Arkansas’ uninsured child rate reached 6.7% in 2023, its highest point in a decade, and now ranks 42nd in the nation, according to report released Sept. 3 by Arkansas Advocates for Children & Families.
The report, “Eyes on the Finish Line: We Cannot Stop Until Every Child Has Health Insurance,” says that 49,874 children lacked insurance in 2023.
The rate reached a historical low of 4.1% in 2016, but that rate has been rising since then. It stabilized from 2020 to 2022 because the federal government temporarily ended Medicaid disenrollments during the COVID-19 pandemic. When that guarantee ended, 94,000 Arkansas children lost coverage between April and December 2023.
“Further analysis did not show a significant shift of the children who were unenrolled during the unwinding onto private insurance,” wrote the report’s author, AACF Health Policy Director Camille Richoux. “In fact, only a small percentage of those who lost coverage during the Medicaid unwinding moved onto private insurance through the marketplace.”
The state, which had an uninsured rate lower than the national average 10 years ago, ranked 42nd in 2023. In 2022, it was 40th.
Children in households with incomes between 100% and 200% of the federal poverty guidelines had the highest uninsured rate at 12.7%. The poverty level for a family of four was $30,000 in 2023. Foreign-born children were five times more likely (35% versus 6.9%) to lack insurance than children born in the United States. The report says that 72.1% of foreign-born children whose family incomes were less than 200% of the federal poverty level were not insured.
The 3rd Congressional District in northwest Arkansas had the highest uninsured rate at 10.1%. The 4th District covering southern and western Arkansas had the second highest at 5.8%. The 2nd District in central Arkansas had a rate of 5.3%, while the 1st District covering eastern and northern Arkansas had a rate of 5.2%.
Broken down by age, the highest percentages of uninsured young people occurred among those ages 0-1 (6.5%) and those ages 11-18 (8.7%). Children ages 2-3 (5.4%) and ages 4-5 (5.5%) had the lowest. Children ages 6-10 had an uninsured rate of 7%.
The report refers to a KFF analysis that found that almost half the state’s children, or 47.1%, were covered by Medicaid or the Children’s Health Insurance Program in 2023. Another 39.5% were covered by employer-sponsored health insurance, while 4.3% directly purchased health insurance from the federal government’s Health Insurance Marketplace. Another 1.8% were covered through other public sources. That analysis found that 7.3% were uninsured.
The report also found that 243,582 adults lacked insurance in 2023, a rate of 13.5%. The number of uninsured adult Arkansans increased from 205,888 in 2022 to 243,582 in 2023 as the pandemic-era guaranteed Medicaid coverage ended. Adults falling within the 139-200% income bracket where the most likely to be uninsured at 22.9%. The report says that parents with health insurance are more likely to enroll their children.
The report concludes by recommending that the state extend guaranteed postpartum Medicaid coverage from the current 60 days to 12 months, increase outreach and enrollment support, and use the Medicaid application process to connect eligible families to other government programs.