Planning for the Medicaid Expansion: a must do for children’s health

A story from the field:  A 2 year-old girl fell and injured her arm badly.  Their neighborhood clinic was closed on the weekend and the parents had no health insurance for their daughter, so they kept her at home, where she lay quietly in agony.  After watching her suffer for two days, they brought her into the clinic on Monday morning, where her displaced fracture was diagnosed and she was sent to a local emergency room for treatment.  For those of us who cared for this little girl and for her parents, the memory of this child’s face reminds us just how critical it is that every child has access to health care.
Yet data recently released by the Children’s Defense Fund demonstrates just how far we have to go to make sure that every child has access to health care.  Two thirds of uninsured children are currently eligible for CHIP or Medicaid, yet over 8 million children remain uninsured.  More than half of uninsured children are members of minority groups and over a third are Latino.  89% of uninsured children are US citizens.  2.4 million uninsured children are under age 5.
Eligible children remain uninsured for complex reasons, but poverty, poor literacy, lack of English fluency, and having a parent who is undocumented are factors for most of these children.  One result is a system in which Latino children are far more likely to be uninsured than white children, regardless of citizenship status.  The Children’s Defense Fund data should be a wake-up call for all of us that implementation of the Medicaid expansion must include measures to address disparities in insurance rates among poor, minority, and non-English speaking populations.  Without defined enrollment targets and incentives for the states for equitable enrollment, we run the risk of exacerbating a two-tiered health care system that leaves out the most vulnerable children.
Data from CDF: