This brief examines well-child visit rates among Black and white Medicaid-enrolled children before and after the onset of the COVID-19 pandemic.

Methods  

We conducted a repeated cross-sectional analysis of well-child visit rates among over 9 million Black, non-Hispanic and white, non-Hispanic Medicaid-enrolled children ages 0–18 in 18 states using 2019 and 2020 Medicaid claims and encounter data from the Transformed Medicaid Statistical Information System. Descriptive and multivariable regression analyses were used to describe patterns in well-child visit rates.

Results 

In 2019, for ages 0–3, white children had slightly higher rates of well-child visits compared with Black children (81.0 percent versus 80.7 percent, respectively); for ages 4–18, white children had slightly lower rates than Black children (48.3 percent versus 50.0 percent). From 2019 to 2020, well-child visit rates declined considerably among both white and Black children of all ages. After adjusting for other observed characteristics, the differential decline was significantly greater for Black children than white children (ages 0–3: -1.38 percentage points, 95 percent CI -1.57 to -1.18; ages 4–18: -2.86 percentage points, 95 percent CI -3.01 to -2.72).

Conclusion

Well-child visit rates among Black and white Medicaid-enrolled children were far below recommended levels in 2019, and they dropped even lower in 2020. The declines in well-child visits from 2019 to 2020 were larger among Black children than white children, suggesting racial disparities in access to care may have worsened during the pandemic. Medicaid programs, plans, and providers may need to do more to ensure children have access to routine, preventive health care.