Urban Study Finds Uninsured Low Income Parents Are Key Beneficiaries of Medicaid Expansion

The latest round of data from the Urban Institute’s Health Reform Monitoring Survey (HRMS) measuring uninsured rates pre- and post-implementation of the Affordable Care Act (ACA) is out today and finds that parents have seen sharp declines in uninsured rates – from 17.3% in June 2013 to 10.4% in March 2015. This amounts to a 35.6% decline in uninsured parents. Children’s coverage rates remained statistically unchanged during this period according to the findings.

HRMS is a national survey so no state-by-state data is available. In a few weeks the Census Bureau will be releasing its 2014 data that will provide a national and 50 state look at uninsured rates for the first time following the implementation of many of the key provisions of the ACA. This will form the basis of our Georgetown CCF annual look at children’s insurance rates by state – a report that Alisa Chester and I are very much looking forward to writing!

But back to today’s news – -the authors note: “Particularly large percentage-point declines were found in the uninsurance rates for low-income parents and Hispanic parents, groups that have historically had higher rates of uninsurance”
In particular, the sharpest reduction is for low-income parents with incomes below 138% of the federal poverty line whose coverage rates increased by 14.2% – i.e. those targeted by Medicaid expansion.Urban figure 2

Obviously it is easier to have greater impact on those groups that had higher uninsured rates to start. And that is one reason why we may not be seeing a reduction in the number of uninsured children – they were doing better to start with. But some provisions of the ACA were expected to reduce the uninsured rates of children – either directly or through what we at CCF call a “welcome mat” effect – in particular by covering their parents.

So I am now waiting even more anxiously for the Census Bureau’s numbers to come out. It is great news that parents are getting coverage – and there is more work to be done there in states that haven’t expanded Medicaid. But let’s hope that kids progress isn’t stagnating – either in some key states or nationally.

Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy.