Report shows huge losses in children’s healthcare coverage: urgent action needed

Medicaid and CHIP (Children’s Health Insurance Program) are a lifeline to hundreds of thousands of Arkansas children, and our ARKids First program (Arkansas’s Medicaid/CHIP program for children) is the result of years of tireless efforts to make sure every child in our state has access to healthcare. But a new report from the Georgetown University Center for Children and Families (CCF) paints a distressing picture of how many children lost insurance coverage in 2023. 

According to the CCF report, Arkansas had one of the steepest drops in children’s uninsured rates in 2023. The report looked at trends in child Medicaid and CHIP enrollment since states began the post-pandemic process of redetermining eligibility for everyone enrolled, or “unwinding.”  

The report showed that nationwide, more than 4 million children had lost Medicaid/CHIP by the end of 2023 — even though most of these children are likely still eligible. Shockingly, one in five kids on ARKids lost coverage, approximately 94,000 children. 

While every state was required to undergo a redetermination process, Arkansas stood out for the magnitude of its coverage losses. The report shows a 21% decline in ARKids First, a figure that ranks Arkansas as the sixth-largest nationally in terms of percentage loss. Comparatively, some states like Kentucky only experienced a 4% decline, underscoring the severity of Arkansas’s situation.  

By December 2023, there were fewer children covered by ARKids First than in February 2020 – before the pandemic. The report also does not show a significant shift of these children onto private insurance. Only a small percentage of those who lost coverage moved onto private insurance through the marketplace. Because income eligibility for children is much higher than adults, most of the children who are losing coverage are likely still eligible. 

The ramifications of this loss of coverage are enormous. Without insurance, children are unable to access crucial preventative screenings and treatments, leading to potential delays in care and worse health issues. Even short gaps in coverage cause children to miss vital prescriptions or not be able to see a doctor when they are sick. These data indicate that many Arkansas children are likely going without the protection that health coverage provides. Additionally, financial strain on vulnerable families is heightened as they grapple with the burden of healthcare expenses. 

Arkansas, once a leader among states for lowering the uninsurance rate for kids, now finds itself ranked among the bottom 10 states for children’s insurance coverage. This backslide is alarming, considering the work that many have done to ensure access to healthcare for all children in the state. 

It’s important that we respond to this crisis with urgency. We believe the state must prioritize outreach to communities and families. We know the Department of Human Services (DHS) shares the common goal of ensuring that Arkansas’s children have the health coverage they need to thrive. The unwinding has presented enormous challenges for DHS, and as families re-apply and re-enroll, we must focus every available resource on making sure Arkansas’s children do not go without health coverage. There are practical solutions to ensure eligible children get covered and stay covered.

  • Conduct communications and outreach campaigns targeting parents, families, providers, and other stakeholders, with messaging on children’s eligibility levels and how to apply for or renew coverage.  
  • Take necessary steps to immediately reduce paperwork backlogs for Medicaid and CHIP applications. This includes improving the state rate of data-driven automatic renewals (also known as ex parte renewals) that reduce paperwork by using other databases the state has on family income and other data. 
  • Invest additional funding in maintaining a stable, experienced workforce of state eligibility workers. Ensure families can reach state eligibility staff. Offer extended hours at local offices and through the call system. 
  • Remove unintended barriers that families face when attempting to apply or renew their coverage. Specifically, invest additional funding in upgrading the technology within the eligibility system, the call system, and the state’s websites and apps. 
  • Support community organizations that are helping children and families enroll in Medicaid. 

Communities and regions that have been disproportionately affected, such as Marshallese communities and rural parts of the state, require special attention and targeted resources. We look forward to working with DHS to make sure no eligible child goes without Medicaid/CHIP, and that Arkansas has the resources necessary to connect eligible children with the coverage they need. By tackling this head-on, we can begin to reverse the decline in children’s coverage and ensure that every child in Arkansas receives the healthcare they deserve.