The increase in the number of uninsured children last year was the largest in more than a decade, even before the pandemic and the recession it caused.
The uninsured rate climbed to 5.7% in 2019, the third year of increases after hitting a historic low of 4.7% in 2016.
The number of kids lacking coverage grew by 726,000 over those three years, according to a Georgetown Center for Children and Families analysis released Friday.
Despite the strong economy and record low unemployment rates that existed prior to the pandemic, the uninsured rates of both adults and children have risen during the Trump administration.
That figure is expected to shoot up in 2020 with millions of Americans losing their jobs and employer-sponsored health insurance.
Much of the improvement in children's rates earlier in the decade was due to the implementation of the Affordable Care Act coverage expansions in 2014, said Joan Alker, the center's executive director.
But the curtailment of marketing and enrollment assistance for the Obamacare exchanges under the Trump administration has eroded the gains, Alker said. Also, many states have increased the requirements to sign up for or remain enrolled in Medicaid or the Children's Health Insurance Program.
Another factor: the "chilling effect" created by the administration's efforts to curtail immigration, including the public charge rule, which makes it more difficult for immigrants who rely on public assistance, such as Medicaid, to obtain legal status.
Hispanic children saw the biggest jump in their uninsured rate, which climbed to 9.2% in 2019, from 7.9% two years earlier.
The share of uninsured children varies widely by state. Texas has the highest rate at 12.7% last year. The number of young Texans lacking coverage grew by 243,000 between 2016 and 2019, accounting for about one-third of nationwide increase. About 1 million children in Texas were uninsured in 2019.
Florida has the second biggest increase at 55,000, which brought its total number of uninsured children to 343,000 in 2019. Some 7.6% of Sunshine State children are uninsured.
More than half of kids lacking coverage live in the South.
Just under half of children have coverage through their parents' employers, while about one-third are insured through Medicaid or CHIP. The remaining have other sources of coverage, including through the Affordable Care Act exchanges, or are uninsured.
While more children are pouring into Medicaid and CHIP this year due to the pandemic-induced economic upheaval, it's likely even more will be uninsured. Some 1.4 million kids signed up for Medicaid or the CHIP, a jump of 4.1%, between February and June this year, according to preliminary federal data.