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By Elizabeth Chuck
Raquel Cruz has a lot of stress in his life. A single mother of three daughters, she is the head of a small health clinic and goes to school full time for a degree of education.
But her biggest stressor is worrying about health insurance.
Cruz, 47, of Pharr, Texas, makes around $ 30,000 a year and can not afford the insurance offered by the pain management office where she works.
Her oldest daughters, college students, do not have any insurance. Her youngest daughter, Korrie Cantu, is 1
7, young enough to receive coverage through the Child Care Insurance, or CHIP, a federal low-income family program that does too much to qualify for Medicaid.
But even it is not guaranteed: Last year, as Cruz prepared to apply for CHIP renewal, Korris coverage was suddenly killed for more than a month.
“I went on the eggshell,” Cruz said. “Even driving, because you always think,” Oh, if I get into a car accident? “Or, Korrie would say,” I’m going to skate “and I’d think,” No, that’s not a good idea. “”
Raquel Cruz, on the left, with her daughters Kellie Cantu, 23; Korrie Cantu, 17; and Kerrie Cantu, 19. Cruz and her two eldest daughters have no health insurance; Her youngest is covered by CHIP, but lost card insurance last year. Court of Raquel Cruz
Korrie is far from the only child who lost the insurance in 2017 and not everyone was lucky enough to get back what she eventually did. Last year, the number of US children without health insurance increased by 276,000 to 3.9 million, from a 3.6 million year in 2016, according to a report published in Georgetown University last week.
This was the first increase in uninsured children in America since 2008, when Joan Alker, Managing Director of the Georgetown Center for Children and Families, and lead author of the study, began to keep track of data.
“What really bothered was that the number went up even though the economy is going well. We expect the number to go down,” says Alker. “The children fall off.”
“What really bothered was that the number went up despite the fact that the economy is doing well. We would expect the number to go down. “
Alker said employer-sponsored health insurance coverage lasted up last year, an expected result of a good economy. But losses in public insurance cover including CHIP, Medicaid and direct coverage through the Affordable Care marketplace Act, reduced enough to drive the total number of uninsured children up.
Several factors led to states refusing to extend Medicaid under the Affordable Care Act, creating a gap in affordable low-income families coverage federal budget cuts to achieve affordable programs health and federal policies aimed at immigrants who discourage people from other countries, even though they are legal US citizens, from enrolling in federal health insurance.
Government delay in renewing CHIP funding, with some families not reusing because they were unsure about The program had ended with money, which also contributed to the chaos, experts say.
Cruz believes that the look of Corridor coverage was due to an administrative misunderstanding on the government side of her renewal application and does not know if it was linked to Congress failure to meet a deadline in September to estimate funding for the program.
University Attendance in Chicago Medical Students Rally to Invite Congress to Reimburse Funding for Children’s Health Insurance Program (CHIP) in Chicago December 14, 2017.  Scott Olson / Getty Images file
She is still worried that it may happen again and is not sure what to do when Korrie ages by t programming next year.
“If you do not have insurance, what happens if something happens?” Cruz said. “I would still take her to the emergency room, but I know it will be in pocket.”
Swapna Reddy, a clinical assistant professor at Arizona State University’s College of Health Solutions, called the decline in the “heartbreaking” coverage, but not surprisingly, given the Trump administration’s reluctance to embrace former President Obama’s signatory health care. “
” Congress could not lift and replace affordable care teams last summer, but we have seen these incremental deaths with a million paper cuts, “Reddy said, citing reductions of up to 90 percent in government funding for healthcare professionals who help customers to sign up for and renewing the federal health insurance plans. In addition, there was a drastic decline in the amount of advertising for federal market plans envisaged by the government paid last year.
People protesting against proposed cuts to Medicaid are removed outside Senate Majority Leader Mitch McConnell’s office on June 22, 2017. Jacquelyn Martin / AP
Even healthcare decisions that do not directly aim to cover children often had unintended consequences – like in states that did not extend Medicaid coverage. Three quarters of the children who lost coverage in 2017 live in such states, and uninsured children prices increased almost threefold in the rate in non-expansion states, according to the Georgetown report.
Reddy said this was consistent with decades of data about Medicaid.
“When mum and dad are insured, you are more likely to be insured all the family,” she said.
But some families who are not considered to be low-income people made the difficult choice to refrain from insurance last year due to balloon costs.
“If something catastrophic happens, we’re screwed.”
Whitney Whitman, 43, Bird Creek, Alaska, works as a professional advisor and mediator. Her husband is a plumber. Neither are health insurance offered through work and they do too much for all public assistance to cover their 8-year-old daughter and 11-year-old son. Still, they do not make enough to feel eligible to spend thousands of dollars a year to insure their family.
Whitney and Jason Whitman pay their pocket for annual checks for their children, Oona, 8 and Odin, 11 for Whitney Whitman
“Fortunately, we are very healthy people. We do not have much need,” Whitman said. “But if something catastrophic happens, we’re screwed.”
Whitman pays off for annual checks for their children and themselves and for dental care for the children. If a major health problem grows up, her plan is to use a nearby, faith-based, ideal hospital that takes them in, regardless of their insurance status.
“I do not prevent my children from doing anything, but I live for fear,” she said. “I live in fear of every football game. They have a program at the school where they go to the local ski resort and go downhill for six weeks. In the six weeks I think” OK, let’s just hope. “
Like Alaska, Texas, where Cruz and her daughters live, one of 12 states last year had the proportion of uninsured children above the average.
In Texas, 10.7 percent of children are uninsured – the highest One of five uninsured children in the United States lives in the state.
The problems in Texas are many. Experts say, in addition to being a medicaid non-expansion state, it has a high level of immigrants, and some Trump administration policy measures discourage likely to be legal immigrants from seeking health insurance. Such a policy was the “public fee” rule, a proposal that would allow officials to consider applicants’ previous use of government services such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP) when they Decides on eligibility for green cards or legal access to the United States
This meant that immigrant parents with children who are American A citizen is advised to seek insurance that their children are entitled to, Alker said.
“Trump administration leads these families to be worried about interacting with the government,” she said, adding that their fears are likely to grow, further reducing the rate of insurance children.
Cruz, born in the United States, does not need to worry about immigration policies that affect the family. But she always looks for ways to get the most out of her paycheck for fear of needing money for an unexpected health issue: She does not have cable TV or the internet, it often hits the lights in her home to cut down the electricity bill, and never eats out.
She looked to pay for insurance through her work for next year, but also the cheapest option was above her budget. Family plans through the Affordable Care Act also did not seem feasible, and she said she could have felt guilty of assuring herself.
“Honestly, as a mother, I can not get insurance for myself and not get insurance for my girls. I would feel bad,” she said.
Although the reduction in children’s levels of insurance across the country can last, Alker said there are ways to relieve or turn around.
“A single safe firing path to reverse if this would extend Medicaid to states that do not have,” she said. “In addition to that, I think we need a targeted national effort to get this number going in the right direction.”
“This has been a source of huge progress that has had bipartisan support in recent years,” she added. “We must make this a priority again.”