Number of uninsured children has fallen by 38 percent

The Affordable Care Act resulted in a significant increase in health care coverage for children, a new study finds.

A study from University of Minnesota’s State Health Access Data Assistance Center, funded by the Robert Wood Johnson Foundation, finds that between 2013–the year before the implementation of the ACA–and 2016, the uninsured rate among children dropped from 7.5 percent to 4.7 percent.

The rate declined all three of those years: first to 6.3 percent, then to 5.1 percent and finally to 4.7 percent.

Related: 5 states with lowest, highest uninsured rates

The greatest impact came from a significant increase in the number of children with public coverage through Medicaid or the Children’s Health Insurance Program (CHIP). However, the number of kids with private insurance also increased.

The decline in the uninsured rate for children has a lot to do with the decline among adults, said the study authors.

“When adults gain coverage, kids do too, as seen by these very positive trends between 2013 and 2016,” said Katherine Hempstead, senior adviser at the Robert Wood Johnson Foundation. “The process also works in reverse—so given the recent uptick in the uninsurance rate and the potential for more, we should be aware that this progress in kids’ coverage may be jeopardized.”

Among kids whose parents or guardians’ education have only a high school education or less, the uninsured rate is highest: 7.9 percent. That drops to 2.2 percent for kids whose parents have college degrees.

Children are more likely to be eligible for public health coverage than adults. In many states, for instance, able-bodied childless adults are not eligible for Medicaid at all. CHIP is also designed to provide coverage for children in families with incomes that are too high to quality for Medicaid, although the income requirements differ by state.

The differences in state policies help explain the dramatic differences in insured rates between states, although there are no doubt other factors, such as the number of undocumented immigrants.

In Massachusetts and West Virginia, only 1.6 percent and 2 percent of kids were uninsured in 2016, compared to 19.5 percent in Alaska and 15.1 percent in Texas.

It is unclear what has happened in the two years since as President Trump and Congressional Republicans have sought to undermine the ACA.

There was a brief scare about children losing coverage due to a standoff over CHIP funding, but Congress ultimately voted to fund the program for a decade in February.