Data released by the Georgetown Center for Children and Families show that nearly 9% of kids in Alaska are uninsured, the third-worst ranking in the nation, with rising concern in Nebraska, Florida and Arkansas.
Pending federal Medicaid cuts don’t bode well for needed care in the future. Many of Alaska’s most rural areas are only accessible by boat, plane or snowmachine, which makes getting medical care to kids a challenge.
Alaska Children’s Trust President and CEO Trevor Storrs said for non-Indigenous children who aren’t covered by the Alaska Area Indian Health Service, the challenging geography, combined with a lack of insurance, means they don’t get preventive care they need, which leaves them vulnerable.
“Further disabilities, mental health challenges, of course chronic diseases, all of that,” said Storrs. “It puts our kids at great risk.”
Storrs said cuts to Medicaid just passed in the federal budget could drive down the number of indigenous kids in rural Alaska who rely on that social service as their only source of insurance.
Georgetown Center for Children and Families’ Executive Director Joan Alker said the hike in uninsured kids is at least partly due to changing Medicaid eligibility rules at the federal level, a so-called “unwinding” post-pandemic, which left many more kids without coverage.
“We were very worried about eligible children being dis-enrolled by mistake during this unwinding process,” said Alker, “especially in states that did not approach the process with the utmost care.”
Nationally, the child uninsured rate rose from 5.1% to 6%, the highest spike in a decade.
Number of uninsured Arkansas children rising
Arkansas has the highest child uninsured rate in a decade, according to a report from Georgetown University’s Center for Children and Families.
The data surveyed insurance coverage for kids between 2022 and 2024 and found in 2023, 94,000 Arkansas children lost their coverage, largely due to Medicaid unwinding.
Camille Richoux, health policy director for the group Arkansas Advocates for Children and Families, said with federal budget cuts looming, kids in the state will suffer.
“Even kids who were not eligible for ARKids — maybe their parents are making more money now so they’re not eligible — they were getting coverage on the Marketplace often with the premium tax credit enhancements,” Richoux explained. “Those are expiring at the end of this year, so a lot of families are going to struggle to be able to afford premiums.”
ARKids First is the state’s insurance plan for children. Richoux pointed out most of the children who lost their coverage come from low-income families and live in rural Arkansas. She added most are still eligible for coverage but have been taken off the rolls because of paperwork problems.
Overall, the report showed the United States saw an 18% increase in the number of uninsured children nationwide. Arkansas’ uninsured rate is higher than the national average.
Joan Alker, executive director of the Center for Children and Families, said not having insurance coverage for children puts a strain on families.
“An accident on the playground or untreated asthma can result in trips to the emergency room which can cost thousands and thousands of dollars, potentially sending families into debt and bankruptcy,” Alker emphasized. “When care is delayed due to lack of insurance, children become sicker. They can wind up in the hospital requiring more expensive care.”
Alker added how a state conducted the unwinding process had a significant effect on how many eligible children kept their insurance covered. Arkansas completed the unwinding in six months.
Florida child uninsured rate sees one of nation’s largest increases
New data reveals a stark trend in Florida’s health coverage for children. The state’s child uninsured rate rose from 7.4% to 8.5% between 2022 and 2024, representing an additional 67,000 uninsured kids. Joan Alker, executive director, Georgetown University’s Center for Children and Families, said the consequences are severe and points directly to the state’s actions.
“Florida had a net enrollment decline during its unwinding period of about 20% of children covered in Florida’s Medicaid program, over half a million,” she said. “And that was a concern to us at the time because most children who are uninsured today are actually eligible for Medicaid or CHIP, but they’re just not enrolled.”
Alker’s analysis shows this decline propelled Florida to rank 46th in the nation for its rate of uninsured children. She noted that many children who lost coverage likely remained eligible but were dropped due to procedural errors. The Florida Department of Children and Families, which managed the eligibility and unwinding process, published information stating its goal was to ensure those no longer eligible for Medicaid were transitioned to other coverage options.
Jennifer Blake Wiedmeyer, a mother in For Fort Myers, said the statistics represent a real-world crisis in access to care. Her 10-year-old son Hayden, who has a rare chromosome defect and multiple heart conditions, was dropped from coverage two years ago.
“Since then, Hayden has been uninsured,” she explained. “He has already missed critical follow-up care, including his biannual cardiology appointment, his echocardiogram, and EKG that he needed to have done 2 years ago, which have been overdue since April of 2024. These are not optional visits, these are life-saving checkups.”
Wiedmeyer noted that had the state implemented a bipartisan KidCare expansion passed in 2023, which raises the income eligibility threshold, her son would already be covered. The implementation is delayed due to an ongoing legal dispute between the state and the federal government over a separate rule requiring 12 months of continuous coverage for children.
Scott Darius, executive director with Florida Voices for Health, said the state’s failure to implement the already-passed KidCare expansion is causing unnecessary suffering.
“Unfortunately, the promise of that pretty remarkable achievement has not been realized because Florida continues to drag its feet in terms of implementation,” he explained.
The expansion, which would raise the income threshold for KidCare, is stalled due to a legal dispute between the state and federal government over premium non-payment rules, leaving an estimated 42,000 children in limbo. Advocates from groups such as the Florida Policy Institute are urging state leaders to resolve the impasse and implement the expansion to stem the tide of children losing coverage.
More uninsured kids in Nebraska prompts concern
The number of uninsured kids in Nebraska is on the rise. Advocates for children say a lack of coverage can lead to lower levels of basic care and more serious mental health or medical issues in the future.
Nebraska ranks right in the middle of the states in terms of the number of children with no health insurance. Based on U.S. Census data, Nebraska’s child uninsured rate rose from 3.7% in 2023 to 5.3% in 2024.
Sara Howard, policy advisor with the advocacy group First Five Nebraska, called the increase significant.
“In Nebraska, on the ground,” said Howard, “that means in 2023 we had about 23,000 kids who were uninsured and now, in 2024, in the data from 2024, we now have 27,000 kids who are uninsured.”
Howard said this is the highest rate of uninsured children in Nebraska since 2019, just before the pandemic. She added that missing preventive checkups and necessary medical and mental health care can lead to kids falling behind in school.
Georgetown Center for Children and Families’ Executive Director Joan Alker said the hike in uninsured kids is at least partly due to changing Medicaid eligibility rules at the federal level, a so-called “unwinding,” which left many more kids without coverage.
“We were very worried about eligible children being dis-enrolled by mistake during this unwinding process,” said Alker, “especially in states that did not approach the process with the utmost care.”
Nationally, the child uninsured rate rose from 5.1% to 6%, the highest spike in a decade.