TEXAS Latino Children’s Health Coverage Facts State officials’ decisions about coverage options, especially in times of crises, have a profound effect on children and can exacerbate pre-existing racial and ethnic disparities. In Texas, the uninsured rate for children overall is higher than the national average (11.1% vs. 5.2%). Additionally, Latino children are almost twice as likely to be uninsured than other children in the state (14.8% vs. 7.6%). Expanding Medicaid and removing barriers to Medicaid and CHIP enrollment would help reduce this disparity. Latino Kids’ Coverage Texas is home to 572,000 uninsured Latino kids The uninsured rate for Latino kids in Texas is 14.8% 2x Latino kids are almost twice as likely to be uninsured compared to other kids Medicaid and Latino Kids Medicaid/CHIP is an important source of coverage for all children in Texas but is especially important for Latino children. Latino families have a higher labor force participation rate than others in the country, but are more likely to work in industries that do not offer employer-sponsored insurance (ESI). Medicaid/CHIP fills an important gap by providing affordable health coverage to these working families. Medicaid/CHIP is the Largest Source of Coverage for Latino Kids Coverage Sources for Kids in Texas, 2018 Covering Parents i All Kids 4.8% 3.7% Uninsured Helps Children 11.1% 42.0% 38.4% ESI Children are about twice as likely to have coverage in states Latino Kids 3.4% 2.4% Medicaid/ that expanded Medicaid to CHIP cover more parents compared Direct to children in states like Texas 14.8% 29.1% 50.3% purchase that have not. Other 0% 20% 40% 60% 80% 100% July 2020 GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES | UNIDOS US 1 Latino Child Trends Over Time 24.7% 23.8% 25% 21.0%* Coverage Disparities Persist 19.2%* Child Uninsured Rates, 2008-2018 20% 17.5%* 17.8% 16.4%* 14.8%^ All children in Texas are significantly more likely to be 13.5%* 13.5% 14.4%* 15% uninsured compared to the national average. Almost 11.2% 10.8% half (49.4%) of all children in Texas are Latino. Coverage 10.2% 10% 9.2%* 8.7% 8.8% disparities between Latino children and other children in 7.6%^ 9.7% 7.4%* 6.4%* 6.3% 7.2%* Texas generally narrowed from 2008 to 2015. Between 8.9%* 8.5%* 7.9%* 7.5%* 7.5% 2016 and 2018, the uninsured rate went in the wrong 5% 6.3%* direction for all children in the state and coverage 5.1%* 5.2%*^ 4.7%* 5.0%* disparities persisted. From 2016 to 2018, the uninsured 0% rate for Texas’ Latino children increased significantly from 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 13.5% to 14.8%. Uninsured Rate for Latino Children National Uninsured Note: * Change significant at the 90% confidence level and relative to prior year. ^ Change Rate for All Children significant at the 90% confidence level (2016-2018). Uninsured Rate for Non-Latino Children Older Children are More Likely to be Uninsured Latino Child Uninsured Rates in Texas by Age, 2016 and 2018 The uninsured rate for Latino children in Texas increased across all age groups between 2016 and 2018, with the sharpest increase for school-aged children 6 to 12 years old. Latino teens have high uninsured rates; 1 in 5 Latino teens in Texas is uninsured. Although over 95% of Texas’s 0-5 years old 6-12 years old 13-18 years old Latino children are U.S. citizens, increased anti-immigrant 2016 2018 2016 2018 2016 2018 rhetoric over the past few years may lead parents to not enroll or renew their children’s coverage out of fear. 9.0% 9.9% 12.0% 14.0%* 20.0% 20.4% 20% 18.2%* 17.7% 16.6% Families in All Income Groups Struggle to Access 15.4% Coverage 15% 14% 14.1% Latino Child Uninsured Rates in Texas by Census Poverty 12.8%* Threshold, 2016 and 2018 10.4% The uninsured rate for Latino children in Texas increased 10% across all income groups studied between 2016 and 2018. The disproportionate job losses among Latinos during the COVID-19 pandemic could result in even more coverage 5% losses. Children in families with incomes between 138 and 199% of the poverty thresholds (about $27,900-40,500 for a family of three) have the highest uninsured rate at 18.2%. Children in this income range are likely eligible for CHIP, 0% 0-137% of 138-199% of 200-249% of 250% of poverty but policies that require a gap in children’s coverage (like poverty poverty poverty and over Texas’s waiting period) may make it harder to enroll. 2016 2018 2 GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES | UNIDOS US July 2020 Top 10 Texas Counties and Congressional Districts with the Most Uninsured Latino Children, 2018 Counties and Congressional districts with large Latino child populations are more likely to have large numbers of uninsured Latino children, but state and local policies have an impact on the coverage rates. Number & Rate of Uninsured Latino Children Number & Rate of Uninsured Latino Children by Congressional by County in Texas District in Texas Number of Number of Latino Kids Latino Kids Congressional District (Geographic reference County Uninsured Uninsured Uninsured Uninsured Rate point) Latino Kids Latino Kids Rate Harris County 112,489 16.4% District 33 (Central Dallas/Fort Worth) 43,740 23.0% Dallas County 69,078 18.0% District 29 (Houston) 38,826 18.6% Hidalgo County 42,704 15.0% District 15 (Central Rio Grande Valley) 34,754 15.4% Tarrant County 33,448 15.5% District 34 (Rio Grande Valley/South Gulf Coast) 31,395 15.1% Bexar County 32,569 9.1% District 28 (Laredo/Rio Grande Valley/South 31,380 14.8% Texas) El Paso County 21,881 10.3% District 18 (Houston) 22,988 19.1% Cameron County 20,711 15.8% District 30 (South Dallas) 21,905 17.4% Travis County 17,889 13.5% District 23 (West Texas/Borderlands) 21,267 12.4% Webb County 12,950 13.9% District 16 (El Paso) 20,124 11.4% Collin County 8,298 16.0% District 20 (San Antonio) 17,558 9.3% Policy Recommendations Health coverage is more important than ever. Any prior gains must be preserved especially as the economy falters. Some states have laid the groundwork to protect children by enacting policies to cover as many children as possible with more straightforward enrollment and renewal processes. Policymakers in Texas can join these leaders and ensure that more children, including Latinos, receive health coverage by: Expanding Adopting 12 months Covering children in Ending CHIP Covering all Adopting Medicaid Medicaid continuous coverage in CHIP up to 250% of waiting periods children regardless for lawfully present Medicaid federal poverty line of citizenship status pregnant women UnidosUS, formerly the National Council of La Raza (NCLR), is the nation’s largest Latino civil Most uninsured children rights and advocacy organization. Through our unique combination of research, advocacy, programs, and a national network of nearly 300 community-based Affiliate organizations are eligible but not across the country, we simultaneously challenge the social, economic, and political barriers enrolled in Medicaid/ that affect Latinos in the United States. CHIP. To find out if The Georgetown University Center for Children and Families (CCF) is an independent, your child is eligible for nonpartisan policy and research center. As part of the McCourt School of Public Policy, free or low-cost health CCF provides research, develops strategies, and offers solutions to improve the health of America’s children and families, particularly those with low and moderate incomes. coverage, go to www. insurekidsnow.gov. For more information about the methodology and sources, visit: https://ccf.georgetown.edu/2020/06/29/fact-sheets-latino- childrens-health-coverage/ July 2020 GEORGETOWN UNIVERSITY CENTER FOR CHILDREN AND FAMILIES | UNIDOS US 3