Rate of uninsured U.S. children increases for first time in nearly a decade

An unprecedented increase in uninsured children, mostly in states that have not expanded Medicaid.

Young girl waits for care in a medical clinic. (Credit: Getty Images)
Young girl waits for care in a medical clinic. (Credit: Getty Images)

Nearly four million children in the United States are uninsured, the highest rate in nearly a decade.

The latest data, released by Georgetown University’s Center for Children and Families on Thursday, reflects an unprecedented increase in the number of children without health insurance, at a time when the Trump administration continues its assault on health care by chipping away at the Affordable Care Act (ACA).

The Georgetown report found that approximately 276,000 more children were uninsured in 2017 than 2016, for a total of about 3.9 million. In other words, five percent of children 18 and under are currently uninsured, compared to 2016, when the rate was 4.7 percent.

“For many years, that rate has been declining thanks to bipartisan efforts to extend coverage through Medicaid and the Children’s Health Insurance Program (CHIP),” wrote Joan Alker, director of Georgetown’s Center for Children and Families. That changed in 2017, as lawmakers stalled on renewing CHIP funding and numerous states sought federal approval to upend their Medicaid programs. In early 2018, the Trump administration aimed to grant those requests with its introduction of Medicaid work requirements.


Alker surmises that the Trump administration’s assaults on immigration may also contribute to the increase in uninsured children.

By targeting undocumented immigrants and proposing to reject green card or visa applicants who may need government assistance, the administration has generated a “heightened fear of interacting with the government,” Alker wrote.

“This may be deterring them from signing their eligible children up for government sponsored health coverage,” she added.

According to the report, not a single state, excluding the District of Columbia, saw a rise in the number of insured children.


“Never before have we seen such uniformity in state behavior,” Alker wrote. “This finding underscores that even states with the best of intentions were not able to overcome the negative national currents that are affecting children’s health coverage.”

The children’s uninsured rate has dropped or remained stagnant since 2008, when 9.7 percent of children were without coverage. Its lowest point was in 2016, thanks to the Affordable Care Act exchanges and the expansion of Medicaid across various states, as permitted under the ACA. A majority of uninsured children — about 75 percent — reside in states that have not expanded Medicaid, with Texas, Florida, and Georgia seeing the most sizable increases.