The Children’s Case for Closing the Health Insurance Coverage Gap

By Rob Thompson, Senior Policy and Communications Advisor

University researchers at Emory University’s Rollins School of Public Health recently released a new study showing the profound benefits of expanding health coverage to uninsured, low-income adults in the health care coverage gap.

The study compares the health of low-income adults in states that have expanded coverage and states that haven’t. The results are compelling: low-income adults in states like North Carolina that haven’t expanded health coverage are less likely to have a regular source of medical care and less likely to receive key preventive services, like routine checkups, dental checkups, flu vaccinations, and blood pressure checks.

This study comes at the one-year anniversary of another study by researchers at George Washington University (commissioned by the Cone Health Foundation and the Kate B. Reynolds Charitable Trust), which documents the statewide and county-by-county economic benefits of expanding health care for every county in North Carolina.

The evidence certainly seems to mounting in favor of expanding health care for uninsured adults, but what does this have to do with our state’s children?

The issue for children is that over 100,000 parents statewide are in the coverage gap, and when parents don’t have health insurance, the whole family is less healthy, both physically and financially.  The parents in the coverage gap have incomes too high to qualify for Medicaid and too low to purchase health insurance in the private market. Most of them are working, but they cannot afford to buy health insurance on the prevailing wages in industries such as retail, construction, or food service. 

Here are some specific reasons why closing the coverage gap is so important for North Carolina’s children:

• When parents are insured, children are more likely to be insured. We know from the experience of other states that when parents get health insurance their children are more likely to be covered as well. In Massachusetts, for example, expanding health coverage for parents helped cut the uninsured rate for children in half. About 90,000 children in North Carolina, more than the total population of Asheville, remain uninsured even though they are eligible for one of North Carolina’s public health insurance programs, Medicaid or NC Health Choice. Offering whole family coverage will help bring down that number.
• A plan for closing the health coverage gap is an important strategy to reduce infant mortality in North Carolina. Across the state, the infant mortality rate correlates with women’s health—a baby is much more likely to be born healthy if her mother is healthy. Statewide, 22 percent of infant deaths are related to prematurity and low birth weight, and 16 percent are related to maternal factors and complications of pregnancy. Access to care before conception and between pregnancies has the potential to substantially reduce our high infant mortality.
• Insuring parents provides economic security to the whole family. Medical debt is a leading cause of bankruptcy. When one member of the family is uninsured, the entire family is at risk of financial ruin. It is only by covering the whole family that children are protected from this vulnerability.

North Carolina can use already available federal dollars to make its own affordable plan to close the coverage gap. Other states like Arkansas, Kentucky, and West Virginia have done it. It’s time for our elected officials to recognize this tremendous opportunity to provide half a million North Carolinians with health insurance at little or no cost to our state. It’s good for health, it’s good for business, and it’s good for children.