Number of insured children in Butler County dropped during pandemic
Pennsylvania has the fifth-highest rate of uninsured children in the country, but children in Butler County are faring better than most surrounding counties, according to a recent report.
The rate of uninsured children in Butler County increased by 0.28% between 2021 and 2022, indicating less children in Butler County have health insurance, according to the Pennsylvania Partnerships for Children’s 2023 State of Children’s Health in PA report.
Over that same period, the rate of uninsured children across Pennsylvania rose from 4.4% to 5.2%, indicating a 0.8% drop statewide, the report showed. The report was released in November.
In Mercer County, the insured rate fell by 2.84%. Likewise, the insured rate fell by 0.4% in Armstrong County, 0.46% in Allegheny County, and 1.09% in Armstrong County. The only bordering county where the rate of insured children increased was Lawrence County, where the insured rate increased by 3.31%.
While Butler County’s drop-off looks small on paper, there is a more serious warning hidden in the fine print, according to Becky Ludwick, vice president of public policy for Pennsylvania Partnerships for Children.
“The uninsured rate for school-age kids in Butler stayed pretty flat, but the uninsured rates for kids under age 6 actually went up,” Ludwick said. “The number of kids under age 6 without health insurance doubled in Butler County.”
County specific data from another recent Pennsylvania Partnerships for Children report showed, in Butler County, 8,245 children aged 6-18 and 3,263 children under age six were enrolled in Medicaid in September 2023. Both numbers are down from a year prior, when 8,491 children aged 6-18 and 3,537 children under six were enrolled. Age-related numbers for Children’s Health Insurance Program were unavailable for 2023.
According to the Pennsylvania Partnerships for Children, 2% of the 47,161 children — defined as anyone under age 19 — in Butler County did not have health insurance between September 2022 and 2023. This compares to 1% of the total 49,569 children living in Butler County without health insurance during the previous year.
Of those insured, 71% were covered through employer-sponsored plans, while 18% were covered through either Medicaid or CHIP, according to the September data.
“We're going in the wrong direction before we even see the result of the ending of pandemic coverage, so that is something that we're flagging right now,” said Becky Ludwick, vice president of public policy for Pennsylvania Partnerships for Children about the report, which details health insurance trends in the final year of the COVID-19 public health emergency.
According to Ludwick, the drop in the statewide insured rate was a surprise, as pandemic-related government leniency measures for both Medicaid and CHIP should have provided more families access to health insurance over that period.
“In what was expected to be another year of improvement thanks in large part to pandemic era flexibilities in Medicaid and the Children’s Health Insurance Program (CHIP), the 2022 data instead shows children in Pennsylvania are less connected to health insurance than the prior year,” the report said.
The report calls the findings significant, as Medicaid’s “continuous coverage” provision — which allowed participants to keep their coverage without filing annual renewals — expired at the start of April 2023. However, this hadn’t even happened by the time the declines took place, meaning further declines could be reflected in upcoming reviews.
According to PPC, only two other states — Connecticut and Wisconsin — saw increases in the rate of uninsured children.
Looking at deeper layers of the data, Ludwick has one theory that might explain the turn of events. As the report explains, private insurance coverage rates for children “significantly declined” in Pennsylvania, something which only happened in five other states.
“This is not the CHIP and Medicaid side. This is on private coverage,” Ludwick said. “So that might partially explain why we are seeing a worse rate. But it's not like a full or clear answer that we all hope to see.”
Most of the counties that saw decreases in the rate of insured children were concentrated in the western and eastern parts of the state, while most counties in the central portion and along the northern border registered increases.
Earlier this year, the the U.S. Department of Health and Human Services sent a letter to state health officials reinforcing that states must provide 12 months of continuous coverage for children under the age of 19 on Medicaid and CHIP beginning January 1, 2024.
“This important action will ensure children have access to the preventative and primary care they need to be healthy and thrive. We will continue to support children and their families, whenever and however it is needed,” HHS Secretary Xavier Becerra said in a September news release.
Continuous eligibility protects families from losing their health care in case of unexpected changes to their livelihood over their usual eligibility period. Ludwick said this is especially helpful for lower-income families who have more than one job or seasonal employment situations.
“If a family's income changes, they're required to report that change or any change in circumstance,” Ludwick said. “If their income fluctuates before the 12 month renewal period, the child could lose coverage. The reason this would be helpful is that regardless of fluctuation in the family’s income, the child would remain covered for that entire year.”
Currently, Pennsylvania only offers continuous Medicaid eligibility for children under age 4, although all children are eligible for CHIP.
Despite this, Ludwick is not optimistic the insured rates for children will bounce back one year later.
“We do expect that the rate next year would look worse,” Ludwick said. “That is something we've been anticipating once the unwinding starts and renewals would have to start back up again.”
