Census Undercounts Mean Less Medicaid Funding For Most Southern States

There were many challenges to the 2020 census, including delays due to the coronavirus pandemic as well as multiple failed attempts by Trump’s administration to add citizenship questions to the decennial surveys. The result would have a significant undercount of the United States population, according to policy analysts and demographers.

However, the national undercount was only 0.5% according to an Urban Institute report released this month — far less than many feared.

Seven states, however had undercounts exceeding 1% of their populations: New York (Alaska), Georgia, Mississippi (New Mexico), New York (Texas), and Texas (Texas). Among the Southern states, the estimated undercounts were greatest in Mississippi, at 1.3%, and Texas, at 1.28%, according to the report, titled “2020 Census: Miscounts and the Fairness of Outcomes.”

Texas will lose $247 million in Medicaid funding for the next decade. Mississippi will lose $20 million for its Medicaid program. According to the report, other Southern states that will lose federal funding for poor people due to undercounts include Alabama ($5 million), Arkansas (10 million), Florida (88 million), Georgia (47 million), Georgia (46.5 million), Louisiana (46.6 million), North Carolina (24.5 million), South Carolina (16 million) and North Carolina (24.5 million). In considering how undercounts affect federal funding, the Urban Institute focused on Medicaid because it’s among the federal programs that use census data most directly to distribute funds.

The reasons for the undercounts in Southern states are complex, according to Diana Elliott, the principal research associate at the Urban Institute’s Center on Labor, Human Services, and Population and one of the report’s authors.

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“It’s more that those states have populations that are historically hard to count, and maybe have not invested in get-out-the-count efforts as much as other states,” Elliott said. “There’s a lot of complexity involved in terms of what makes a population hard to count.”

She also noted that it was difficult to count homeless people accurately in the census. Increasing distrust of the government This also contributes to undercounts.

“What you see in the South is that a lot of those factors that make groups and geographies harder to count kind of come together at a confluence in a lot of communities,” she said.

Elliott and Jessica Shakesprere, co-authors, used a microsimulation modeling to estimate a hypothetical full census count for the U.S. population. This ensured that no one was left out and no one was counted twice. The microsimulation was able to measure fairness, net accuracy, quality. The Urban Institute model indicated that the 2020 census was most likely to have 4.1% omissions (undercounts), and 3.6% erroneous inclusion (overcounts), which led to an overall net undercount (0.5%).

The study revealed that the Black population in the United States was undercounted by 2.45% and Latino or Hispanic populations by 2.17%. Children under five years old were undercounted by 4.86%, undocumented persons by 3.36%, renters by 2.13%, and children under five by 5.96%.

Elliott said that it was not unusual for these historically difficult-to count groups to have undercounts. However, an overcount of the white population was also expected.

However, Texas officials were not aware of the possibility of an undercount. waited until August 2020 — four months after the census count began — to spend $15 million on an ad campaign to encourage participation, the Texas Tribune reported. Mississippi spent less than $500,000 2020 will see an increase in census participation Mississippi Today reported.

“If states are concerned — and they should be concerned — about having an accurate count, building up networks and thinking about how to message the importance of the census and various Census Bureau efforts, it’s really important to do that earlier rather than later,” Elliott said.

The 2030 Census Improvement Report called for more promotion at the state- and local level, operational changes, and better funding.

“If you want to have a community that gets the right investments of health care or vaccines or testing, those estimates are ultimately derived from census data collection efforts,” Elliott said. “It’s really important for states and communities to understand that these products and the Census Bureau’s work is incredibly important for their communities and their residents.”