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As we have previously written, while this sounds like a highly technical change, it would likely result in fewer children eligible for Medicaid and the Children’s Health Insurance Program (CHIP) relative to current law, with the number of children losing Medicaid and CHIP growing larger over time. This is a potential change that is entirely discretionary and yet the Administration includes no detailed legal and policy analysis justifying such a change from the use of CPI-U for purposes of adjusting the OPM for inflation. It is essential that if the Administration is to make such a significant change to calculating the OPM — which, in turn, would affect determination of the HHS poverty guidelines — it must also include detailed analysis and estimates of the likely effects such as whether such a change is permissible under federal law, how it would affect eligibility, benefits and access to needed services to all federal programs that rely on the HHS poverty guidelines which are based on the OPM, and how it would affect providers that furnish services to program beneficiaries. The Center on Budget and Policy Priorities, for example, estimates that using chained CPI to adjust the OPM would result in more than 300,000 fewer low-income children enrolled in Medicaid and CHIP by 2029, relative to current law.

Since the 2017 ACS data was released in September 2018, we have been concerned about the first increase in the number of uninsured children in a decade as highlighted in our annual uninsured children’s report. As we were researching the latest report, we got more troubling news in a new brief showing that the child participation rate in Medicaid and CHIP declined in 2017 for the first time since the participation rate was first measured by researchers at the Urban Institute. However, in 2017 – the same year the number of uninsured children increased by 276,000 from 4.7 percent to 5 percent – the child participation rate declined to 93.1 percent. At a time when the economy is strong, the decline in child enrollment in Medicaid and CHIP in 2018, following an increase in uninsurance among children and a decrease in the participation of eligible children in Medicaid and CHIP in 2017, the critical question is whether children are moving to private coverage or becoming uninsured.

The number of children getting health coverage through two large government programs fell by more than 800,000 last year, according to a new report from Georgetown University. The enrollment decline could be an indicator that the number of kids without any kind of health insurance went up in 2018, one year after that figure rose for the first time in a decade. It’s impossible to be sure, because firm, up-to-date estimates on the number of uninsured children won’t be available until the release of new census data in the fall.

A new cost model created by researchers at Mathematica finds that untreated mood and anxiety disorders among pregnant women and new moms cost about $14.2 billion for births in 2017, when following the mom and child pair for five years after birth. As a recent CCF report found, maternal and infant death rates are higher in non-expansion states than in expansion states, and that expansion improves health for infants and can help reduce racial disparities in maternal and infant health. The Mathematica model calculates how these disorders lower productivity in the workforce, increase reliance on public benefits and raise health care costs for treating worse maternal and child health. Children can miss out on important bonding experiences that can set them on a path for future behavioral and developmental disorders, families lose the economic security that comes from an engaged and employed caregiver, and moms are at risk for a lifetime or poor health.