As we wait with bated breath to see whether Congress will pass a long-term CHIP funding extension before the holidays, a timely new report serves as a good reminder of importance of Medicaid and CHIP for our nation’s youngest children and their parents—and the very real possibilities that the gifts of this coverage could be taken away at a moment’s notice.
Our friends at the Urban Institute examined 2015 health coverage data for children age 3 and younger and their parents, nationally and by state. It’s chock full of great information on family characteristics and state data that reinforce the notion that Medicaid is crucial for children—especially the nation’s youngest children— and their parents.
Coverage has improved for infants and toddlers and their parents alike, but there’s much room for improvement for parents. As we often say, Medicaid, CHIP and the ACA have been success stories, bringing children’s insurance rates to their lowest levels on record—children under 3 and their parents are no exception to this trend. The rate of infants and toddlers without health insurance (3.5 percent) is much lower than for their parents (13.2 percent)—these parents are nearly four times more likely to be uninsured than their children. Parents of infants and toddlers are also more likely to be uninsured than parents of older children. Given what we know about the importance of coverage for parents on their children’s healthy development, this is a great opportunity for improvement that has a clear policy solution–Medicaid expansion!
Medicaid and CHIP are key coverage sources for all children, but especially infants and toddlers. Their parents have more limited access to Medicaid, which varies widely by state. Just under half (48.8 percent) of all infants and toddlers rely on Medicaid/CHIP. This ranged from 27.7 percent in North Dakota to 64.7 percent in New Mexico (See map). Among parents of infants and toddlers, Medicaid coverage ranged from 9 percent in South Dakota to 35 percent in New Mexico and West Virginia. This makes sense, of course, since eligibility levels are much lower for parents and vary widely across states based on Medicaid expansion status and income eligibility (from 18 percent of the federal poverty level to 221 percent). In contrast, Medicaid/CHIP income eligibility for children is much higher, ranging from 175 percent to 405 percent FPL.
The ACA’s Medicaid expansion matters for infants and toddlers and their families. Say Ahhh! readers will not be surprised to see that infants and toddlers and their parents were more likely to be uninsured in states that did not expand Medicaid under the ACA. (Welcome mat anyone?) This was especially stark for parents of children 3 and younger—those in non-expansion states were twice as likely to be uninsured as those in expansion states.
This report reminds us of the outsized role Medicaid and CHIP play for our youngest children, and the ways the programs successfully increased coverage for these children and their parents—with more opportunity for parents ahead. Even so, Congress just passed a $1.5 trillion tax bill that sets the stage for fights over Medicaid and other proposed health care cuts next year, while CHIP remains unfunded. Right now, states are taking steps to freeze or close their programs, putting coverage the line for 2 million kids in just the next month. What happens with Medicaid and CHIP in the coming weeks, months, and years, will play a substantial role in the trajectory of the nation’s youngest children for many years to come. Let’s hope our lawmakers get it right this holiday season and well into the new year.