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  • Team Advocatia

The number of uninsured children has risen by 400,000 since 2016

The number of uninsured and the uninsured rate for children are now at their highest levels since 2014, when the ACA’s major coverage expansion first took effect. A recent report by the Georgetown University Health Policy Institute Center for Children & Families brought to light this unfortunate trend. Most of these children are eligible for Medicaid but are not enrolled. You can read the report here. For your convenience, we have summarized the key findings in this blog.

15 states saw statistically significant increases in the number and/or rate of uninsured children

If you live, work, or care for individuals in Alabama, Arizona, Florida, Georgia,

Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Texas, Utah, West Virginia then your state saw a significant increase. The most distressing fact is that only one state, North Dakota, moved in the right direction. Some states saw increases as great as 25% between 2016 and 2018.

Loss is most pronounced for children in low and moderate income

families who are eligible for coverage

Children from families earning between 138% and 250% of the federal poverty limit ($29,435 - $53,325 annually for a family of three) saw the sharpest increase in uninsured rate. Most children in this income bracket are eligible for Medicaid or CHIP insurance but are not enrolled.

Babies, toddler, and preschool age children saw an increase over 13% in their uninsured rate

Young children who require regular preventive care, immunizations, routine care and developmental screenings saw the largest increase in uninsured rate. The rate of uninsured for this vulnerable age group moved from 3.8% to 4.3% nationally. This age group typically has the most generous income limits for enrollment, and has long had the lowest uninsured rates, but this trend appears to be reversing.

Most uninsured children live in the south in non-expansion states

States that have not expanded Medicaid to adults are more likely to have higher rates of uninsured children, and that rate is rising faster than states that did expand Medicaid. Additionally, while 39% of the nation’s children live in the South, 53% of uninsured children do.

There are no signs that this disturbing trend in children’s health coverage will abate in the near-term. This trend is also taking place during a period of economic growth when normally it would be expected for uninsured rates to drop. If your facility is already assisting more uninsured children or you want to take a proactive approach to slow this trend Advocatia Solutions can help.

Advocatia Solutions ( provides hospitals with an omni-channel platform to assist their uninsured and under-insured patients. Advocatia simplifies how financial counselors and self-pay patients identify financial assistance programs and ensures providers can enroll more individuals into health coverage. Health systems use our platform to quickly determine eligibility, reduce application errors, and automate form submission. Our customers screen a higher percentage of self-pay patients, see increased Medicaid reimbursement, and decreased bad debt.


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