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.

Protect Health Care for Children and Families!

Thanks to Medicaid, the Children’s Health Insurance Program (CHIP) and the Affordable Care Act (ACA), 95 percent of children in the U.S. have health coverage, but it is being seriously threatened. The new Congress has just convened and Congressional Republicans already are working to repeal the ACA, which they call “Obamacare,” a step that would harm millions of children. Congress must put children first and adopt a “do no harm to children” standard as they consider revisions to the ACA. Any repeal of the ACA also must be accompanied by passage of a full, immediate replacement that meets the needs of children and their families. There are also threats to Medicaid that would undermine its critical protections, hard-earned coverage and resulting health gains for low-income children, pregnant women, children and adults with disabilities, and seniors made over more than 50 years. Structural changes and cuts to Medicaid must be opposed. Children must not lose ground. 

Learn more about the threats to programs that children and families rely on to strive and thrive in the below resources.

The Children's Defense Fund and Other Organizations Urge Congress to Protect the Affordable Care Act

"As organizations dedicated to improving the health and well-being of children, adolescents, and pregnant women, we urge you to keep the unique needs of children in mind as you consider the future of the Affordable Care Act (ACA) and ensure that any changes do no harm to children. Thanks to Medicaid, the Children’s Health Insurance Program (CHIP) and the ACA, ninety-five percent of children in the United States have health coverage – an historic high.i Children must not lose ground: any health reforms must build on achievements already made to further improve coverage for children. We look forward to working with you to ensure no child is worse off as changes to our health care system are contemplated, and that we can work together to make even more progress for children." Read the full letter.

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 need it.

CHIP provides child-appropriate health coverage to more than 8 million children in working families across America with higher income eligibility 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 demonstrated that ACA's marketplaces can guarantee 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.

Ten Ways the Better Care Reconciliation Act Harms Children and Offers Worse Care

Ten Ways the Senate’s “Better Care Reconciliation Act” Harms Children and Offers Worse Care

June 27, 2017

Children’s Health Community Statement Opposing Medicaid Per Capita Caps

June 21, 2017

Protect Medicaid and Keep Kids Covered Flyer

June 20, 2017

Statement of the Children’s Community Urging Congress to Act Quickly on a Strong, Five-Year Extension of Funding for the Children’s Health Insurance Program

As advocates for children and pregnant women, today we call on Congress to take immediate action to stabilize CHIP in its current form and enact a five-year extension of CHIP funding. Congress should protect the gains in children’s health coverage that have resulted in more than 95 percent of all children in America being enrolled in some form of insurance coverage. Together, Medicaid and the Children’s Health Insurance Program (CHIP) are an integral part of this success and we urge Congress to ensure that coverage for children and pregnant women provided through Medicaid and CHIP is protected and not disrupted in any upcoming legislation.

June 14, 2017

Children's Group Letter to The Honorable Bill Cassidy

As child health advocates and pediatric providers working together toward a common goal of improving access to health coverage for our nation’s children and pregnant women, we thank you for drawing attention to children’s unique health needs and for arguing in favor of a “Jimmy Kimmel test” before acting on health reform legislation. This test is one that should ensure that we protect children’s coverage.

June 12, 2017

Keep Medicaid Strong for Children

Thanks to Medicaid, the Children’s Health Insurance Program (CHIP) and the health insurance marketplace, more than 95 percent of children in America have health coverage.

June 17, 2017

Why The American Health Care Act Harms Children and Other Vulnerable Groups and Why It Must Be Rejected

AHCA ends Medicaid’s guarantee of comprehensive, affordable health coverage to millions of people in America, including 37 million low-income children and children with disabilities.

May 17, 2017

Children's Group Letter to House: Do No Harm

March 22, 2017

More Children's Health Data

Child Watch® Columns

Child Watch Columns: Children's Health

  • 07/21/17
    Child Watch® Column: "Keep Working and Never Ever Give Up!"
    As Senate Republicans spent the last few days in closed door meetings frantically trying to plot new ways to achieve their wretched plans to destroy the Affordable Care Act and end Medicaid as we know it, hundreds of people of faith spent our week gathered at the annual Samuel DeWitt Proctor Institute for Child Advocacy Ministry to rekindle our shared conviction that all great religious traditions call us to acts of love and justice especially for children who are impoverished, vulnerable, marginalized and excluded and to renew our deep and shared commitment to resisting evil and injustice with unrelenting determined nonviolent action.
  • 07/14/17
    Child Watch® Column: "An Open Letter to the United States Senate "
    I learned my first lessons about injustice and health as a little Black girl growing up in segregated Bennettsville, South Carolina. I remember my parents’ and my sadness over the senseless death of little Johnny Harrington, who lived three houses down from our church who died before he reached 10 because his hard working grandmother didn’t know about the need for or have the money for him to get a tetanus shot after he stepped on a rusted nail. I also remember being awakened in the middle of the night after a Black migrant family’s car collided with a White truck driver’s vehicle on the highway in front of our parsonage, and the horror I felt when my Daddy, my siblings and I witnessed the White ambulance driver and attendants arrive on the scene only to leave behind the seriously injured Black migrant worker after they saw that the White truck’s passengers were not hurt.
  • 07/07/17
    Child Watch® Column: "Tell Congress to Stop Picking on Our Most Vulnerable Children!"
    It is unfathomable to me that week after week I must continue to defend the Medicaid program that for more than 50 years has protected the health and well-being of tens of millions of America’s most vulnerable. We know many of the 37 million children enrolled in Medicaid today are from poor or low-income families and that 40 percent of children with special health care needs benefit from Medicaid. Among these children are almost half a million foster children, nearly 40 percent of them under age six. These children, invisible to many, are the most vulnerable of the vulnerable.
  • 06/30/17
    Child Watch® Column: "Stand Up and Protect the Basic Human Right to Health Care"
    Every July 4th Americans come together to celebrate the promise of our Declaration of Independence. We know for millions of Americans our nation has never fully lived up to that creed, but for all who still believe in the American ideal this has never been a reason to give up. Instead in every generation a new group of women and men and youths and even children have come forward to do their part in pushing America closer to its full promise. The current administration and Congress show how far we still have to go.
  • 06/23/17
    Child Watch® Column: "Prayers for a More Just Nation"
    Our nation has lost its way as Congress stealthily debates dismantling the Medicaid and health safety net for the neediest children and adults. And as we await the Congressional Budget Office’s cost and impact report and the final outlines of the Senate health care proposal the only thing I can think of at this moment is to pray for our leaders to rediscover some semblance of common sense and moral decency and protect the 37 million children on Medicaid and the millions of disabled adults and others for whom it is an indispensable lifeline.

Past Child Watch® Columns about Children's Health