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Medicaid Matters for Young Children and Their Families

Medicaid, along with the Children’s Health Insurance Program (CHIP), covers more than 40% of the nation’s young children under age six, including three quarters (75%) of young, low-income children (below 200% of the federal poverty level).1In seven states, Medicaid/CHIP covers at least half of children under age six (AL, AR, KY, LA, MS, NM, OK) as shown in the table below.

Medicaid Provides Economic Security for Young Children and Their Families

Young children are the age group most likely to live in poverty.2 Families with young children are often just starting out in their jobs, with most facing high costs for child care, and other basic needs.3 Lower income families are less likely to have access to affordable employer-based health coverage, making Medicaid and CHIP particularly important for our youngest children. Medicaid does not impose arbitrary annual or lifetime caps on child health coverage providing parents with the peace of mind of knowing children born prematurely or with complex health needs will be able to receive life-saving care.

Medicaid Helps Build the Foundation for Health and Development of Young Children

The foundations for lifelong health are laid in the earliest years of life.4 Young children’s brains and bodies develop most rapidly in the first months and years following birth. Relationships with parent and caregivers, grounded in early experiences, are foundational to positive early childhood development.

Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) child health benefit is designed to help children get the care they need, when they need it.5 This includes preventive care through well-child visits, a regular source of care when illness occurs, and coverage for needed services to reduce chronic conditions and disabilities.6 Regular pediatrician-recommended check-ups, more frequent in the earliest months and years of life, help to identify and treat any problems early before they become more costly to address. Well-child visits also allow the opportunity to support parents and work together to get every child off to the right start. Medicaid is a major source of payment for the care young children receive from a doctor, a community clinic, or a children’s hospital. Each year, approximately 90% of young children have a health care visit.7

Parent and Caregiver Coverage Supports Early Childhood Development

Young children’s strong relationships and interactions with caregivers are the cornerstone of strong early childhood development. Parents and caregivers are touchpoints for infants and toddlers as they explore the worlds around them. When parents have health coverage children are more likely to stay enrolled in coverage and get to their regular check-ups.8 When parents can get their health, mental health, and substance use treatment needs met, they are better equipped to focus on their child’s growth and development. The ACA’s Medicaid expansion helps many parents and caregivers—including child care workers—stay healthy by providing affordable health insurance.9

States Look to Medicaid as a School Readiness Tool

A growing number of states have adopted policies that focus on addressing young children’s health needs as early as possible to help them arrive at kindergarten ready to learn. Medicaid coverage can boost access to services that prevent or lesson conditions before they become more costly and complex to treat later. Nine states have sought to decrease gaps in health coverage that can lead to delayed care by adopting continuous coverage for children from birth to their sixth birthday (HI, MN, NM, NC, NY, OR, PA, WA) or birth to age three (CO).10,11 Illinois and Ohio are also seeking federal permission to adopt similar policies.

Continuous Medicaid for young children ensures stable coverage during a period of rapid development12,13by removing additional renewal paperwork that can interrupt care.14 Even a short gap in coverage can result in missed well-child check-ups, needed treatment for conditions such as asthma, or costly visits to the emergency room that could have been prevented.15 Children with gaps in enrollment are more likely to have fair or poor health.16

Beyond enrollment, states have also begun to look more closely at ways Medicaid coverage can do more to boost the number of children getting recommended screenings and needed care under its pediatric benefit, EPSDT. In recent years, federal and state lawmakers have sought to improve access to appropriate care under EPSDT. Many opportunities exist to improve the quality of care.17 Leaders and experts have set out a vision for the transformation of child health services that help all families of young children obtain the services and supports they need.18 This includes preventive and primary care, screening for development, necessary treatments, and care coordination when needed. In addition, a number of states use Medicaid to finance evidence-based models to enhance primary care.19 All states pay for dental preventive, primary, and treatment services, as well as vision and hearing care.

Medicaid for Young Children Leads to Better Health Outcomes

Health coverage is key to ensuring that every young child has the opportunity for optimal health and productivity in adulthood. This is imperative for the nation’s future. Investment in children and families improves not only child health but also school achievement, workforce productivity, and cost-effectiveness in public spending.20

Research shows that childhood enrollment in Medicaid can lead to better health in childhood and adulthood.21 Children who have Medicaid coverage early are also more likely to attend school, graduate from high school and attend college. Medicaid coverage for low-income young children birth to sixth birthday is linked to improved health in adulthood (ages 25-54), as measured by a group of conditions including high blood pressure, diabetes, heart disease/heart attack, and obesity.22

Higher earnings and tax contributions can also result from having Medicaid early in life.23 Each additional year of childhood Medicaid eligibility was associated with an increase in total federal tax payments made in adulthood.

Medicaid Supports Positive Early Development and Mental Health

Screening young children is recommended to identify risks related to overall development, social-emotional development, and autism.24 Typically, Medicaid pays for such recommended screening delivered in well-child visits.

