family’ health coverage, and more likely to take their children to the doctor. In short, covering parents also means covering children, protecting families from economic strains associated with medical debt, and laying the groundwork for optimal child development.”

The benefits of expansion (and the problems caused in the holdout states like North Carolina that have refused to expand) are borne out by the numbers. As the executive summary also notes:

Growing numbers of uninsured children are concentrating in states that have not expanded Medicaid. Between 2016 and 2019, the child uninsured rate in non-expansion states grew at nearly three times the rate of expansion states. Non-expansion states saw their child uninsured rate jump from 6.5 percent to 8.1 percent during the period examined while expansion states saw it increase from 3.5 percent to 4.1 percent. Moreover, two non-expansion states, Texas and Florida, were responsible for 41 percent of the coverage losses for children over the three-year period.”

In short, the summary explains:

Extending access to Medicaid coverage for adults benefits the whole family by providing continuous access to care and improving reproductive health. Medicaid expansion has been shown to improve preconception and prenatal care, including increased use of folic acid supplements, critical health screenings, and mental health services. Expansion is also associated with lower maternal and infant mortality rates.”

Here are some of the key numbers from the report:

4.1% – share of children who lack health insurance in states that have expanded Medicaid under the Affordable Care Act

8.1% – share of children in states that have not expanded Medicaid

5.8% – share of children who lack health insurance in North Carolina

Approximately 142,000 – number of children this represents

+0.6% – growth in the percentage of uninsured children in states that have expanded Medicaid between 2016 and 2019

+1.65% – growth in states that have not expanded during the same period

39 – number of states (including the District of Columbia) that have expanded Medicaid

12 – number (including North Carolina) that have not expanded

53.8% – share of the uninsured children in the U.S. who live in those 12 states

38.2% – share that live in just four non-expansion states: Texas, Florida, Georgia and North Carolina

41% of the Federal Poverty Level – current income limit for a parent to be eligible for Medicaid in North Carolina – parents making more than this are not eligible

$8,905 –annual income this represents for a family of three – families making more than this in a year (or more than $171.25 per week) are not eligible

0 – income limit for childless adults in North Carolina – these low-income North Carolinians are not eligible for Medicaid under any circumstances

Click here to explore the Georgetown report in greater depth.

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Rob Schofield
Rob Schofield

NC Newsline Editor Rob Schofield oversees day-to-day newsroom operations, authors and voices regular commentaries, and hosts the 'News & Views' weekly radio show/podcast.