Despite Pandemic, Children’s Uninsurance Rates Declined In 2021

While COVID-19 job losses may have led to uninsurance for some Americans, it doesn’t appear that children’s insurance rates were negatively impacted. In fact, new research suggests that children’s uninsurance rates actually fell between 2019 and 2021.

The report, published by Urban Institute this week, looks at survey data from the National Health Interview Survey (NHIS) and Current Population Survey (CPS) to determine insurance rates for children. It found that childhood uninsurance dropped to 4.1% overall in 2021 from 5.1% in 2019, according to the NHIS. That means that approximately 700,000 children gained insurance coverage during that period.

Notably, the data didn’t indicate a gradual decrease in the number of uninsured children over the stretch of time. Instead, uninsurance rates remained steady between early 2019 and early 2021, before rates saw a significant drop in late 2021, down to 3.5% for the final quarter of 2021 compared to 4.6% in the first quarter.

The data also indicated that the primary sources of children’s insurance changed: There was a 4.3% decrease in private insurance rates for children between early 2019 and early 2021, while public insurance simultaneously saw an almost 5% increase in children’s coverage, according to the NHIS.

Despite the positive trends, around 3 million children remained uninsured at the end of 2021.

It’s unusual to see an increase in insurance rates during an economic downturn, the report noted, but the situation can likely be attributed to the various health care assistance programs put in place during the COVID-19 pandemic. “Policies like the Families First Coronavirus Response Act, the American Rescue Plan Act and other economic recovery efforts seem to have protected children’s insurance coverage and contributed to a decline in uninsurance by the end of 2021,” said Urban Institute senior research associate Jennifer Haley in a press release.

Moving forward, the loss of these pandemic policies, including the reduction in expanded health care marketplace subsidies, could lead to more than 300,000 kids becoming uninsured. To ensure coverage remains high, the report suggests that stakeholders aim to bolster Medicaid/CHIP enrollment and maintain the expanded health care marketplace subsidies.


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