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Study: Uninsured children up in state

More Minnesota children were uninsured in 2010 compared to three years ago, a new study shows.

But an administrator for the Minnesota Department of Health questions the study's findings.

Minnesota was the only state to see a statistically significant increase in the number of uninsured children in the past three years, according to Georgetown University Health Policy Institute's Center for Children and Families, which looked at new health insurance data from the U.S. Census Bureau.

Nearly 11,700 fewer children had health insurance in 2010 than in 2008.

Minnesota, Kansas and Wisconsin saw an increase in the number of uninsured children. Nevada has the highest rate of uninsured children while Massachusetts has the lowest, the report said.

The news comes as the number of uninsured adults has risen in the past few years.

Stefan Gildemeister, interim director of the Health Economics Program for the Minnesota Department of Health, is not convinced the report paints an accurate picture of health insurance coverage in the state.

"It is drawn out from a survey that has not shown itself to be accurate when it comes to showing certain health insurance statistics," Gildemeister said Tuesday.

The MDH publishes its own survey of health insurance, he said, and is about to release its 2011 survey of health insurance coverage.

"With everything we know about coverage in Minnesota - Minnesota provides broad health coverage for children," he said. "I am skeptical about the numbers because I'm not aware the eligibility rates of children have changed."

For years, Minnesota has operated under a federal waiver that differed from other states. The waiver said children eligible for the state's insurance program were not also eligible for the federal program, meaning the state lost out on enhanced matching funds.

In the past several years, the state has made cuts. For example, the program used to allow children born on Medicaid to remain on the program until age 2 regardless of circumstances. Now a child can remain until age 1.

The state has attempted improvements such as creating gap coverage between Medicaid and Minnesota Care, but the federal government didn't sign off, she said.

"Doing the things that other states have done is more costly for Minnesota," former Minnesota Sen. Linda Berglin, a longtime champion of health care services, told the Associated Press. "It makes me sad. Obviously I believe having all children insured is a goal we should be striving for. If we are going to implement federal reform, that will take care of a lot of the problem."

Gildemeister said he finds it hard to believe the results from the study for several reasons.

"The recession has affected all states," he said. "In some ways our unemployment rates in Minnesota is not as low (as other states'). I'm surprised we would have seen a greater decline in insurance coverage for children."

It is tricky to get accurate uninsurance estimates at the county level, Gildemeister said, because "it is difficult to survey enough people to make reasonable assumptions."

However, the U.S. Census Bureau's Small Area Health Insurance Estimate has county-level information on the percentage of uninsured persons under the age of 19.

The SAHIE report showed that in 2009, 10 percent of Beltrami County residents under the age of 19 had no health insurance. In the same year, Clearwater County had a 12 percent rate, Cass Lake a 10.3 percent rate and Hubbard County an 8.7 percent rate.

The SAHIE program creates on mathematical models based on employment, income and labor information. While this method relies on little direct information, the SAHIE provides "a good indication," Gildemeister said.

According to the SAHIE website, data on health insurance coverage for all counties are not currently available elsewhere. For the fall 2011, the American Community Survey provides three-year health insurance estimates for areas with a total population size of 20,000 or more.

Nationally, the Georgetown report found that even with more children living in poverty because of the rough economy, the number of children without health insurance in the U.S. has dropped by 1 million in the past three years.

Overall, 34 states had a significant decrease in the rate of uninsured children.

Florida made the most progress, dropping from 667,758 to 506,934 during that time period, although the state still has one of the highest rates of uninsured children in the nation.

Nevada has the highest rate of uninsured children while Massachusetts has the lowest, according to the report.

Many states have expanded eligibility for, and simplified access to, the children's Medicaid program. This has helped shrink the number of uninsured children from 6.9 million in 2008 to 5.9 million in 2010. Experts say the Affordable Care Act, the federal health care overhaul that requires states to maintain income eligibility levels and discourages other barriers to coverage, has played a key role in the improvement.

High unemployment rates and the increasing cost of private insurance are driving more families to the federal-state Medicaid and Children's Health Insurance Programs, also known as CHIP. Both programs provide health insurance for children, but come from different funding streams and allow states more flexibility in how they run their programs.

President Barack Obama signed an extension of CHIP and provided $87 billion to help states pay for Medicaid in the 2009 economic stimulus, and experts say a bipartisan national commitment aimed at covering children has given states new tools and incentives to follow through. For example, some states once required face-to-face interviews; now many states have online applications.