Children need 14 doctor visits before age 6, but preschoolers are increasingly not covered by insurance, especially in Kentucky

Kentucky Health News

In 2018, the number of Kentucky pre-schoolers without health insurance was about half again as large as the number had been in 2016, and that was one of the largest increases in the country over that time.

Researchers at Georgetown University in Washington, D.C., found that 4 percent of Kentucky children under 6 lacked insurance in 2018. In 2016, it was 2.7%. In percentage points, Kentucky's increase was the nation's fifth largest.

Chart by Stateline, Pew Research Center

Kentucky's percentage stayed under than the national average, but got much closer to it. The U.S. figure rose to 4.3% from 3.8%.

Ten other states — Alabama, Florida, Georgia, Illinois, Kentucky, Missouri, Ohio, Tennessee, Texas, Washington and West Virginia — also had significant increases, alarming health officials and experts.

Kentucky was one of seven states where the uninsured rate for children under 6 was higher than the rate for those 6 to 18.

"The first years of life play an outsize role in human health. They are foundational to the development of the brain and the cardiovascular, immune and metabolic systems. Early childhood is when medical interventions to correct problems in any of those areas are most likely to succeed," Michael Ollove writes for Stateline, a publication of the Pew Charitable Trusts.

"The American Academy of Pediatrics recommends that children visit the doctor at least 14 times before they turn 6 years old. During those visits, they should receive speech, hearing and vision tests, as well as screenings for genetic disorders and the possible effects of trauma or toxic exposure. The U.S. Centers for Disease Control and Prevention recommends that children under 6 receive numerous vaccinations, including for hepatitis A and B, diphtheria, whooping cough, polio, chicken pox, and measles, mumps and rubella."

Experts say children need 14 medical checkups before age 6.
(Photo by Amber Arnold, Wisconsin State Journal, via Stateline)

Al Race, deputy director at the Center on the Developing Child at Harvard University, told Ollove that a lack of health-insurance coverage often leads to a lack of health care, and can allow health problems to persist into adulthood instead of being corrected: “The earlier you can catch them, the easier it is and the better results you’ll have to put things back on track.”

After Kentucky expanded Medicaid under the Patient Protection and Affordable Care Act in 2014, the percentage of children in the state with health insurance rose to 96.2%, from 93.6%. Children are covered by the Children's Health Insurance Program, a program similar to Medicaid in which the federal government pays most of the cost, but the Medicaid expansion encouraged more enrollment. As the economy improved, adult Medicaid enrollment declined.

Supporters of the ACA said the reduction in the adult uninsured rate stalled because of the Trump administration's attempts to repeal and "sabotage" the law, through a shorter window to sign up for subsidized health insurance, huge cuts to the advertising budget and the number of "navigators" who help people find an insurance plan and the removal of the individual mandate to have insurance. Critics of the ACA blamed the stalled progress on rising premiums in the individual market.