With the heightened awareness of racial inequality in the news, we wanted to refresh our research showing the importance of Medicaid and the Children’s Health Insurance Program (CHIP) to children of color. More than half of American Indian or Native Alaskan, Black, other or multi-racial, and Hispanic children rely on Medicaid and CHIP as their source of health coverage.

The 2018 analysis differs from prior race and ethnicity snapshots that we have published in that we report race and ethnicity separately following the Office of Management and Budget guidelines. The American Community Survey follows a two-question format for capturing race and ethnicity data. People may choose to report more than one race group. People of any race may be of any ethnic origin and vice versa. Ethnicity is reported as Latino or non-Latino.

As we look to close the gap on health disparities for children of color, Medicaid and CHIP provide an opportunity to assess and address the health inequalities that exist for low-income children. But this means we have work to do. Too often, the focus on improving health outcomes plays second fiddle to lowering costs. Kids are often left out because they generally have the lowest health care costs. We need better data to disaggregate health outcomes by race and ethnicity and to prioritize health care quality improvement for children. Of course, this isn’t just about ensuring that kids get appropriate health care; it also requires that we address the social determinants of health that are so impactful to children’s health, as well as their success in school and beyond. Focusing on reducing health care costs among high cost populations is important. But if we are ever going to bend the health care cost curve long-term, we need to stop filling up the generational pipeline with adults who have multiple chronic conditions that are rooted in inadequate access to nutritious food, stable housing, safe neighborhoods, quality education, and health care during their childhood.