Children Eligible for Medicaid: Pay Now, or Pay Later

Children Eligible for Medicaid: Pay Now, or Pay Later

I recently stumbled across a stunning number.

2 million kids.

That’s roughly half the number of children living in Florida.

It’s also roughly the number of children in Florida who are eligible for Medicaid.

Just let that thought sink in.

The primary basis for Medicaid eligibility is household income. If the household income is low enough, taxpayers, through Medicaid, will pick up the cost of your medical care.

The threshold varies with the age of the child. According to Medicaid.gov, here are the thresholds for Florida’s children:

Ages 0-1                  206% of poverty level

Ages 1-5                  140% of poverty level

Ages 6-18               133% of poverty level

I took those percentages and multiplied them times the federal poverty guidelines for 2016 for families of different sizes.  For a household with two people (think a single parent with one child), here’s what those income levels are for 2016:

Ages 0-1                  $33,001.20

Ages 1-5                  $22,428.00

Ages 6-18               $21,306.60

For a household with three people (think a single-parent household with two children):

Ages 0-1                  $41,529.60

Ages 1-5                  $28,224.00

Ages 6-18               $26,812.80

If that single parent is working a full-time job at Florida’s median wage of $15.29/hr, the household gross income would be almost $32,000/yr (52 weeks at 40 hrs/wk). That’s still below the Medicaid eligibility threshold if one has an infant, but above the threshold for the toddler or older, even if one has two children in the household.

But that’s the median wage. By definition, 50% or more of Florida’s full-time working population makes the median wage or less.

For example, according to an FIU study, The State of Working Florida 2015, roughly 40% of Florida’s full-time workers made less than $29,000/yr (in 2014), and 30% made a little less than $25,000.

If those households have children (and many do), that puts those kids closer to or inside the Medicaid eligibility window.

What a report last month from the Bureau of Labor Statistics tells us is that, among mothers with children younger than 18 living in the home who did not have a spouse in the household, the unemployment rate nationally in 2015 was 8.9% nationally, substantially higher than the 5.3% rate for women generally. An additional 25% of these women were not participating in the labor force. The comparable statistics for fathers without spouses were 7.4% unemployed and 13% not active in the workforce. The vast majority of single-parent households are headed by women.

How many kids are living in single-parent households? Using data from CountyHealthRanking.org, I came up with roughly 1.5 million (more than a third of all kids).

Running these sorts of numbers gives context to that stunning statistic of 50% of Florida’s children being eligible for Medicaid. With many kids in single-parent households, many headed by women (who still make less than men on average), and Florida’s wages where they are, it is less surprising that an awful lot of kids are growing up on the financial edge.

The problem is that Medicaid eligibility isn’t the same thing as ensuring adequate medical care. It may mean that kids grow up without adequate attention to the development of their speech and hearing, increasing the odds of school failure and future unemployability. It may mean that they can’t see a doctor at all, or see one less than needed, because so many doctors are declining to participate in the program, increasing serious childhood health trauma and decreasing both life expectancy and adult productivity.

For someone like me, with a deep philosophical and emotional commitment to the well-being of children, these numbers cry out for redress. Kids should have good food to eat in ample quantities, good medical care (including dental care), good educational opportunities, and a safe environment. For me, those are givens . . . period.

But you don’t have to agree with me to have some concern about the health care needs of Florida’s poorest children. Money spent now, to ensure these children are healthy, will return benefits in the future in productive citizens who cost us less in public health care and contribute to the taxes that pay for the care of others.

 

 

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