CARSON CITY -- Nevada has the highest percentage of children without health insurance in the nation, according to a new report. Just over 16 percent of Nevada kids are uninsured, and the analysis by the Center for Children and Families at Georgetown University says that is more than double the national rate of 7.5 percent - and considerably higher than the "next worst" state, Texas, at just over 13 percent.

At Nevada's Children's Advocacy Alliance, executive director Denise Tanata Ashby says much of the problem is that the state stopped its outreach efforts to save money during the recession.

"That's a huge, huge issue. The majority of kids - even right now - who are uninsured are eligible for either Medicaid or the Nevada Check-Up program. Our state has not done a good job of doing outreach - or even with assistance filling out some of the applications."

Gov. Brian Sandoval has not made a decision about whether to expand Medicaid, using 100 percent federal dollars for the first three years under the Affordable Care Act. But Jon Sasser, Legal Services' statewide advocacy coordinator, says expansion is one logical way to make a dent in the number of uninsured children.

"That would bring about 25,000 parents onto the program that aren't otherwise there. All the national studies show that if you get insurance for the parents, then they're far more likely to sign up their kids."

Tanata Ashby says she is hoping the state looks at the long-term costs and implications rather than the short-term.

"In the long run, we need to be getting more people on Medicaid or Nevada Check-Up - getting them the preventive health care that they need, keeping them out of the emergency room. It is more expensive to have these kids not insured than it is to insure them."

The report looked at numbers of uninsured children from 2009 through 2011. It says Nevada improved slightly, but not enough to bring the state out of its top spot on the national list. In Nevada, 107,000 children still do not have health insurance.

The report is available at http://ccf.georgetown.edu.