Four million American children had no health insurance in 2024. some will die of cancer
A recent analysis showed that the rate of uninsured children in the US is projected to increase from 2022 to 2024. Experts say this could lead to more deaths from cancer in children.
More than four million American children under the age of 19 lack health insurance in 2024. The uninsured rate reached 6.1 percent — the highest level in the past decade, according to a recent analysis By the Georgetown University Center for Children and Families, a health policy research organization. This represents a nearly 20 percent increase in the number of uninsured children nationwide since 2022.
Not having insurance creates gaps in medical care. And these gaps not only interfere with routine pediatric care; They also impede treatment of serious diseases such as childhood cancer, for which early detection is often a matter of life and death.
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“When you don’t have insurance, you’re likely to delay care,” says Kimberly Johnson, a pediatric cancer epidemiologist and professor at Washington University in St. Louis. “In the case of cancer, this may lead to a delay in diagnosis, and the cancer may become more advanced, which is then associated with a worse prognosis.”
The rise in the number of uninsured children is a direct result of Americans’ broken health care system. This patchwork of public insurance, private insurance and other employer plans creates an unstable environment for families whose income or job situation changes, says Derek Brown, a health economist and professor at Washington University in St. Louis. These life changes may force parents to lose insurance and re-enroll frequently, putting their children’s health at risk.
Many uninsured children are eligible for Medicaid (a government insurance program for people with limited income) or the Children’s Health Insurance Program (a joint federal-state program that provides federal funds to help states insure children) but are not enrolled, says Joan Elker, a research professor at the Georgetown McCourt School of Public Policy. People may not know they are eligible, and undocumented individuals may fear deportation. “Especially in today’s environment, there are families where the child is a citizen and the parent is an immigrant, and they are afraid to interact with the government,” Alker says. But she says such fears may explain only a small portion of those who are uninsured.
More children are losing insurance because of bureaucratic red tape. In a process informally known as “Medicaid unwinding,” states have resumed Medicaid eligibility checks after a period of continuous coverage during the COVID pandemic. Some people who were earlier eligible have had their nominations canceled not because of ineligibility but merely because of bureaucratic mistakes.
These gaps in insurance coverage will result in more children getting sick and dying. A national study in 2020 International Journal of Epidemiology A study of more than 58,000 children and teens under 20 with cancer found that those who were uninsured had a much higher risk of dying within five years than those with private insurance for most cancer types. Eleven percent of uninsured study participants did not receive any cancer-directed treatment, while 6.7 percent of privately insured participants did not receive any cancer-directed treatment. Children and teens without insurance were 31 percent more likely to be diagnosed with cancer at a later stage and 32 percent more likely to die in the five years after diagnosis than those with private insurance — living on average about two months less.
In the study, those on Medicaid had a higher risk of dying than those on private insurance, suggesting that other differences between the groups may explain the former’s higher death rates, such as family income level.
Because different types of cancer grow differently, however, the insurance gap does not harm every child in the same way. For some types, the sooner they were found, the higher the survival rates. For example, in tumors of the reproductive organs, the study found that about 40 percent of the survival difference between privately insured and uninsured people was explained by catching the disease at a later stage, while for brain and spinal cord tumors, it did not matter what insurance they had at the time of diagnosis — possibly because the latter type of cancer is normally less treatable.
Even if children have insurance for a period of time, going on and off Medicaid can jeopardize cancer treatment. In a 2024 study Pediatric Blood & Cancer Johnson, Brown and their colleagues looked at more than 30,000 children and teens under 20 diagnosed with cancer between 2006 and 2013. Those who were intermittently insured by Medicaid during the evaluation period were twice as likely to be diagnosed at a later stage when the cancer had metastasized and had an increased risk of death from cancer compared with their continuously insured and non-Medicaid-insured peers — among whom Most were private. Insurance.
The five-year survival gap was greatest among children and adolescents with soft tissue cancers and liver tumors, for whom losing Medicaid coverage could interrupt life-saving treatment; Neuroblastoma was the only cancer that did not follow this trend. People with other types of cancer, such as leukemia, a form of blood cancer, also benefited from continued insurance. Leukemia symptoms are often so urgent that children have to be sent to the emergency room, leading to faster diagnosis, unlike many quietly-progressing solid tumors whose symptoms parents may not recognize as urgent.
“As a country, it’s taken us a long time to get to a system where no child should leave the hospital without (insurance) coverage, just like they should not leave the hospital without a car seat,” Alker says. The Trump administration is phasing out a policy that allowed some states to continuously cover children up to age six regardless of any changes in a family’s circumstances.
Experts say the situation is not hopeless. Paperwork errors can be corrected, and legislators can make new guarantee To prevent children from losing insurance. Additionally, hospital and clinical social workers should help people stay connected with Medicaid enrollment support and guide them through some common pitfalls and challenges, Brown says. She says for caregivers of children with cancer, it’s especially important to make sure each state’s Medicaid enrollment process is accessible, which requires clear websites and adequate staffing.
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