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 pediatric 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), 94 percent of all children have access to health coverage. However, many children eligible for Medicaid and CHIP remain uninsured. 

Depending largely on family income, immigration status, and whether the family has an offer of affordable employer-sponsored coverage, in the post-ACA world, most insured children will have one of three types of coverage: Medicaid or CHIP, employer-sponsored insurance or ACA marketplace.

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 coverage.

A child’s eligibility for Medicaid and CHIP is primarily based on family income and assets, set by the states within broad federal guidelines. The result is a wide variety in coverage from state to state, from a few that meet or barely exceed minimum federal requirements to others that go far beyond to cover more children.

Medicaid is the single largest health insurer for children, providing virtually no cost health coverage to more than 36 million low-income children and children with disabilities. Medicaid coverage is comprehensive, covering all medically necessary services children need to survive and thrive. THe ACA requires states to cover children up to 138 percent of the federal poverty level under Medicaid, but as mentioned above, many states go beyond that to cover children at higher incomes.The ACA also allows children in foster care on their 18th birthday to continue Medicaid coverage to age 26. Importantly, the ACA encouraged states to expand Medicaid to low-income adults, which also increases child health coverage, as insured parents are more likely to have insured children and seek care when they needi it.

CHIP provides child-appropriate health coverage to more than 8 million children in working families across America with higher income eligibilty than Medicaid. 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. State CHIP programs may be rolled together with Medicaid, be a stand-alone separate program or some combination pf the two. The ACA required states to maintain their CHIP programs without cuts until 2019, but only funded it through 2015. In March 2015 funding for CHIP was extended for an additional two years, through September 30, 2017. To ensure that children do not lose ground, CDF strongly supports preserving, improving and funding CHIP at least until it has been demostrated that ACA's marketplaces can guaranree children health coverage that is comparable or better to what they have now in CHIP.

The Affordable Care Act (ACA)’s Additional Supports for Children

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

Other Resources

Petition for Rulemaking

Federal data sources and CDF publications relevant to child health.

Child Poverty in America 2015 National FactSheet

Poverty data released by the U.S. Census Bureau on September 13, 2016 reveal child poverty declined last year to 14.5 million poor children, one million fewer than in 2014, but still higher than before the recession began in 2007.

September 13, 2016

2015-children-in-the-states-complete

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.

October 28, 2015

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

July 30, 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.

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.

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.

FY2016 House and Senate Budget Fact Sheet

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 28, 2015

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

Community
Catalyst

First
Focus

 

Children’s Dental
Health Project

 

Georgetown Center for
Children and Families

March
of Dimes

Children’s Hospital
Association

Family
Voices

National Health
Law Program

Center on Budget
and Policy Priorities

Families
USA

 
Child Watch® Columns

Child Watch Columns: Children's Health

  • 09/16/16
    Child Watch® Column:
    Ending Child Poverty: A Moral and Economic Necessity
    Poverty data just released by the U.S. Census Bureau reveal child poverty declined last year to 14.5 million poor children from 15.5 million in 2014, one million fewer but still higher than before the recession began in 2007.
  • 09/02/16
    Child Watch® Column:
    Insure All Children!
    The Children’s Defense Fund (CDF) and AASA, The School Superintendents Association, have just released Happy, Healthy, and Ready to Learn: Insure All Children! a toolkit to help schools and districts connect children to health care coverage as part of routine school enrollment.
  • 08/19/16
    Child Watch® Column:
    Back to School
    As a new school year begins, parents, teachers and administrators are all thinking about how to make it the best year ever. One of the keys to student success sounds very simple but can make a profound difference: making sure every student is in school every day. This is not the case in many schools and school districts across the country. The Department of Education estimates that five to seven and a half million students miss 18 or more days of school each year, or nearly an entire month or more.
  • 07/12/16
    Child Watch® Column:
    Don’t Make Our Most Vulnerable Children Wait Longer!
    In an important show of bipartisanship, Congress is on the cusp of an historic step to help many of the most vulnerable children in our nation who are abused and neglected and at risk of entering foster care and lingering in group care.
  • 05/20/16
    Child Watch® Column:
    Building Strong Children Today For a Strong Nation Tomorrow
    Pediatricians aren’t usually day-to-day policy makers but policy decisions affect the work they do every day as frontline caregivers for our nation’s children.

Past Child Watch® Columns about Children's Health