In most states Medicaid also finances screening for maternal depression; In addition, 37 states reimburse for dyadic family therapy to provide mental health services for parents and young children together to improve family wellbeing and children’s development.25

Young children are developing the social-emotional skills and experiences they need to grow into adults with good mental health. Medicaid infant-early childhood mental health (IECMH)-related policies can improve screening and access to intervention services.26

Endnotes

  1. Georgetown University Center for Children and Families analysis of U.S. Census Bureau 2023 American Community Survey (ACS) Public Use Microdata Sample (PUMS). ↩︎
  2. Children’s Defense Fund. 2023 State of America’s Children Report. 2023. Available here.
    US Census Bureau, American Community Survey. Older Adults and Child Poverty Rates Changed in Many States in 2023. September 12, 2024. Available here. ↩︎
  3. https://www.childcareaware.org/price-landscape24/ ↩︎
  4. Harvard Center for the Developing Child. Key Concepts: Lifelong Health and Well-being. 2025. Available here. ↩︎
  5. Centers for Medicare and Medicaid Services. Early and Periodic Screening, Diagnostic, and Treatment. (Website. Updated 1/6/25). Available here. ↩︎
  6. Perrin JM, Alker JC, & Mann C. “EPSDT: Medicaid’s Mandate for Children and Adolescents.” New England Journal of Medicine. 2025 Apr 24;392(16):1565-1567. https://doi.org.10.1056/NEJMp2415618. Epub 2025 Apr 19. ↩︎
  7. Child and Adolescent Health Measurement Initiative. 2022-2023 National Survey of Children’s Health (NSCH) data query (Indicator 4.1). Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved 05/01/2025. Available here. ↩︎
  8. Searing, A and Osorio, A.  “How Covering Adults Through Medicaid Expansion Helps Children.” (Washington: Georgetown Center for Children and Families, November 2024). Available here. ↩︎
  9. “Medicaid is a Critical Support for the Early Childhood Education Workforce.” (Washington: Georgetown Center for Children and Families, May 2025). Available here. ↩︎
  10. Wright Burak, E. “CMS Approves Five More States to Adopt Medicaid Multi-Year Continuous Coverage for Young Children as Threats to Coverage Loom.” (Washington: Georgetown Center for Children and Families, November 15, 2024). Available here. ↩︎
  11. “Biden-Harris Administration Announces Approvals in Five States that will Keep Eligible Children and Adults Enrolled in Medicaid and CHIP.” Centers for Medicare and Medicaid Services. (November 14, 2024). Available here. ↩︎
  12. Mann, C and Daugherty, E. “States Are Adopting New Policies to Help Children Stay Enrolled in Medicaid and CHIP,” To the Point (blog), The Commonwealth Fund, Dec. 20, 2023. DOI.  Available here. ↩︎
  13. Singer PM, Mandle J, & Nelson DB. “Child Enrollment in States With and Without Continuous Coverage in Medicaid and CHIP During COVID-19.” American Journal of Public Health. 2021 Dec;111(12):2103-2104. https://doi.org/10.2105/AJPH.2021.306550. ↩︎
  14. Vasan, A. and Rosenquist, R. “The Importance of Medicaid Continuous Enrollment Policies for Children and Families.” (Philadelphia: Penn LDI, June 7, 2023). Available here. ↩︎
  15. “Multi-Year Continuous Eligibility for Children.” (Washington: Georgetown University Center for Children and Families). Available here. ↩︎
  16. Brantley E & Ku L. Continuous Eligibility for Medicaid Associated with Improved Child Health Outcomes. Medical Care Research Review. 2022 Jun;79(3):404-413. https://doi.org/10.1177/10775587211021172.  ↩︎
  17. Consensus Statement: Opportunities for Medicaid to Transform Pediatric Care for Young Children to Promote Health, Development, and Health Equity. National Institute for Children Health Quality. Sept. 2019. Available here. ↩︎
  18. National Academies of Sciences, Engineering, and Medicine; Committee on Improving the Health and Wellbeing of Children and Youth through Health Care System Transformation. Launching Lifelong Health by Improving Health Care for Children, Youth, and Families. Editors: Tina L. Cheng and James M. Perrin. National Academies Press, 2024. https://doi.org/10.17226/27835. ↩︎
  19. Johnson K & Willis D. Guide for Transforming Care of Young Children in Community Health Centers. Nurture Connection. Sept. 2024. Available here. ↩︎
  20. OP CIT. National Academies of Sciences, Engineering, and Medicine; Committee on Improving the Health and Wellbeing of Children and Youth through Health Care System Transformation. Launching Lifelong Health by Improving Health Care for Children, Youth, and Families. Editors: Tina L. Cheng and James M. Perrin. National Academies Press, 2024. https://doi.org/10.17226/27835. ↩︎
  21. Park E, Joan Alker J, & Corcoran A. Jeopardizing a Sound Investment: Why Short-Term Cuts to Medicaid Coverage During Pregnancy and Childhood Could Result in Long-Term Harm. Commonwealth Fund (blog), Dec. 8, 2020. https://doi.org/10.26099/qe16-9f97. ↩︎
  22. Boudreaux MH, Golberstein E, & McAlpine DD. The long-term impacts of Medicaid exposure in early childhood: Evidence from the program’s origin. Journal of Health Economics. 2016;45:161-175. https://doi.org/10.1016/j.jhealeco.2015.11.001. ↩︎
  23. Brown DW, Kowalski AE, Lurie IZ. Long-Term Impacts of Childhood Medicaid Expansions on Outcomes in Adulthood. Review of Economic Studies, 2020 March;87(2):792–821. https://doi.org/10.1093/restud/rdz039. ↩︎
  24. Lipkin PH, Macias MM; and Council on Children with Disabilities, Section on Developmental And Behavioral Pediatrics. Promoting Optimal Development: Identifying Infants and Young Children with Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics. 2020 Jan;145(1):e20193449. https://doi.org/10.1542/peds.2019-3449. ↩︎
  25. Smith S, Granja MR, Burak EW, Johnson K, & Ferguson D. “Medicaid Policies to Help Young Children Access Key Infant-Early Childhood Mental Health Services: Results from a 50-State Survey.” National Center for Children in Poverty and Georgetown Center for Children and Families, June 2023. Available here. ↩︎
  26. Burak EW. “Medicaid Policies to Help Young Children Access Infant-Early Childhood Mental Health Services: Results from a 50-State Survey.” (Washington:Georgetown University Center for Children and Families, June 9, 2023). Available here. ↩︎

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