Many families with young children struggle to afford diapers. Forty percent of families with infants and toddlers cannot consistently afford enough diapers to keep their children clean, dry, and healthy. Research has linked diaper insecurity to food insecurity, material hardship, caregiver depression, and adverse child health outcomes.

To address this challenge, policymakers in several states are exploring whether Medicaid could serve as a vehicle for providing diapers to eligible families. This brief presents new findings from Urban Institute microsimulation models that estimate who a national Medicaid diaper benefit would reach, how children and parents might benefit at different life stages, and what such a policy could cost.

Why This Matters

Diapers are a basic need, but many families lack access to sufficient diapers and diapers are generally not covered by federal safety net programs, including Medicaid. As states and policymakers consider new approaches to addressing health-related social needs, questions remain about whether diaper assistance could improve outcomes for children and families and about the costs of implementing it. Understanding the potential impacts of diaper access can help policymakers, health systems, advocates, and researchers evaluate the role diapers play in promoting child development, parental well-being, and long-term economic mobility.

What We Found

Using two Urban Institute microsimulation models, the Social Genome Model and the Health Insurance Policy Simulation Model, we estimate that a national Medicaid diaper benefit could produce benefits for both children and parents:

• A Medicaid diaper benefit could reach millions of families. We estimate that providing diapers through Medicaid could reach 4.6 to 5 million children and 5.6 to 6 million parents each year.
• Parents could experience long-term economic gains. Young parents who receive diapers through Medicaid are projected to experience increased lifetime earnings of 1.55 percent on average, or about $7,000 per parent. Nearly 8,000 fewer parents are projected to live below the federal poverty level at age 30 each year, and more parents would earn associate and bachelor’s degrees.
• Children could experience better educational, health, and behavioral outcomes. Diapers provided through Medicaid are projected to improve children’s academic performance (equivalent to roughly 14 to 19 additional days of learning by age 15), school attendance, and health, and reduce delinquent behavior. These gains are associated with better long-term opportunities for young people.
• The policy would require a substantial but targeted public investment. Depending on participation rates and utilization, federal costs are projected to range from $2.4 billion to $4.1 billion a year, with state costs ranging from $1.5 billion to $2.6 billion. Federal spending per participating child would range from roughly $320 to $830 a year.

Together, these findings suggest that diaper access may influence much more than a family’s ability to afford a basic necessity. By reducing material hardship during a child’s earliest years, a Medicaid diaper benefit could improve parents’ economic mobility while supporting children’s educational and health outcomes.

How We Did It

We used two Urban Institute microsimulation models. We used the Social Genome Model to project how reducing diaper insecurity for young children and parents could affect long-term outcomes related to education, earnings, health, poverty, and child well-being. We used the Health Insurance Policy Simulation Model to estimate how many families would receive a diaper benefit through Medicaid and projects the associated federal and state costs. Together, these models allow us to estimate how a national diaper benefit might affect families, governments, and long-term outcomes.

The brief also includes state-by-state estimates of the reach and costs of a Medicaid diaper benefit.