Children's Health

To survive and thrive, all children need access to comprehensive, affordable health coverage that is easy to get and keep. Unmet health and mental health needs can result in children falling behind developmentally and having trouble catching up physically, socially and academically. Poor children and children of color have worse access to health care and as a result often start life several steps behind their wealthier and healthier White peers. This is why the Children’s Defense Fund works to ensure all children have access to child-specific health coverage that is affordable for families. Thanks in large part to Medicaid and the Children’s Health Insurance Program (CHIP), today, the number of uninsured children is at a historic low. We are working to protect those gains. We must not move backward. Instead we must work to expand health coverage for the remaining uninsured children, keep all children enrolled in coverage, and ensure timely access to appropriate care.

Children's Health Coverage in the United States

Today, the number of uninsured children is at a historic low. Thanks in large part to Medicaid and the Children's Health Insurance Program (CHIP), which provide comprehensive and affordable health coverage to more than 44 million children (57 percent of all children), and to the new coverage options offered by the Affordable Care Act (ACA), 95 percent of all children have access to health coverage. However, millions of eligible children remain uninsured. 

Depending largely on family income, immigration status, and whether or not there is an offer of affordable employer-sponsored coverage, in the post-ACA world, most children will fall into three categories of coverage: Medicaid or CHIP, the new marketplaces, or private (typically employer-sponsored). 

Medicaid and CHIP

Medicaid and CHIP provide comprehensive health coverage to millions of people in America — including more than 44 million children under age 19 — who would otherwise be unable to afford health insurance. In FY 2012, Medicaid and CHIP provided health coverage to 57 percent of all children at some point during the year.

A child’s eligibility for these programs is primarily based on family inc-ome and assets. Each state sets its own eligibility standards within broad federal guidelines. The result is a wide variety in coverage from state to state, from a few that meet minimum federal requirements to others that go far beyond to cover more children.

Medicaid is the single largest health insurer for children, providing affordable health coverage to more than 36 million low-income children and children with disabilities. Medicaid covers all medically necessary services children need to survive and thrive. While all children up to 138 percent of poverty were already covered by Medicaid or CHIP, the ACA has made some children who were previously enrolled in CHIP eligible for Medicaid's more comprehensive benefit package. Children in foster care on their 18th birthday are eligible for Medicaid and can continue Medicaid coverage to age 26. In addition, the ACA also makes medical coverage available to millions of low-income parents in states that have implemented the ACA's Medicaid expansion, which in turn encourages them to enroll their children in health coverage.

CHIP provides child-appropriate health coverage to more than 8 million children in working families across America. Created specifically for children, CHIP’s benefits and provider networks are designed to ensure children have access to child-appropriate services, providers, specialists, and facilities. Cost-sharing for CHIP (when states choose to apply it) is affordable for families. States cover children in CHIP through Medicaid, a stand-alone separate CHIP program or a combination approach. The ACA maintained CHIP until 2019, fully funding it through 2015.

The Affordable Care Act (ACA)’s Additional Supports

The ACA has a significant impact on children with private insurance coverage too. Insurers are no longer able to refuse to cover children with pre-existing conditions, revoke coverage when a child gets sick or place annual or lifetime caps on coverage. Today all “Bright Futures” services — the standard of pediatric well-child and preventive coverage recommended by the American Academy of Pediatrics– are now covered for children in public and private insurance without a co-payment. 

Ensuring the Promise of Health Reform

What Does It Mean For Children?

Learn more about what health reform means for children here.

CDF’s Comments on ACA Regulations

CDF is working hard to ensure the Affordable Care Act is implemented in a way that is as child-friendly as possible. Since the enactment of the law, we have submitted a number public comments on various provisions that affect children and families. You can learn more about these implementation issues and our recommendations in our comments. Read CDF's comment letters.

Resources on Key Implementation Issues for Children and Families

Even though health reform implementation is well underway, states are still working to ensure all children and families benefit from the law. Learn more about new coverage options, the impact the law is having in your state and about the opportunities to help reach all eligible children and parents in your community.

The Benefit of Medicaid

Together, Medicaid and the Children’s Health Insurance Program have reduced the number of uninsured children in the United States to the lowest recorded level, ever. Let’s work together to support and expand Medicaid as it continues to age! See our new fact sheets on the benefit of Medicaid.

Data and Publications

Federal data sources and CDF publications relevant to child health.

Child Poverty in America 2014 State Fact Sheet

State data released by the U.S. Census Bureau on September 17, 2015 reveal that child poverty in 2014 remains at record high levels in the states. Children are the poorest age group, and the poorest are children of color and those under age six.

September 22, 2015

Child Poverty in America 2014 National Fact Sheet

Poverty data released by the U.S. Census Bureau on September 16, 2015 reveal that child poverty declined slightly in 2014, from 21.5 percent in 2013 to 21.1 percent in 2014. While child poverty rates declined for Hispanic, White and Asian children, Black children saw an increase and continue to have the highest child poverty rate. Despite some decreases child poverty among all children remains at shamefully high levels. One in five children – 15.5 million – were poor in 2014, and children remain the poorest age group in the country.

