October 25, 2012
By Jennifer Robison
A new report says a big share of Nevada kids lack health insurance.
But observers disagree on how to help them get coverage.
The Silver State had an uninsured rate of 16.2 percent among children in 2011, well above the national rate of 7.5 percent, and significantly ahead of the 13.2 percent rate in No. 2 Texas, according to a study from the Georgetown University Health Policy Institute’s Center for Children and Families.
It’s not the first time Nevada has been highlighted for its uninsured. A 2007 report from the Nevada Legislature noted the state ranked No. 4 in its proportion of uninsured adults, at 23.9 percent, and No. 4 in its share of uninsured children, at 17 percent. Nevada also placed last for percentage of kids covered by government health insurance. Fifteen percent of the state’s children were covered through public programs, compared with 27 percent nationally. Plus, 2010 Census data showed Nevada second only to Texas in share of uninsured residents, at 21.9 percent. Even back in 2000, Nevada ranked in the top 10 for its percentage of uninsured kids.
What’s different this time, though, is that the state has lost ground even as other states improved their coverage rates, said Denise Tanata-Ashby, executive director of the Nevada nonprofit Children’s Advocacy Alliance.
The declines came partly from job loss among parents – local and state unemployment in 2011 languished between 12 percent and 14 percent, and is still near 12 percent. But it’s also because of lower funding for outreach to Medicaid-eligible families, Tanata-Ashby said. That means Nevada has a high number of uninsured kids who qualify for public programs but aren’t signed up to participate.
She said two things would help.
First, Nevada needs to compete for grants that the Centers for Medicare and Medicaid Services provide for outreach and application assistance for eligible families. State officials reined in efforts to qualify for outreach money because of the cost of covering more Medicaid enrollees during the recession. As a result, the number of kids signed up for Nevada Check Up, the government program for low-income families, fell from a high of 29,899 in June 2007 to less than 21,500 in 2011, the Georgetown study said.
Second, Nevada should embrace Medicaid expansion under federal insurance reform, Tanata-Ashby said. The move would cover an additional 25,000 parents of low-income children, according to the state Department of Health and Human Services, and that coverage would link thousands more kids to insurance.
But Geoffrey Lawrence, deputy policy director of free-market think tank Nevada Policy Research Institute, said broadening Medicaid is the wrong idea.
A better approach would be to focus on job creation so more parents could afford health insurance via private markets, Lawrence said. Expanding Medicaid would put upward pressure on taxes, and higher taxes would hamper job growth, he said.
Plus, lifting some of Nevada’s 50 or so coverage mandates would make health insurance more affordable, because consumers could purchase only the coverage they actually need. Making health insurance competitive across state lines and creating a tax deduction for families who purchase insurance through individual markets would help, too, he said.
Lawrence also said studies offer mixed reports on whether Medicaid actually improves health outcomes.
Mary-Sarah Kinner, a spokeswoman for Gov. Brian Sandoval, said Sandoval has not decided whether to expand Medicaid.
Contact reporter Jennifer Robison at jrobison@reviewjournal.com or 702-380-4512. Follow @J_Robison1 on Twitter.
