April is Medicaid Awareness Month. For decades, Medicaid and the Children’s Health Insurance Program (CHIP) have been crucial sources of coverage for America’s children. Two-thirds of Americans have a personal connection to the program, either having received coverage themselves or knowing a friend or family member covered by Medicaid. And the Medicaid program remains widely popular as it has served as a lifeline for children and families during the coronavirus pandemic. As millions of families have lost their jobs and health care, Medicaid and the ACA have given them a place to turn to for comprehensive, affordable coverage. Unsurprisingly, by September 2020, Medicaid enrollment grew to an all-time high of 77 million Americans.
Former President Trump spent years sabotaging the Medicaid program, which resulted in at least a million children losing Medicaid coverage. Now, President Biden is reversing course by signing the American Rescue Plan into law, historic legislation that includes the most significant health care expansion in a decade. The American Rescue Plan provides additional financial incentives for the 14 states that have not yet implemented Medicaid expansion, and it extends coverage to new mothers one year postpartum. These measures will have profound impacts on children and their families for years to come.
Republican Efforts To Block Medicaid Expansion Reduces Children’s Coverage
Republican efforts to block Medicaid expansion continue to hurt children and their families. Research shows that when parents have access to Medicaid, children are more likely to be covered themselves. Alarmingly, the children’s uninsured rate in states that have rejected expansion is nearly double the rate in states that expanded the program. The Urban Institute estimates that more than 6 million people would enroll in Medicaid if the remaining 14 states implemented expansion, including some children who are currently eligible for the program but would newly enroll as their parents seek coverage.
|By The Numbers
More Than 37 Million Children Are Enrolled In Medicaid And CHIP. Roughly 37.4 million children in the United States are enrolled in Medicaid or the Children’s Health Insurance Program (CHIP). Nearly 2 in 5, or 37.5% of children in America have health insurance through Medicaid.
More Than 6 Million People Would Gain Coverage If Remaining States Expanded Medicaid. Pre-pandemic estimates from the Urban Institute found that roughly 6 million people, including children, would enroll in Medicaid and the Children’s Health Insurance Program (CHIP) if the remaining states implemented expansion.
The Children’s Uninsured Rate In Medicaid Holdout States Is Double The Rate In Expansion States. According to the Georgetown Center for Children and Families, in 2019, the child uninsured rate was 8.1 percent in holdout states, compared to 4.1 percent in states that adopted expansion.
Almost Half Of Births Are Covered By Medicaid. According to the Kaiser Family Foundation, 49 percent of births are covered by Medicaid. Thanks to the American Rescue Plan, states have the option to extend coverage to new mothers for one year postpartum, which will improve maternal health outcomes.
17 Percent Of Parents Have Health Insurance Through Medicaid. 17 percent of parents have health insurance through Medicaid. When parents are covered, their children are more likely to have access to health care.
In 2010, Medicaid Kept 2.6 Million Americans Out Of Poverty. Even before the Affordable Care Act’s expansion of Medicaid, the program kept 2.6 million people out of poverty, “making it the third largest anti-poverty program in the country,” according to the Georgetown University Center for Children and Families.
