MARY LOUISE KELLY, HOST:
A bit of heartening news today from the Census Bureau - child poverty is at a historic low. That's according to an annual report on income, poverty and health insurance. And the uninsured rate dropped in 2021 compared to the previous year. But the good news may be short-lived. Here to explain, NPR correspondents Jennifer Ludden, who covers economic inequality - hey, Jennifer...
JENNIFER LUDDEN, BYLINE: Hey there.
KELLY: ...And Selena Simmons-Duffin, who covers health policy. Hello to you.
SELENA SIMMONS-DUFFIN, BYLINE: Hi.
KELLY: Jennifer, you kick us off. When we say a record low for child poverty, how low, and how did this come about?
LUDDEN: It was a substantial drop from last year, about - down by nearly half compared to 2020 to 5.2% for child poverty. Now, the overall poverty rate for everyone was just under 8%, a smaller drop. This poverty measure takes into account all kinds of expenses families have as well as, you know, that range of pandemic aid a lot of families got. And the census officials say the key here was the child tax credit. In 2021, the American Rescue Plan, Congress boosted that credit, and it expanded it to include millions more low-income families and even those who were not working. Sharon Parrott is with the Center on Budget and Policy Priorities, and she's looked at how those families spend that child tax credit.
SHARON PARROTT: They spend it on their housing; they spend it on food; they spend it on education. They're able to do some of those extracurricular activities that middle- and high-income kids take for granted. They are investing in their kids, and their families are able to make ends meet in really important ways.
LUDDEN: And Parrott says all those things can have really important long-term benefits for kids like, you know, doing better in school and just being healthier.
KELLY: So some really good news there. OK, Selena, pick up with the other piece of this, that the uninsured rate fell in 2021, not to a record low, but approaching one, which is interesting to me because, as you've been reporting, there were all these worries that people would lose coverage during the pandemic. What happened?
SIMMONS-DUFFIN: Right. So census numbers today show that 8.3% of Americans, that's about 27.2 million people, did not have health insurance in 2021. So on the flip side, almost 92% did have health insurance. And it's true that when the pandemic began, a lot of health insurance experts projected the coverage losses would be devastating - millions and millions of people losing their jobs, losing their job-based coverage and then not going to the doctor when they're sick, which would help the virus spread faster. But that is not what happened. And instead, more people now have health insurance, and that is being driven by Medicaid. That is the public health insurance option for people with low incomes. Here's Sabrina Corlette at the Georgetown Center on Health Insurance Reforms.
SABRINA CORLETTE: The reason the Medicaid rates have increased is because of a COVID relief bill that Congress passed in March of 2020.
SIMMONS-DUFFIN: The Families First Coronavirus Response Act essentially said to states, as long as the pandemic is happening, you can't make people prove they still qualify for Medicaid to stay covered. So people can enroll in Medicaid, but you can't kick anyone off. And the census officials who briefed reporters today say this is what has been driving the gains in insurance coverage.
KELLY: But stay with that line you just said - as long as the pandemic is happening. If this was a pandemic measure that helped staunch health insurance losses, what happens if the pandemic - when the pandemic ends?
SIMMONS-DUFFIN: Yeah. So this measure is going to end, too, and that's why the good news may be fleeting. Jamila Michener is a professor of government at Cornell and an expert on Medicaid, and today she pointed out to me that it was a policy move that staved off those pandemic doomsday scenarios.
JAMILA MICHENER: Any of the improvements that we see, whether it's insurance or in poverty out of these census numbers, are a reflection of political choices.
SIMMONS-DUFFIN: And she says these gains won't continue and will, in fact, unravel unless policymakers continue to make choices in support of these gains. As it stands now, when the public health emergency ends - and that could be as soon as January - there are estimates that between 13 and 15 million people could end up losing Medicaid coverage. So some will be able to get coverage elsewhere, but millions more may become uninsured.
KELLY: So, Jennifer, connect this up. What could - what Selena is saying, what could that mean for poverty rates?
LUDDEN: Absolutely - millions more expected to go, you know, perhaps this year - be back into poverty because that expanded child tax credit ended last December. And, you know, it ran out just as inflation was really starting to climb to what became its historic high - so not good news for families, you know, with children. The Biden administration and many Democrats wanted to make this expanded child tax credit permanent. The U.S. House actually passed such a measure, but it did not survive in the Senate.
KELLY: And setting aside children for a moment, what about other age groups? Anything notable there?
LUDDEN: There is. One group that saw more people in poverty last year was seniors. Now, census officials say this is likely because they're on fixed incomes, and, already last year, inflation was starting to tick up, really squeezing their budgets. But again, they point out that Social Security did keep more than 26 million people out of poverty, and that includes several million children being raised by their grandparents.
KELLY: All right. That is NPR's Jennifer Ludden and NPR's Selena Simmons-Duffin. Thanks so much to both of you.
SIMMONS-DUFFIN: Thank you.
LUDDEN: Thank you.
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