Brief Progress in Children's Coverage Continued to Stall Out in 2018
Jennifer M. Haley, Genevieve M. Kenney, Clare Wang Pan, Robin Wang, Victoria Lynch, Matthew Buettgens
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Between 2013 and 2016, children’s uninsurance fell, their Medicaid/CHIP participation rate rose, and the number of children eligible for Medicaid/CHIP but uninsured declined, according to American Community Survey data. But these gains stalled in 2017 and 2018, as children’s uninsurance rose and program participation fell relative to their 2016 levels. In 2018, consistent with prior years, children’s uninsurance and Medicaid/CHIP participation rates varied across states, and long-standing disparities in coverage and participation across subgroups continued. Also like in previous years, more than half of uninsured children appeared to be eligible for Medicaid/CHIP but not enrolled. Further, just over half of all Medicaid/CHIP-eligible but uninsured children in 2017–18 lived in just seven large states (Arizona, California, Florida, Georgia, New York, Pennsylvania, and Texas).

This brief was revised on October 6, 2020, and January 13, 2021. On page 2, the share of uninsured children eligible for Medicaid/CHIP but not enrolled in 2018 is 57.4 percent. A previous version said the share was 56.7 percent on page 2 but 57.4 percent on pages 10 and 11. In table 4, the percentage-point differences in the shares of citizen children, children with citizen parents, and children with at least one noncitizen parent between 2016 and 2018 are 0.6, -0.5, and -0.8; these values were 4.4, -1.0, and 0.9 in a previous version. For the latter two values, we have also added significance levels mistakenly excluded in a previous version.

This brief was revised again on July 13, 2021. On pages 10 and 11, we corrected the following numbers in the text and in figure 6 because a coding error occurred when categorizing uninsured children's ineligibility for Medicaid/CHIP. We estimate that 33.0 percent (not 32.7 percent) of uninsured children were ineligible for Medicaid/CHIP solely because their family incomes were above the state’s eligibility threshold. Another 8.0 percent (not 5.4 percent) met the income requirements but did not qualify because of their immigration status, and 1.6 percent (not 4.5 percent) were ineligible because of both income and immigration requirements.

Research Areas Health and health care
Tags Health insurance Medicaid and the Children’s Health Insurance Program  State Children's Health Insurance Program Maternal, child, and reproductive health
Policy Centers Health Policy Center