The number of children in Nevada without health insurance was cut by more than half between 2011 and 2016, but the state’s rate of uninsured kids remains the ninth-highest in the U.S., according to a new report.
The gains in insurance coverage occurred after passage of the Affordable Care Act in 2010 and Nevada’s subsequent expansion of the federal Medicaid program, said Elizabeth Lukanen, deputy director of the State Health Access Data Assistance Center. The policy research center based at the University of Minnesota released the report Friday.
Denise Tanata, executive director for the Children’s Advocacy Alliance, a nonprofit in Nevada, said the state’s current rate of uninsured children of 6.3 percent is a big improvement from the beginning of the decade.
“We’re absolutely still behind, and we’ve got a ways to go to catch up, but we’re definitely moving in the right direction to do that,” Tanata said. “The fact we’re not last anymore is good.”
The report analyzed U.S. Census Bureau survey data in all 50 states and Washington, D.C., tracking changes in public and private coverage and in the uninsured rate by race and ethnicity and household members’ income and educational status.
From worst, to ninth
Lukanen said the drop in the state’s uninsured rate quickened after 2013.
That may have been the result of the ACA’s individual mandate requiring uninsured Americans to acquire health insurance or pay a penalty, which took effect the next year, Tanata said. Parents typically buy their children insurance when acquiring it for themselves, she said.
The Medicaid expansion, which doubled the number of Nevadans insured under the program to 600,000, also took effect the next year, lowering the uninsured rate for children and adults alike.
“Definitely, Nevada was sort of a standout state in terms of reductions in uninsurance,” Lukanen said.
The 8.1 percentage point decline in the state’s uninsured rate among children between 2013 and 2016 was the largest percentage point drop in the nation, she noted.
Even so, Nevada remains among the worst states in terms of its uninsured rate among children. That’s because it started as worst in the nation in 2013, when 14.4 percent of children in the state lacked health insurance, ahead of No. 2 Texas, which had a rate of 13.2 percent.
“It’s kind of an uphill battle,” Lukanen said.
Disparities persist
Despite significant improvements across the board, disparities in insurance rates persist in the Silver State. About 10 percent of Hispanic children and children from households where family members achieved a high school education or less still lack health insurance, the report said.
One reason may be that parents whose children are eligible aren’t signing them up.
For example, undocumented parents often fear sharing their personal information with the government could lead to deportation or cancellation of a residency application, Tanata said, meaning they are reluctant to apply for their citizen children.
That’s despite the 2017 passage of state Senate Bill 325, which eliminated the five-year wait period to become eligible for Medicaid and Children’s Health Insurance Plan previously required for children who were granted legal residence.
Lukanen and Tanata fear that questions about the future of the Affordable Care Act and the demise of its individual mandate provision, as well as anti-immigrant rhetoric from some Republican lawmakers, could reverse the progress made in Nevada and across the nation.
“I think every time you infuse uncertainty and question into a policy area, people get confused and, most likely, lose out,” she said.