Early numbers on uninsured rates following the close of the enrollment period for the Affordable Care Act (ACA) suggest that the bill has been successful in connecting uninsured Americans with health coverage. Although the ACA primarily affects adults, many uninsured children stand to gain coverage through their parents. As a result, the recent health insurance reforms may have a significant impact for the 5.8 million American children who were uninsured in 2012.
A new report released by the Robert Wood Johnson Foundation last week on recent trends in the uninsured rate for children can provide us with a starting point for understanding what the ACA means for children. The broader story in Nebraska was relatively consistent with how children across the country fared through the recession. Nationally, a 2.3% decline in uninsured children was observed from 2008 through 2012, while Nebraska saw a 1.5% decline. The public-private coverage breakdown tells us just how crucial public programs were in supporting families during the economic downturn. Private coverage rates for children declined by 6.2% in Nebraska during this time period (5.5% nationally), while public coverage rates increased by 7.7% (7.8% nationally).
The report also captured considerable economic and racial disparities in insurance coverage that we know to be a troubling issue for kids in Nebraska. When compared to the rest of the country, Nebraska has some of the most startling gaps. Non-white children in Nebraska are 2.7 times more likely to be uninsured than their white counterparts, and a Hispanic child is 4.8 times more likely to be uninsured, leaving our state ranked as the second- and first-worst by ratio, respectively.
So what can we do to ensure that kids in Nebraska have affordable access to quality health insurance? If we follow the lead of other states that have led the country in reducing uninsured rates of children, there are a variety of legislative, administrative, and community-based approaches that may be worth exploring. Measures such as expanded eligibility levels, continuous eligibility, or administrative renewal can directly address the many challenges that families face in getting adequately covered.
It is also crucial to recognize that health is just one piece of the much larger puzzle in evaluating and improving the well-being of all children in Nebraska. It is impossible to meaningfully speak to the disparities observed in trends of uninsured rates without examining their relationships to gaps in other areas of concern. Join us this Wednesday for our “Race for Results” event, where we will be highlighting the latest Race for Results Report and learning more about where Nebraska stands from our expert panel!