September 17, 2015

NCH Invited Written Testimony Marian Wright Edelman

August 26, 2015

The Affordable Care Act’s Medicaid Expansion Helps Adults and Children

A key element of the Affordable Care Act (ACA) was the requirement that states expand eligibility for Medicaid to 138 percent of the federal poverty level to cover more children and low-income adults, a requirement which became an option for states after a U.S. Supreme Court decision in June 2012. As of July 20, 2015, 30 states and the District of Columbia have taken this option, expanding affordable health coverage to more than 10 million low-income Americans and reducing the rate of uninsurance nationwide from 17.6 percent to 10.1 percent.

July 29, 2015

Medicaid Primer - July 2015

Fifty years ago, on July 30, 1965, President Lyndon Johnson signed legislation creating Medicaid for "protection or security against the economic effects of sickness," and for fifty years, Medicaid has done just that for millions of children and low-income families across America.

July 29, 2015

Top Ten Reasons to Expand Medicaid

Since January 2014, 30 states and the District of Columbia have taken the Affordable Care Act’s (ACA) option to expand Medicaid to adults with incomes at or below 138 percent of the federal poverty level (FPL) ($32,913 for a family of four in 2014).i All of those states have seen dramatic reductions in their uninsured population and other benefits to children, individuals, families, and communities.

July 29, 2015

FY2016 House and Senate Budget Fact Sheet

April 9, 2015

Ending Child Poverty Now

For the first time, this report shows that by investing an additional 2 percent of the federal budget into existing programs and policies that increase employment, make work pay, and ensure children’s basic needs are met, the nation could reduce child poverty by 60 percent and lift 6.6 million children out of poverty.

January 9, 2015

Action Strategies and Resources Guide: Promoting Children's Mental Health Screens and Assessments

The Action Strategies and Resources Guide, which is part of the Children's Mental Health Resource Kit, is designed to help promote access to and availability of mental health screens and assessments for children.

December 16, 2014

Governors CHIP document for Proctor

List of states, governors, and CHIP program names.

July 16, 2014

More Children's Health Data

Other National Organizations

We work closely with many partners and friends across the country to help improve children’s health and access to comprehensive, affordable coverage. 

Some of these organizations include:

American Academy
of Pediatrics




Children’s Dental
Health Project


Georgetown Center for
Children and Families

of Dimes

Children’s Hospital


National Health
Law Program

Center on Budget
and Policy Priorities


Child Watch® Columns

Child Watch Columns: Children's Health

  • 10/02/15
    Child Watch® Column:
    Progress for Children's Health
    Recently released data from the U.S. Census Bureau’s Current Population Survey show the Affordable Care Act (ACA) is working and helping get people health coverage. This is a welcome stark contrast to new census data showing children remain our poorest age group and the younger they are the poorer they are.
  • 09/25/15
    Child Watch® Column:
    The Piercing Cry of Child Poverty in Economically Rich but Spiritually Poor America
    Pope Francis speaks out faithfully and forcefully against poverty and has been called “the pope of the poor.” But on his first visit to the United States there was demoralizing news about poverty, especially child poverty, in our nation—the world’s largest economy.
  • 08/28/15
    Child Watch® Column:
    Wise Lessons in Servant-Leadership from Howard University's President
    Today Howard University’s president Dr. Wayne Frederick is carrying on the tradition of inspiring college leadership set by Dr. Johnson, by our beloved Morehouse College president Dr. Benjamin E. Mays, who mentored Dr. Martin Luther King, Jr. and many civil rights activists in my generation, and by Dr. Howard Thurman and other great visionaries who graced Howard’s campus and school of religion and set a high example of excellence, integrity, commitment to service, love, and hopefulness for a new generation.
  • 08/07/15
    Child Watch® Column: "Helping Black Boys Survive: What a Difference a Smile Makes"
    “If I tell you a smile could save a life, would you believe me? A smile can save a life. There was a gentleman, a young gentleman … named Kevin. Kevin was one of those children who did well in school and had great grades. People liked Kevin. Kevin was a handsome young man. But Kevin was a miserable young man. Kevin suffered from depression. Kevin decided that he was going to walk across the Golden Gate Bridge and jump. … Kevin said, ‘If there’s one person who would smile at me or ask me if I was okay, I would not jump.’ Kevin jumped.”
  • 06/05/15
    Child Watch® Column:
    End All Youth Detention and Torture at Riker's Island Now
    In his speech the night before his murder Dr King repeated the Biblical parable of the Good Samaritan who stopped and helped the desperate traveler who had been beaten, robbed, and left half dead as he journeyed along the road from Jerusalem to Jericho.

Past Child Watch® Columns about Children's Health