A new report from the from the Georgetown Center for Children and Families finds that across the nation the rate of uninsured children declined sharply in 2014 following the implementation of key Affordable Care Act (ACA) provisions. The percentage of children in the U.S. who are uninsured dropped to 6.0 percent in 2014, from 7.1 percent in 2013, and 9.3 percent in 2008, according to the report’s analysis of recently released American Community Survey data.

Wisconsin also saw some gains, but they weren’t nearly as dramatic. The rate of uninsured children in our state declined to 4.4 percent in 2014, compared to 4.7 percent the previous year and 5.2 percent in 2008.

One reason for Wisconsin’s more modest decline in the number of uninsured children is simply that our state started out with a relatively low number of children lacking insurance. However, the lower uninsured rates in neighboring states illustrate that Wisconsin could be doing much better. The bar graph illustrates that the four states bordering Wisconsin achieved an uninsured rate below 4.0 percent in 2014.

According to Jon Peacock, research director at WCCF, “If Wisconsin achieved the average uninsured rate for kids of our four neighbors (3.5%), we would have about 11,800 fewer uninsured children, which is a 20 percent reduction in the number of uninsured children.” The percentage decline in uninsured children was almost twice as large in states (including Wisconsin’s neighbors) that utilized the option under the Affordable Care Act to extend Medicaid coverage to all adults up to 138% of the federal poverty level. Research shows that parental coverage is closely linked to child coverage and limiting coverage for parents can have a negative effect on children.

Figure 3 illustrates the much larger improvement in the states that expanded coverage of adults, and it shows that Wisconsin lagged far behind the other states that chose not to cover parents and childless adults to 138% of the poverty level. That can be attributed at least in part to the fact that Wisconsin sharply reduced BadgerCare eligibility last year, cutting it in half to 100% of the poverty level.

There are several things the state could do to improve BadgerCare participation and catch up to our neighbors in improving access to preventive health care for kids:

• Utilize the Affordable Care Act to expand eligibility for parents, which would indirectly improve coverage of children.
• Carefully study and implement options for improving the renewal process, in order to reduce the churning that reduces participation among eligible families.
• Improve outreach—particularly among immigrants, who are sometimes unaware that their lawfully present children are eligible for Medicaid, even when the parents are not.

It’s time for Wisconsin to regain its leadership in improving health care coverage for kids. Research shows that children with Medicaid coverage are less likely to drop out of high school and more likely to graduate from college. They also have better health and economic success as adults, making them less reliant on safety net programs.

Sashi Gregory