For the first time in a decade, the number of children without health insurance in the United States has risen — and Texas again has the largest share.

A Georgetown University Center for Children and Families report released Thursday found that more than one in five uninsured children in the U.S. live in Texas — about 835,000 as of 2017. The state saw an increase of about 83,000 uninsured children from 2016 to 2017.

Researchers are most vexed that the report marks the first time since the data was collected in 2008 that the nationwide number — as well as the rate — of uninsured children increased, after a decade of decline. The national rate increased from a historic low of 4.7 percent in 2016 to 5 percent in 2017. Texas’ rate of uninsured children in 2017 was at 10.7 percent, up slightly from the previous year and still more than double the national average.

“The absence of significant progress across the country suggests that even states with the best intentions were unable to withstand strong national currents to protect children from losing health coverage,” researchers wrote.

Texas has had the highest number of uninsured kids two years in a row. Estimates for comparable numbers of uninsured children by state before 2016 were not immediately available from researchers or the U.S. Census. That’s because the Census in 2017 changed the definition for children in its American Community Survey data. Previously, children were defined as 17 and under, but now the federal agency counts them as 18 and under.

The new rates are “a big red flag,” said Joan Alker, the center’s executive director. She said she wasn’t expecting an improvement — “the best outcome would be stagnation” — but she was surprised by the results.

The increase in the number of uninsured children comes from a combination of factors, Alker said. She pointed out that Texas has the highest uninsured rate among adults in the country, meaning children are less likely to have coverage if their parents don’t. It’s also a challenge for Texas families to receive Medicaid, the joint federal-state health insurance program for the poor and disabled, since some low-income families make too much money to qualify. Alker also said jobs in common Texas industries including the agriculture and service sectors are less likely to offer insurance coverage.

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