Children’s Health Coverage: The Role of Medicaid and CHIP and Issues for the Future

Together Medicaid and the Children’s Health Insurance Program (CHIP) play an important role in providing health coverage for children in families with low and moderate incomes. This brief summarizes the role Medicaid and CHIP play in providing coverage to children, discusses the importance of Medicaid and CHIP for children’s health and well-being, provides an overview of the eligibility for coverage of the remaining uninsured children, and raises issues impacting the future of children’s coverage. It shows:

• Medicaid and CHIP are central sources of coverage for the nation’s children, covering nearly four in ten children nationwide. Medicaid and CHIP play a particularly important coverage role for low-income children and children of color. Medicaid’s size and scope is broader compared to CHIP, covering 36.1 million children in 2014, with CHIP covering another 8.1 million children at some point during the year. Enrollment in Medicaid and CHIP has positive impacts on children and families, including improving children’s access to health care services and providing financial protections for families.
• Despite consistent coverage gains for children, which have reduced their uninsured rate to a record low of 6%, an estimated 5 million children remain uninsured. About half of remaining uninsured children live in just seven states, mostly in the South and West. Hispanic and American Indian and Alaskan Native children are at least twice as likely to remain uninsured compared to White children, and two-thirds (65%) of the remaining uninsured children are eligible for Medicaid or CHIP.
• Going forward, sustaining and advancing coverage gains for children will hinge in part on the future of CHIP as well as outreach and enrollment efforts and state adoption of policy options. CHIP funding was extended through September 30, 2017 as part of the Medicare Access and CHIP Reauthorization Act (MACRA), so Congress will again consider options around CHIP and children’s coverage. Without CHIP, some children would retain Medicaid coverage, others could get coverage through the Marketplace and others may become uninsured. Targeted outreach and enrollment efforts to reach uninsured children and continued adoption of state policy options to expand eligibility and streamline enrollment and renewal can help advance new coverage gains for children in the future.