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There were fewer uninsured kids in Texas during the pandemic — experts fear that could change

Marbell Castillo held her granddaughter, Maia Powell, as she was being examined by nurse practitioner Molly Lalonde at Burke Pediatrics in Burke, Va., in October 2017. Maia is insured through Virginia's Children's Health Insurance Program.
Matt McClain
/
The Washington Post/Getty Images
Marbell Castillo held her granddaughter, Maia Powell, as she was being examined by nurse practitioner Molly Lalonde at Burke Pediatrics in Burke, Va., in October 2017. Maia is insured through Virginia's Children's Health Insurance Program.

Federal pandemic dollars funded insurance for low-income families during COVID-19. Children’s advocates fear when that money goes away, the percentage will rise again.

The percentage of children in Texas and across the country without health insurance dropped during the pandemic, according to a new study of Census data. But researchers fear those gains are temporary.

Texas, which still has the highest percentage of uninsured adults and kids in the country, nonetheless saw its uninsured rate among kids drop to 11.8% in 2021, according to Census data researched by Georgetown University’s Center for Children and Families. Pre-pandemic, 12.7% of kids were uninsured.

Nationally, the rate of uninsured kids dropped from 5.7% to 5.4% between 2019 and 2021. Children in low-wage working families — those with annual incomes between approximately $30,000 and $55,000 for a family of three — saw the biggest reductions in their uninsured rates.

Researchers say the uptick in insured children is thanks to federal emergency Medicaid insurance funding.

That national funding is expected to end in 2023.

“We have millions of children who will need to renew their coverage,” said Anne Dunkelberg, with the nonprofit policy think tank Every Texan.

To avoid a return to rising rates of uninsured children in Texas again, Dunkelberg urged state lawmakers to expand Medicaid coverage.

That seems unlikely, as Texas leaders have steadfastly rejected such attempts for at least a decade, since the approval of the Affordable Care Act in 2010. Both Gov. Greg Abbott and Lt. Gov. Dan Patrick have openly opposed the ACA.

They've also successfully rejected any legislative attempts to expand Medicaid, which would increase the number of Texans — including children — with insurance.

Over the years, Texas Republicans have argued expansion would cost the state too much money, and matching federal funds would eventually dry up. That could force the state to pay more.

Other critics say health insurance coverage under Medicaid is poorly provided and managed, leaving many eligible Texans to reject it.

Democrats say that’s not so, adding most states now accept federal funds, helping millions of residents gain health insurance.

Texas remains of one of 11 that hasn’t expanded Medicaid.

Still, some lawmakers have tried to change that in Texas, including state Sen. Nathan Johnson, D-Dallas, and state Rep. Julie Johnson, D -Carrollton.

Both have independently filed Senate and House bills for the upcoming session that propose to create a “Live Well Texas” program. The approach to expansion would utilize Medicaid waivers to provide incentives to working adults to manage their health care responsibly.

However, both lawmakers tried and failed with these bills before. Little has changed in the Republican-led Texas legislature, where leadership was overwhelmingly re-elected just last month.

The next legislative session begins Jan. 10.

Bill Zeeble has been a full-time reporter at KERA since 1992, covering everything from medicine to the Mavericks and education to environmental issues.