More families buoyed by strongeconomic growth is one possible reason why the number of childrenenrolled in public health programs has decreased. (Photo:Shutterstock)

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There was a “precipitous drop” in the number of kids enrolled inMedicaid and the Children's Health Insurance Program (CHIP) –likely due to the elimination of the Affordable Care Act's individual mandate and reduction incommunication outreach efforts, but also maybe because manyfamilies' incomes grew enough in the strong economy to get bumpedout of the government programs.

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Enrollment fell by nearly 600,000, to 35.4 million children inthe first 11 months of 2018, according to U.S. Centers for Medicareand Medicaid Services data. Speculation by state officials for theunderlying causes of the drop was across the board, posted in an article on Pew Trust's Statelineblog.

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“I'm sure Idaho's strong economy is playing a role,” enablingfamilies to leave public health programs, guessed Niki Forbing-Orr,spokeswoman for the Idaho Department of Health and Welfare. Idahorecorded one of the largest percentage drops (6.7 percent).

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“While it's hard to pinpoint, the economy has improved in thisstate, and that would be a reasonable factor,” said MattWesterfield, communications officer for Medicaid in Mississippi,another state with a large percentage drop (5.8 percent).

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State officials in Texas and California speculated the samething – more families buoyed by strong economic growth was likely amain reason why those states posted the biggest drop in totalnumbers, by 134,000 and 130,000, respectively.

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However, Missouri officials believe it's the Republicans' faulton the federal level why the Show-Me State had the largestpercentage decrease of enrolled kids in the first 11 months of 2018at 8.1 percent, or 50,505 kids.

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“In a letter to legislators this week, Patrick Luebbering,director of the family support division of the Missouri Departmentof Social Services, cited federal actions as one of the causes ofthe decline, including the Trump administration's cuts in servicesto educate and assist consumers enrolling in health insurance,”Stateline's blogger writes. Luebbering “also pointed to Congress'repeal of fines for people who failed to enroll in healthinsurance.”

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Other factors that could have contributed to the enrollment dropinclude states unable to reach beneficiaries to alert them it wastime to re-enroll; families moving to another state; changes instate data systems and illegal immigrants' fears of enrolling theirchildren in public services for fear the family's status would befound out, resulting in deportation.

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Reactions from health policy analysts and advocates were mixedabout how children are ultimately being impacted by the drop inenrollment numbers.

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“Essentially, we have done a fairly magnificent job in thiscountry over the last 10 years in terms of kids insured,” saidDennis Johnson, head of policy and advocacy for the Children'sHealth Fund. “It's the reversal of that trend that has us worried.We see trouble on the horizon.”

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However, Heritage Foundation health policy expert EdmundHaislmaier said the overall decrease is relatively small – and that35.4 million children were still enrolled as of November.

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“You're talking about less than a 1.5 percent difference,”Haislmaier said. “I would find it hard to make even a molehill outof that.”

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Katie Kuehner-Hebert

Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.