Medicaid Coverage Has Long-Term Benefits For Children
New Research Shows Medicaid Prevents Children From Dying Young And From Developing A Disability As An Adult. “Minneapolis Fed economist Andrew Goodman-Bacon recently dropped a stone-cold classic of the genre, examining how the rollout of Medicaid in the late 1960s affected people who were children at the time. If you got health insurance through the program as a child, he found, you were less likely to die young; you were likelier to be employed and less likely to have a disability as an adult; and all these benefits actually wound up saving the government money.” [Vox, 3/25/21]
- Medicaid For Children “Pays For Itself.” “It helps so much, in fact, that it saves the government money in the long term. The fiscal benefits of the policy to the government, Goodman-Bacon concludes, amounted to about $200 billion (in 2017 dollars) if you calculated the net present value in 1965, compared to a coverage cost of roughly $92 billion.” [Vox, 3/25/21]
Medicaid Helps Children Stay Healthy, Leads To Long-Term Benefits For Children When They Grow Up. “Medicaid coverage has a significant positive impact not only on children’s health, but also on their educational attainment and job earnings. Children covered by Medicaid during their childhood have better health as adults, with fewer hospitalizations and emergency room visits, research shows.” [Center on Budget and Policy Priorities, 4/18/17]
Thanks To Medicaid, Students Have Access To The Resources They Need To Focus In School. “Under [Medicaid’s Early Periodic Screening Diagnostic and Treatment (EPSDT)] benefit, children and adolescents under the age of 21 have guaranteed access to a robust set of comprehensive and preventive health services, including regular well-child exams; hearing, vision, and dental screenings; and other services to treat physical, mental, and developmental illnesses and disabilities. The EPSDT benefit also covers medically necessary supplies and equipment that help students in schools, such as hearing aids, eyeglasses, wheelchairs, and other assistive technology to help students hear and see.” [Center on Budget and Policy Priorities, 4/18/17]
One Study Found Medicaid To Have A Larger Impact On Child Poverty Than All Other Tested Benefits Combined. “Medicaid is among the most effective anti-poverty programs…Medicaid had a larger effect on child poverty than all non-health means tested benefits combined. It is estimated to reduce child poverty by 5.3 percentage points.” [Georgetown University Center for Children and Families, 3/8/18]
Medicaid Helps Keep Families Out Of Debt. “Recent expansions in Medicaid for children and adults correspond with a decline from 2011 to the first half of 2016 in the share of families reporting problems paying medical bills. The percentage of poor and near poor children and adults who were in families having problems paying medical bills decreased by almost 30 percent…Health care costs are consistently found to be one of the most significant drivers of bankruptcies. One study estimated that more than 60 percent of all bankruptcies in 2007 were due to medical costs.” [Georgetown University Center for Children and Families, March 2017]
The ACA’s Medicaid Expansion Helps Children Gain Access To Care
After the Affordable Care Act expanded access to Medicaid, the children’s uninsured rate fell to an all-time low. Research confirms expanding access to Medicaid for parents has had ripple effects for their children. At the same time, states that continue to reject expansion are limiting children’s health care access:
When Parents Have Medicaid, Their Children Are More Likely To Have Regular Care. As summarized by Georgetown University’s Center on Children and Families, recent research finds that “Parents enrolled in Medicaid have children who are 29 percentage points more likely to receive a well-child visit. The relationship is strongest for families with household incomes between 100% and 200% [of the federal poverty line]. In these families, parents enrolled in Medicaid have children who are 45 percentage points more likely to receive a well-child visit.” [Georgetown University Center for Children and Families, 1/12/18]
Medicaid Expansion Led To Gains In Coverage For Children As Well As Parents. A study in Health Affairs found that “710,000 children gained public coverage when their parents enrolled in Medicaid between 2013 and 2015. If the remaining 19 non-expansion states expanded Medicaid, 200,000 additional children would gain health coverage through existing programs. The effect was largest among children whose parents gained Medicaid eligibility through the expansion.” [Georgetown University Center for Children and Families, 1/12/18]
The Children’s Uninsured Rate In States That Have Rejected Expansion Is Twice The Rate In States That Expanded The Program — And That Gap Is Growing. “Growing numbers of uninsured children are concentrating in states that have not expanded Medicaid. Between 2016 and 2019, the child uninsured rate in non-expansion states grew at nearly three times the rate of expansion states. Non-expansion states saw their child uninsured rate jump from 6.5 percent to 8.1 percent during the period examined while expansion states saw it increase from 3.5 percent to 4.1 percent (see figure 3 ). Moreover, two non-expansion states, Texas and Florida, were responsible for 41 percent of the coverage losses for children over the three-year period.” [Georgetown Center For Children And Families, 2/17/21]