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By Elizabeth Chuck
Raquel Cruz has a lot of stress in her life. She is a single mother of three daughters and runs a small infirmary. She attends a full-time school for training.
But her biggest stressor is worried about health insurance. Cruz, 47, of Pharr, Texas, earns around $ 30,000 a year and can not afford the insurance offered by the Pain Bureau where she works.
Her eldest daughters, college students, also have no insurance. Her youngest daughter, Korrie Cantu, is 1
But even that is not guaranteed: Last year, when Cruz was preparing to apply for a CHIP extension, Korrie's reporting was suddenly torn for more than a month.
"I ran on eggshells," Cruz said. "Even driving, because you always think," Oh, what if I get a car accident? "Or Korrie would say, 'I'll go ice skating,' and I would think, 'No, that's not a good idea.'
Korrie is a long way off Not everyone was lucky enough to get them back, according to a report released last week by Georgetown University
that the number of US children without health insurance increased by 276,000 from 3.6 million in 2016 to 3.9 million The number of uninsured children in America since 2008, when Joan Alker, the executive director of the Georgetown Center for Children and Families and principal author d he study tracked the data.
"What was really disturbing was the number Even though the economy is doing so well, we expect the number to go down," said Alker. "Children are falling off."
"What was really disturbing was that the number has gone up even though the economy is going so well, we would expect the number to go down."
Alker said employer-sponsored health insurance coverage increased last year, an expected result of a good economy. However, losses in public insurance coverage, including CHIP, Medicaid and direct coverage through the Affordable Care Act marketplace, have declined so much that the total number of uninsured children is increasing.
Several factors led to this: States refused to extend Medicaid under the Affordable Care Act: creating a gap in affordable coverage options for low-income families; Cuts in the federal budget for outreach programs for the Affordable Care Act; and federal policy aimed at immigrants who prevent people from other countries, even legal US citizens, from signing up with state health insurance.
The government is delaying the renewal of funding for CHIP, with some families failing to respond because they were not sure if they were not sure The program was out of money, it also added to chaos, experts say ,
Cruz believes the error in Korrie's reporting is due to a government administrative misunderstanding regarding her renewal request, and does not know if it relates to it Congress's failure to meet deadlines in September to allocate funds for the program ,
Still worried it might happen again, she's not sure what she'll do when Korrie comes of age The program next year.
"If you have no insurance, what happens if something happens?" Cruz said. "I would still take her to the ER, but I know it will be out of pocket."
Swapna Reddy, a professor of clinical assistence at Arizona State University's College of Health Solutions, called the drop in coverage rates "heart-wrenching." But not surprisingly, given the Trump government's unwillingness to adopt the health care law of former President Obama.
"Although Congress was unable to lift and replace the Affordable Care Act last summer, we have seen these incremental deaths" around a million paper cuts, "Reddy said, citing cuts in state funding for" navigators Health care up to 90 percent. People who help clients to enroll and renew state health insurance plans. In addition, there was a drastic reduction in the number of federal health promotion promotions that the government had paid last year.
Even health care decisions that did not directly target children's coverage often had unintended consequences – as in states where coverage of Medicaid was not expanded. Three-quarters of the children who lost their coverage in 2017 live in such states, and the uninsured rates for children increased almost threefold compared to non-enlargement countries, according to the Georgetown report.
Reddy said that was consistent with decades of Medicaid data.
"If mom and dad are insured, it's more likely that the whole family is insured," she said.
But even some families who have no low income have had a hard time deciding not to take insurance last year because of balloon costs.
"When something catastrophic happens, we get screwed up."
Whitney Whitman, 43, of Bird Creek, Alaska, works as a professional consultant and facilitator; Her husband is a plumber. There is also no health insurance offered by the work, and they provide too little public support for their eight-year-old daughter and her eleven-year-old son. Yet they do not earn enough to feel justified in spending thousands of dollars a year to insure their families.
"Fortunately, we are very healthy people, we have no great needs," Whitman said. "But if something catastrophic happens, we'll mess up."
Whitman pays out of pocket for annual exams for her children and herself and for the children's dental care. When a serious health problem crops up, her plan is to establish a nearby nonprofit hospital that will accept her regardless of her insurance status.
"I do not stop my children from doing anything, but I live in fear," she said. "I live in fear at every football match, they have a program at their school where they ski and ski for six weeks, and for those six weeks I'm like, OK, let's just hope. "Like" Alaska, Texas was home to Cruz and his daughters, one of twelve states where uninsured children's rates were above the national average in the past year.
In Texas, 10.7 percent of those are Children uninsured – the highest rate in the country – every fifth uninsured child in the US lives in that state.
The problems in Texas are numerous, and experts say they are not just a Medicaid non-expansion state, but also high rates of immigration and certain Trump Administrative Guidelines would most likely discourage legal immigrants from health insurance, such as the Public Charge Rule, a proposal that would allow officials to seek government services such as Medicaid and Supplemental Nutrition Assistance Program (SNAP) of the applicants if they have the right to Legal entry into the US "That means that immigrant parents are entitled to children who are US citizens who are deterred from insuring their children," Alker said.
"The Trump administration is prompting these families to worry about interacting with the government," she said, adding that her fears were likely to increase and the rate of insured children would continue to decline.
US-born Cruz does not have to worry about her family's immigration policy. However, she is constantly looking for ways to use her paycheck, fearing that she will need money for an unexpected health problem: She has neither cable television nor internet and often turns off the lights in her home to reduce her electricity bills and never eat out.
She wondered if she was going to pay for the insurance for the next year, but even the cheapest option was over her budget. Family plans through the Affordable Care Act also felt unworkable, and she said she could have felt guilty about just insuring herself.
"Honestly, as a mother I can not assure myself and no insurance for my girls." "That would feel bad," she said.
While the decline in national insurance rates for children could continue, Alker said there were opportunities to ease or reverse them.
"A single surefire way to reverse this would be to extend Medicaid states that do not have them," she said. "Besides, I think we need a new national effort to get that number in the right direction."
"This has been a source of tremendous progress that has been supported by both parties in recent years," she added. "We have to make that a priority again."