Even Though it is Turning 50, Medicaid is Still a Children’s Program

Today marks 50 years since President Lyndon B. Johnson signed the Medicaid program into law in 1965. The program has continued to evolve since then – playing a key role in our health care system serving low-income families, people with disabilities, HIV, and those receiving long term care.

The Affordable Care Act expanded Medicaid eligibility for low-income adults and simplified enrollment processes, making the program more accessible to millions of families. Medicaid has also seen its fair share of controversy – a Supreme Court case that made Medicaid expansion for low-income adults optional for states continues to reverberate in fierce debates in some states, and proposals to turn the program into a block grant are de rigeur in Congress. A key component of Medicaid often missing from these debates is that Medicaid is, and for 50 years has been, a children’s program.

Of the 68 million people provided health coverage through Medicaid, nearly half (48%) are low-income children. In 2013, Medicaid covered 33 million children – or 37 percent of all children and 77 percent of all children living in families below the federal poverty line. Medicaid, in combination with the Children’s Health Insurance Program (CHIP), has helped reduce the rate of uninsurance among children from 14 percent in 1997 to 7 percent in 2013.

Perhaps unsurprisingly given the breadth of its role in our health care system, Medicaid is a program that touches many Americans. A recent poll by the Kaiser Family Foundation found that 64 percent of respondents reported a personal connection with Medicaid.

With 50 years of experience serving growing numbers of America’s children, a new body of research is able to take a look at the long-term effects of childhood Medicaid coverage. Medicaid expansions in the 1980s and 1990s provided a natural experiment for researchers to evaluate how Medicaid eligibility affects children later in life. This longitudinal research tells us that children eligible for Medicaid grow up to be healthier, more academically successful, and financially secure adults than their non-Medicaid-eligible peers. We released a report that summarizes these findings earlier this week.

As we pause to reflect on Medicaid’s accomplishments over five decades, it is not only a time to reflect on its success, but to also to remain committed to a day when no child is uninsured. While the uninsured rate has come down substantially, we continue to see high rates of uninsurance among certain sub-populations – such as Hispanic children and those with incomes below 100 and 200 percent of the federal poverty line. Policies to expand eligibility and simplify enrollment in Medicaid remain necessary to continue reducing the number of uninsured children. California’s recent action to cover all children regardless of immigration status, even without federal Medicaid funding, speaks to a day in the future when all children may have a path to coverage.

A clear look at evidence-based research points to Medicaid’s value as a public investment to improve the health and well being of our nation’s children. Despite its success, strongly held beliefs about the role of government in our public discourse ensure that Medicaid will remain contentious even though it is popular with the American public. Thinking about the value of Medicaid for children may be an opportunity to move toward greater consensus.


(P.S. Check out one of 10 new videos on this topic featuring many of our state partners! Below features Texas –  we encourage you to check out and share the rest at this link.)

Texas – Medicaid 50th from Georgetown CCF on Vimeo.