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Rate of ‘underinsured’ kids in U.S. rose from 2016 to 2019, but has changed slightly since pandemic

A group of toddlers walk down the street with an adult.
Emma Lee

On today’s episode of The Confluence: A new study finds a third of children nationwide are “underinsured,” meaning families, even with health insurance, could experience inadequate coverage; and Pittsburgh City Council has approved legislation to give employees their full pension, removing a 17-year-old policy that reduced pension benefits for some.

A new study found an increasing number of children have become underinsured, driven by a rise in inadequate coverage that’s costly or doesn’t meet their needs
(0:00 - 11:25)

The rate of “underinsured” children in the U.S. rose from about 31% in 2016 to 34% in 2019.

This data comes from a newly published study in the journal, Pediatrics.

Researchers looked at the results from an annual, self-reported survey taken by parents or caregivers of children about their child’s health care coverage, and determined a child was underinsured if they did not consistently have health coverage over a year, or if the insurance was inadequate.

“The rise in underinsurance was primarily driven by the rise in inadequate insurance, and by looking at the components that make up insurance adequacy, we saw those are primarily due to a rise in unreasonable out of pocket medical costs,” says Justin Yu, an assistant professor of pediatrics at the University of Pittsburgh’s School of Medicine, and the lead author on the study.

“The primary concern for us, especially as it relates to unreasonable out of pocket medical costs and … especially for families and parents of children who have special healthcare needs and chronic health conditions, they have to choose between basic necessities, like paying rent, paying a mortgage, or paying for food, ... or paying for their child’s health care needs.”

Yu says the biggest predictors of whether a family had underinsured children as if they child had complex, special health care needs, or if the children were covered by private insurance.

“Those private insurance plans are getting worse,” says Yu. “There’s a lot of research, especially in the adult sphere, that shows that these private insurance plans are shifting costs to consumers or U.S. citizens.” Yu says that cost gets passed through increased premiums or monthly fees, higher deductibles and more restrictive benefits.

Conversely, Yu says the Children’s Health Insurance Program, or CHIP, and Medicaid have protected families from inadequate insurance.

Yu says the solution will require large-scale policy reforms from the federal government, not just a piecemeal approach from states or counties.

Eligible Pittsburgh city employees can now opt in to receive their full pension
(11:30 - 18:30)

Some employees of the City of Pittsburgh had their pension pay decreased once they reached their maximum Social Security retirement age. But on Monday, the mayor approved an ordinance to remove this pension offset, giving employees the opportunity to receive full benefits.

Those affected by the offset include about 400 nonunion employees, and those hired after June 30, 2004.

The bill to remove the offset was co-sponsored by City Council President Theresa Kail-Smith, who says it’s not clear to her why it was in place to begin with.

“It was something that came before me,” says Kail-Smith. “We talk a lot about what’s right for employees, and tell people how they should pay employees, how many days they should give them off, … and here we are with our own employees not receiving a pension that they worked really hard for.”

Eligible employees will have to opt in to pay an increased amount (6%, compared to the previous 4%) to offset the cost of their pension.

Kail-Smith says a fellow councilor is working to alert eligible employees of the change. She says those represented by unions will have to negotiate the change with the mayor's office.

The Confluence, where the news comes together, is 90.5 WESA’s daily news program. Tune in Monday to Thursday at 9 a.m. and 7:30 p.m. to hear newsmakers and innovators take an in-depth look at stories important to the Pittsburgh region. Find more episodes of The Confluence here or wherever you get your podcasts. 

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