MEDICAID: Nearly 5 Million Uninsured Kids Are Eligible

      Nearly one-fourth of all uninsured children eligible for Medicaid are not enrolled in the program, according to a new federal study published today in the journal Health Affairs (release, 5/18). The study found that "4.7 million children -- far more than previously estimated are eligible for Medicaid but are not enrolled in the program." The New York Times reports that "[t]he finding means that two of every five uninsured children in the United States could have coverage through Medicaid. Thomas Selden, the study's main author, said, "Over all, we estimate that 4.7 million children age 18 and under were uninsured despite being eligible." The Times notes that this "represent[s] 39% of uninsured children." Previous estimates had placed the number of children who were eligible for Medicaid but not enrolled at three million. According to the study authors, "[e]arlier studies focused on children ages 10 and younger and did not consider all children who might benefit from recent state expansions of the Medicaid program." The number of children eligible for Medicaid has nearly doubled since the 1980s due to the expansions.

Reasons Why
      The decoupling of Medicaid from welfare benefits is one reason that many families are not taking advantage of Medicaid for the children because they now "have to make special efforts to get such health benefits" (Pear, 5/18). Joan Henneberry, who directs the National Governors' Association's maternal and child health program, noted that "uninsured children eligible for Medicaid are traditionally hard to find because they typically are not on other welfare programs and therefore do not interact with state and county agencies" (AP/Dallas Morning News, 5/18). The families may also have lived in communities with lower Medicaid prevalence, which contributes to lowered awareness of the Medicaid program and an increase in the stigma associated with the government assistance program. The results, according to AHCPR "highlight the importance of both the on going community and state efforts to improve outreach."

Other Implications
      The low Medicaid enrollment rates also have implications for the Children's Health Insurance Program because states must enroll all uninsured children who qualify for Medicaid in that program, thereby increasing Medicaid enrollment rates and costs. In addition, noting that overall the Medicaid take-up rate was only 70% in 1996, Selden said, "The low take-up rates that we observed among expansion-eligible children suggest that simply expanding public coverage to high-income groups will not solve the problem of limited access to medical care for uninsured children" (release, 5/18).