Nationwide 95.5 percent of children had health insurance in 2016, up from 95.2 percent the previous year—and up from 92.9 percent in 2013, the year before the ACA was fully implemented. While relatively few children rely on the ACA’s Marketplace for insurance, many gained coverage in Medicaid or CHIP when their parents signed up for their own coverage. The share of children covered by employer-sponsored insurance has remained largely unchanged in the past three years.

The report provides a state-by-state snapshot that shows 16 states saw the rate of uninsured children decline in 2016 and only the District of Columbia saw an increase. Since the ACA took effect in 2014, 44 states have seen improvements in coverage for children. The states with the biggest gains include: Nevada, Montana, Florida, Arizona, California, Colorado, and Idaho.

Researchers at the Georgetown University Center for Children and Families publish this report annually: November 2018, October 2016, October 2015, November 2014, November 2013, October 2012  and November 2011.