Rate of Uninsured Infants and Toddlers on the Rise

In This Report:


The percentage of infants and toddlers without health insurance is growing. The overall rate of uninsured children under 3 increased significantly for the first time in several years, growing from 3.5 percent in 2016 to 4.1 percent in 2018 (see Figure 1). This trend mirrors the national increase in the uninsured rate for all children under 19, as well as children under 6. Both groups showed statistically significant increases during the same two-year period.1

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The data presented in this report was derived from the U.S. Census’ annual American Community Survey (ACS) using one-year estimates from an augmented version of the 2008-2018 ACS – the Integrated Public Use Microdata Series (IPUMS) prepared by the University of Minnesota Population Center.

Infants and toddlers were defined as those individuals under age 3 (0 to 2 years old). In the ACS, data on sources of health insurance coverage are point-in-time estimates that convey whether a person has coverage at the time of the survey. Individuals can report more than one source of coverage, so such totals may add to more than 100 percent. Furthermore, due to rounding percentages may not total to 100 percent. Children covered by Medicaid/CHIP exclusively or Medicaid/CHIP in combination with another coverage type were reported here as “Medicaid/CHIP.”

Data suppression rules were applied to portions of this analysis to strengthen reliability, leaving some states out of the analysis due to data limitations or quality concerns. To avoid potentially unreliable estimates which can likely lead to misleading findings and inaccurate conclusions, we suppressed 1) states a small estimated number of infants and toddlers (Vermont) and 2) states where estimates and/or percent estimates yielded a large margin of error (i.e., 5.0 percent uninsured +/- 3.0 percent) and a coefficient of variation of 25 percent or more (Alaska, Arkansas, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Iowa, Maine, Massachusetts, Montana, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, West Virginia and Wyoming).


ZERO TO THREE created the Think Babies™ campaign to make the potential of every baby a national priority. Funding partners for Think Babies™ include the Robert Wood Johnson Foundation, which supports the campaign’s public education aspects, and the Perigee Fund, which supports the campaign’s public education and advocacy aspects. Learn more at www.thinkbabies.org.

  1. J. Alker, O. Pham, “Nation’s Progress on Children’s Health Coverage Reverses Course,” Center for Children and Families (November 2018), available at https://ccf.georgetown.edu/2018/11/21/nations-progress-on-childrens-health-coverage-reverses-course/. Also see E.W. Burak, M. Clark, L. Roygardner, “Nation’s Youngest Children Lose Health Coverage at an Alarming Rate,” Center for Children and Families (December 2019), available at https://ccf.georgetown.edu/2019/12/09/nations- youngest-children-lose-health-coverage-at-an-alarming-rate/.