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Fener Sitkoff

Georgia’s Medicaid and PeachCare programs covered 20,000 fewer children at the end of 2018 than the year before, a new report says.

That 1.6% drop is less than an overall 2.2% decline in enrollment nationally, according to the Georgetown University Center for Children and Families.

The report, released Thursday, said that nationally, about 828,000 fewer children were enrolled in Medicaid and the Children’s Health Insurance Program, which in Georgia is called PeachCare for Kids.

Not every child cited in the statistics is now necessarily without coverage. With unemployment low, many less affluent people have been able to find work. So some children may have moved to private insurance as their family income increased beyond the eligibility limits for the two government programs.

Nevertheless, “there are clearly other factors at play, and they are putting children at risk,” said Tricia Brooks, the lead author of the Georgetown report, in a statement. “The federal government took several steps that undermined enrollment, including cutting outreach and consumer assistance funding to help families. Proposed immigration policies have kept many eligible families from seeking or renewing coverage for their children.”

A drop in child enrollment in Medicaid and CHIP is unusual, the report said. Between 2000 and 2016, enrollment decreased in only one year — 2007 — by 1.1%. During this period, the nation achieved historic success in covering children, with the rate of uninsured children reaching an all-time low of 4.7% in 2016.

“What needs to be determined is what happened to the 20,000 in Georgia,’’ said Erica Fener Sitkoff, of the advocacy group Voices for Georgia’s Children. Last fall, she noted, a report found the number of uninsured children in Georgia rose by 21,000 in 2017, mirroring a national trend.

She said that Georgia can continue to reduce barriers to kids having insurance, including by improving enrollment processes and extending continuous eligibility in Medicaid to 12 months from six months.

Health insurance coverage improves children’s access to well-child visits, immunizations and prescription drugs. Uninsured children “will not have the access they need to preventive care and well visits,’’ Fener Sitkoff said. “They have to wait much longer when they do need care.’’

Children without coverage are more likely to have unmet health needs and lack a usual source of care.

The Georgetown report found that the declines in child enrollment in Medicaid and CHIP were concentrated in seven states — California, Florida, Illinois, Missouri, Ohio, Tennessee, and Texas — which accounted for nearly 70% of the losses.

Nine states — Idaho, Illinois, Maine, Mississippi, Missouri, Ohio, Tennessee, Utah, and Wyoming — had decreases of more than double the national average.

“The fact that nearly one million children in 38 states lost Medicaid and CHIP coverage is very alarming,” Joan Alker, executive director of Georgetown University center, said in a statement. “This report puts federal and state policymakers on notice that the success the U.S. has achieved on children’s health coverage is in jeopardy.’’

In September, the U.S. Census Bureau will release the 2018 data on the rate of uninsured children. That’s when the significance of the enrollment decline will come into better focus, said Bill Custer, a health insurance expert at Georgia State University.

The Georgetown report data, he said, “could be a statistical blip,’’ or reflect kids moving to private insurance, or could be a sign of barriers to enrollment in some states.

“We have one piece of the puzzle,’’ Custer said. “We’ll have to get the whole picture.’’

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