Health insurance coverage for children and their parents can facilitate access to affordable health care, protect families’ economic security, enhance families’ overall well-being, and promote children’s healthy development. During the COVID-19 public health emergency, numerous federal and state policies were enacted to protect access to affordable health insurance coverage. Prior research has shown that uninsurance fell during this period for both children and nonelderly adults; however, little analysis has focused specifically on coverage changes between 2019 and 2022 among young children and their parents.
WHY THIS MATTERS
Access to affordable health care is particularly critical in the perinatal period and during early childhood, given the high and inequitable risks of infant and maternal mortality, and the important physical, cognitive, and socio-development occurring in children under age 3. Children also benefit when their parents have insurance coverage, which reduces the entire family’s financial risks and burdens related to medical costs, improves the likelihood of getting needed care, and benefits parents’ mental health.
WHAT WE FOUND
- Uninsurance among young children and their parents declined between 2019 and 2022, with the largest drops occurring among mothers of young children.
- Uninsurance dropped from 4.5 to 4.1 percent for children, from 12.3 to 9.4 percent for their mothers, and from 14.1 to 12.3 percent for their fathers.
- Declines in uninsurance were greater for parents of young children in states that implemented Medicaid expansion under the Affordable Care Act between 2019 and 2022 (4.8 percentage points for mothers and 3.6 percentage points for fathers) and in states that had not adopted Medicaid expansion by 2022 (5.2 percentage points for mothers and 2.2 percentage points for fathers) compared with drops of 1.5 percentage points for mothers and fathers in states that had already expanded Medicaid by 2019.
- Declines in uninsurance were greater for young children in states that did not provide 12 months of continuous coverage for children in both Medicaid and the Children’s Health Insurance Program (CHIP) in 2019 (0.7 percentage points) compared with those that already provided 12 months of continuous coverage in both Medicaid and CHIP (0.2 percentage points).
- Parents of young children remained much more likely than their children to be uninsured in 2022; mothers and fathers of young children were over twice and three times more likely to be uninsured than their young children (9.4 and 12.3 percent, respectively, versus 4.1 percent).
- Approximately 1 in 6 (16.8 percent) mothers and 3 in 10 (30.6 percent) fathers with incomes below 138 percent of the federal poverty level (FPL) were uninsured in 2022, along with close to 1 in 7 mothers (13.7 percent) and 1 in 5 (21.4 percent) fathers with incomes 138 to 250 percent of FPL.
- Noncitizen parents of young children were over three times as likely to be uninsured as citizen parents in 2022.
- Uninsurance was also higher among parents of young children in the South and in Medicaid nonexpansion states in 2022.
- An estimated 2.1 million young children and their parents were uninsured in 2022, including 915,000 fathers of young children, 788,000 mothers of young children, and 434,000 young children.
HOW WE DID IT
We used American Community Survey data collected in 2019, before the pandemic, and the latest available American Community Survey data from 2022, when the public health emergency was still in effect. We focus on coverage among children under age 3 and their custodial parents, assessing coverage changes among young children and their parents between 2019 and 2022 and uninsurance among different subgroups of young children and their parents in 2022.