Key Findings
- Between 2022 and 2024, the uninsured rate for infants and toddlers under age 3 rose significantly from 4.1% to 5.1%. This increase is equivalent to approximately 113,000 additional uninsured infants and toddlers.
- Uninsured rates for infants and toddlers vary by state. Out of the 39 states with available data, rates range from 1.5% in Connecticut to 10.5% in Wyoming. Nearly 1 in 10 children under age 3 are uninsured in Texas (9.3%) and Oklahoma (9.1%) .
- Nine states, detailed in Figure 4, experienced a significant increase in the uninsured rate among infants and toddlers during the two-year period. Only one state, Kentucky, saw a significant improvement in the uninsured rate for infants and toddlers.
- Medicaid and the Children’s Health Insurance Program (CHIP) cover 4 in 10 (39.7%) children under age 3. For families earning less than 200% of the federal poverty level—about $54,640 for a family of three—Medicaid and CHIP are even more critical sources of coverage, insuring approximately three-quarters (74.6%) of infants and toddlers.
- Medicaid and CHIP cover more than 6 in 10 American Indian and Alaska Native children (63.3%) and Black children (60.9%) under age 3, and more than half (53.4%) of Hispanic and Latino children under age 3.
- Medicaid and CHIP coverage rates vary by state. At least 4 in 10 infants and toddlers are covered by Medicaid and CHIP in 20 states, including more than half of infants and toddlers in Oklahoma (51.4%), Mississippi (54.5%), Louisiana (55.6%), and New Mexico (66.5%).
Methodology
Data Sources
This brief from the Georgetown University Center for Children and Families (CCF) analyzes data from the U.S. Census Bureau’s American Community Survey (ACS) Public Use Microdata Sample (PUMS) for 2015-2024. Because of differences in sample size and data processing, the estimates published here may differ from estimates produced using other ACS products and should not be compared, including those produced for children under age 6 using the ACS detailed tables.
Statistical Significance, and Data Reliability and Suppression
CCF uses the Census Bureau’s Statistical Testing Tool to determine statistical significance between estimates at a 90% confidence level. Differences between estimates should not be assumed to be statistically significant unless noted.
CCF calculates coefficients of variation (CVs) to measure data reliability for each estimate. CCF suppresses any estimate with a CV greater than 25 percent.
Geographic Areas
Data are analyzed at the national and state levels. Data on uninsured rates are suppressed in several states in accordance with data reliability standards above.
Health Insurance Coverage and Medicaid Undercount
ACS data represent a “point-in-time” estimate of an individual’s insurance coverage. The Census Bureau does not consider access to Indian Health Service (IHS) services alone as a comprehensive form of health insurance coverage; individuals who indicate that IHS is their only source of coverage are designated as uninsured.
ACS estimates are not adjusted by the Census Bureau (or by CCF) to address the “Medicaid undercount” observed when comparing the number of individuals covered by Medicaid/CHIP in surveys to the reported numbers of individuals enrolled in Medicaid/CHIP using federal and state administrative data. In 2022, the Medicaid continuous coverage provision may affect children’s reported coverage source—including uninsurance—if more individuals misreported their coverage source, including families who were unaware that they still had Medicaid coverage. Additionally, research on the decennial Census shows that young children in particular are undercounted, likely exacerbating the Medicaid undercount among children.
Demographic Characteristics
The ACS allows respondents to self-identify as the following races: White, Black/African-American, American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, “Some other race,” and “Two or more races.” To improve sample sizes and data reliability, CCF combines estimates for Asian and Native Hawaiian or Other Pacific Islander and reports the calculations as “Asian, Native Hawaiian, or Other Pacific Islander” and also combines “Some other race” alone and “Two or more races” and reports the calculations as “Other/Multiracial.” Except for Other/Multiracial, all racial categories refer to individuals who reported belonging only to one race.
The Census Bureau recognizes and reports race and Hispanic origin (i.e., ethnicity) as separate variables. As “Hispanic or Latino” refers to a person’s ethnicity, Hispanic and non-Hispanic individuals may be of any race.