Extensive evidence shows that, relative to being uninsured, coverage through Medicaid and the Children’s Health Insurance Program (CHIP) improves children’s access to and receipt of health care, with benefits that extend throughout a child’s life. But some children with Medicaid/CHIP coverage may face systematic barriers that constrain their access to care. Understanding the extent of access problems, the subgroups of children who are at highest risk of not receiving needed care, and other hardships faced by those experiencing greater access challenges can help identify policies that could improve families’ ability to obtain the care their children need.

Why This Matters

Ensuring the quality and accessibility of physical, dental, and mental health care for Medicaid/CHIP-enrolled children is important for ensuring their immediate needs are being met as well as allowing them to grow and develop into healthy adults.

What We Found

• In 2016–19, Medicaid/CHIP programs across the country appeared to be providing access to health care for most enrolled children’s basic needs. More than three-quarters received preventive medical and dental care in a 12-month period, and very few covered by the programs were reported to have unmet needs for health services.
• However, about 4 in 10 Medicaid/CHIP-enrolled children faced at least one observed barrier to accessing care, and some children were reported to have more than one of these issues. Challenges reported included not receiving regular preventive medical or dental care, experiencing noncost delays in obtaining needed care, parents always or usually experiencing frustration when trying to obtain care for their children, or children having health needs that remained unmet.
• Several subgroups of Medicaid/CHIP-enrolled children were at higher risk of experiencing one or more of these access problems. For instance, groups reported to have higher unmet needs included adolescents, Black children, children in fair or poor health, children living with a single parent, noncitizens, children with a foreign-born parent, and children who experienced a period without coverage in the past year. Children who are Hispanic, Asian American/Pacific Islander, and American Indian/Alaskan Native, as well noncitizens or children with non-English-speaking or foreign-born parents were at higher risk of having received no preventive medical and/or dental visits.
• Though most families of Medicaid/CHIP-enrolled children also participated in at least one other public program, many also reported other material or financial hardships, indicating the need to better connect families to other supports. Rates of hardships such as food insecurity or a family’s troubles meeting basic needs were generally higher among Medicaid/CHIP-enrolled children also facing health care access challenges.

How We Did It

This chartbook uses data from the 2016–19 National Survey of Children’s Health and 2016–18 National Health Interview Survey to present patterns nationally, regionally, and across key subgroups, including comparing Medicaid/CHIP-enrolled children to children with private coverage and uninsured children.