New research from the Maine Children’s Alliance reveals a strong relationship between parents’ health insurance status and children’s health. The report shows hundreds of children who had health coverage through MaineCare lost coverage, even though they were still eligible, when their parents lost coverage due to recent changes in state law.
Mainers know that our future rests on how well we foster the health and well-being of the next generation, and MCA’s report shows how integral parents’ health coverage is to whether Maine children are positioned to thrive. The MCA report, Ensuring Health Coverage for Maine Families with Children in 2014, examines challenges that have developed for parents because of recent eligibility cuts to MaineCare, Maine’s Medicaid program, and analyzes how to address those challenges.
The report reveals data indicating that when parents are uninsured, it is more likely their children will be uninsured, even when children themselves are eligible for coverage. Children with uninsured parents also have a greater risk of gaps in coverage and are less likely to receive checkups, preventive care and other health care services. It shows that extending health insurance coverage to parents is important for children — even when children themselves have coverage. In Massachusetts, for example, when Medicaid coverage was extended to more parents and other adults, the rate of insurance among children doubled.
In 2013 and 2014, about 28,500 low-income working parents with children at home lost or have lost traditional MaineCare coverage because, in 2012, Maine’s 125th Legislature passed legislation, which Gov. Paul LePage signed into law, that cut income eligibility for parents from 200 percent to 100 percent of the poverty level. This coverage was important to sustaining lower uninsured rates in Maine, especially during difficult economic times.
Although only parents, and not their children, were slated to lose coverage under Maine’s 2012 legislation, caseload data from the Department of Health and Human Services indicates that many children did as well — roughly 13 percent of child cases, or 474, were closed at the time parents were cut.
It is very important to understand that all of the children who lost coverage were eligible for coverage. Neither Maine’s Legislature nor MaineCare administrators intended for children to lose coverage when their parents were cut. But it is likely that parents who received notice of their own termination from MaineCare believed, erroneously, that their children were also being terminated.
While maintaining coverage for all parents is important to the health and wellbeing of children, maintaining coverage during the postpartum period couldn’t be more important for infants and their mothers. Healthy development is critical in the early months when the baby’s brain architecture is being shaped. It is the child’s early experiences and relationships that provide the foundational structures in the brain on which all learning and development are based. Postpartum depression is of particular concern during this critical period, given its potential to disrupt these early, essential interactions when left untreated. Thus, the state cuts in MaineCare eligibility can prove pernicious to new mothers suffering from postpartum depression. These new moms will be at risk for losing access to essential treatments.
The report offers policy recommendations, including accepting federal funds to expand Medicaid to adults earning up to 138 percent of the federal poverty level, including some of the parents who have lost coverage. Data also indicate that low-income parents will find it very difficult to secure coverage through the Affordable Care Act because of the premiums and cost-sharing required in the online health insurance marketplace. Despite working full-time jobs, too many families struggle to put food on the table, gas in their car or pay for fuel to heat their homes. They would find it difficult to afford the premiums, deductibles and copayments required by the marketplace.
It’s clear that to keep children healthy, regardless of family income, Maine must assure parents have health coverage. We know that as parents lose MaineCare, the number of children with health coverage drops as well. Providing Medicaid coverage for parents working full-time in low-wage jobs is not only important for their health, but for their children as well.
Claire Berkowitz is executive director of the Maine Children’s Alliance.