This post was originally published on Health Affairs.
Moms have another reason to smile this Mother’s Day: the uninsurance rate among mothers living with dependent children under the age of 19 fell 3.8 percentage points between 2013 and 2014, declining to 15.7 percent, the lowest rate observed since 1997.
According to a new Urban Institute analysis, uninsurance rates fell for mothers in almost all of the subgroups examined, with particularly large declines among young mothers, black and Hispanic mothers, and mothers living in the West. These gains followed the implementation of the major coverage provisions of the Affordable Care Act (ACA), which included an expansion of Medicaid, subsidies for coverage through the new Marketplaces, health insurance market reforms, and penalties for going without insurance. In addition to the policy changes occurring under the ACA in 2014, the improving economy may also have contributed to these coverage gains.
While uninsurance rates dropped for mothers nationally, the data show a larger decline in uninsurance in the 26 states (including DC) that had adopted the ACA’s Medicaid expansion by early 2014 compared to the states that had not expanded—4.8 versus 2.8 percentage points. In 2014, mothers living in nonexpansion states were nearly 1.7 times more likely to be uninsured than mothers living in states that had expanded Medicaid. Just over 60 percent of uninsured mothers lived in a state that had not expanded Medicaid in 2014, up from 54.7 percent in 2013.
Despite the good news about the gains in coverage relative to 2013, 5.9 million mothers were still uninsured in 2014. Just 26.6 percent of uninsured mothers said they had lacked coverage for less than a year; the rest said that they lacked coverage for longer or had never had insurance. Moreover, uninsurance rates remained over 30 percent for mothers with low incomes and those who were Hispanic, noncitizens, or who had not graduated from high school.