To help children, expand Medicaid for parents


Healthy children come from healthy families. That’s why providing health insurance for parents has numerous benefits for children and, conversely, leaving those parents uninsured puts children at risk. A report released this week by the Georgetown University Center for Children and Families shows that using federal Medicaid dollars earmarked for North Carolina to close the state’s coverage gap would provide health insurance coverage for over 125,000 parents, laying the foundation for better life and health outcomes for our state’s children.

North Carolina and 21 other states have not taken advantage of generous federal dollars available under the Affordable Care Act to cover working poor adults. This funding requires no state match until 2016, after which North Carolina will never pay more than 10 percent of the cost to provide coverage.

Most North Carolinians who would be eligible for a plan using new Medicaid funding are working but cannot afford to buy health insurance on prevailing wages in industries such as retail, construction or food service. (For example, adults who earn between $737 a month and $1,674 a month for a family of three are in this coverage gap and are currently ineligible for either Medicaid or the premium tax credit under the Affordable Care Act.)

More than a fourth of the adults who would be eligible for a new Medicaid plan are parents with children at home. Of these parents, the majority are white (55 percent) and are working outside of the home (64 percent). Because those parents are uninsured, their children are less likely to be insured and are subject to ongoing economic and health risks associated with their parents’ uninsured status.

Here’s why a North Carolina plan to use federal Medicaid funding this year is so important for children:

▪ A plan for closing the health coverage gap is an important strategy to reduce infant mortality in North Carolina. The infant mortality rate correlates with women’s health statewide—a baby is much more likely to be born healthy if her mother is healthy. Statewide, 22 percent of infant deaths are related to prematurity and low birth weight, and 16 percent are related to maternal factors and complications of pregnancy. Access to care before conception and between pregnancies would address both of these factors and has the potential to reduce infant mortality substantially.

▪ When parents are insured, children are more likely to be insured. We know from the experience of other states that when parents get health insurance their children are more likely to be covered as well. In Massachusetts, for example, health coverage expansions for parents helped cut the uninsured rate for children in half. About 90,000 children in North Carolina, more than the total population of Asheville, remain uninsured even though they are eligible for one of North Carolina’s public health insurance programs, Medicaid or NC Health Choice. Offering whole family coverage will help bring down that number.

▪ Insuring parents provides economic security to the whole family. Medical debt is a leading cause of bankruptcy. When one member of the family is uninsured, the entire family is at risk of financial ruin. It is only by covering the whole family that children are protected from this vulnerability.

▪ When parents and children are insured, children are healthier in the short and long term. According to multiple studies, children with health insurance are certainly healthier in the short term, but the benefits extend in the longer term to lower rates of mortality, higher educational attainment, improved earning potential and, because they had higher earnings and paid more taxes later in life, government savings.

State officials, including Gov,. Pat McCrory, have said they would propose an alternative Medicaid plan to cover up to 500,000 uninsured citizens, including about 120,000 parents, currently in the coverage gap.

Such an action could leave a permanent legacy of health and prosperity. The future success of our state’s children is directly tied to the physical, mental and financial health of their families. Using federal Medicaid dollars wisely will make families healthier and more financially secure, which means our children will be healthier and better prepared to be the next generation of workers, leaders and innovators.

Michelle Hughes is the executive director of NC Child, a statewide child advocacy organization. Joan Alker is the executive director of the Georgetown Center for Children and Families.