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!

Two months have now passed since Congress let funding for the Children’s Health Insurance Program (CHIP) expire and 9 million children and their parents are still waiting for funding to be extended. Sadly, once again children are being held hostage to political debates. Created specifically for children, CHIP’s benefits and provider networks ensure children in working families with higher income eligibility than Medicaid have access to child-appropriate services, providers, specialists, and facilities. The historically strong bipartisan support for CHIP continues with a commitment to a strong five-year extension of CHIP, but politics, other priorities and disagreements over pay-fors have kept Congress from moving forward on CHIP.  As a result, agencies and families are truly in crisis mode as states are being forced to use dwindling dollars to plan to shut down their programs and families just at holiday time are being warned they might lose the health care their children depend on to survive and thrive.  Congress must move CHIP forward now. Please call (877) 233-9025 TODAY and urge your Senators and Representatives to pass a strong, five-year extension of CHIP NOW that is not accompanied by harmful offsets. We’re so close to the finish line. There is bipartisan support for CHIP and 9 million children and families are counting on it. 

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.

Statement of Leading Children’s Health, Medical and Advocacy Organizations: Congress’ Failure to Include a Strong Five-Year Extension of CHIP on This Week’s Spending Bill is a Missed Opportunity to Protect Children and Families

December 6, 2017

National Childrens Health Groups CHIP Letter to Leadership

As advocates for children and pregnant women, we are growing increasingly distressed by Congress’ failure to take timely action to extend funding for the popular Children’s Health Insurance Program (CHIP). Funding for CHIP is now 61 days past its September 30 deadline and the families of the 9 million children and over 370,000 pregnant women who rely on the program face an uncertain future.

November 30, 2017

National Childrens Health Groups CHIP Letter to Leadership

As advocates for children and pregnant women, we are growing increasingly distressed by Congress’ failure to take timely action to extend funding for the popular Children’s Health Insurance Program (CHIP). Funding for CHIP is now 61 days past its September 30 deadline and the families of the 9 million children and over 370,000 pregnant women who rely on the program face an uncertain future.

November 30, 2017

Children's Groups CHIP Deadline Statement

September 29, 2017

Leading Children's Health Groups Statement on Graham-Cassidy Proposal

September 25, 2017

Children's Defense Fund Statement for the Record Graham Cassidy Proposal

September 25, 2017

Child Welfare and Medicaid One Pager

Medicaid is a critical children’s health coverage program, and a key vulnerable population that Medicaid serves is children involved with the child welfare system. Children in or at risk for entering foster care experience disproportionate exposure to trauma and often have complex medical needs.

September 22, 2017

Extend CHIP for 5 More Years

Today, CHIP provides child appropriate health coverage to 8.9 million children across the country. However, unless Congress takes action, there will be no new funding for this highly successful program after September 30, 2017.

August 8, 2017

CHIP Five-Year Funding Extension Statement

August 7, 2017

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

More Children's Health Data

Child Watch® Columns

Child Watch Columns: Children's Health

  • 12/08/17
    Child Watch® Column:
    "I Didn't Make This World For You"
    The Tax Cuts and Jobs Act recently passed on a nearly straight party line Republican vote in the U.S. Senate is, like the House-passed bill, a moral abomination. Their enactment would be the death of America’s dream for tens of millions of children. The House and Senate bills favor the wealthiest Americans and most powerful corporations over poor and moderate-income children and families -- billionaires over poor babies and powerful corporations over poor children. They are evil.
  • 09/22/17
    Child Watch® Column:
    The Continuing Mean Assault on Our Children’s Health
    It’s back. The assault on our children’s health coverage has been resurrected for a final last-minute attempt at passage and is even more dangerous and cruel than ever. The latest Graham (R-SC)-Cassidy (R-LA) revision of the health repeal bill feels like a Halloween movie cliché with a zombie-like villain that refuses to die if its threats to children, seniors, and more of America’s most vulnerable weren’t so deadly serious.
  • 09/15/17
    Child Watch® Column:
    A Prayer to End Child Poverty in Our Time
    We know what to do to end child poverty if we want to in rich America. The U.S. Census Bureau reported this week that the number of children in poverty declined slightly again for the second year, but that children shamefully are still our poorest age group.
  • 09/08/17
    Child Watch® Column:
    CONGRESS: ACT ON CHIP
    Now 20 years after CHIP put an entire generation of children on the path to a healthy adulthood, we stand at another pivotal moment: Unless Congress takes action, funding for this essential, popular, highly successful program will end after September 30, 2017. Without this funding millions of children could lose health coverage or pay more for less comprehensive coverage, leaving millions of children significantly worse off than they are today.
  • 07/28/17
    Child Watch® Column:
    Happy Birthday Medicaid from the Millions Who Love and Need You
    President Lyndon B. Johnson said this fifty-two years ago on July 30, 1965 as he signed the bipartisan legislation that established the federal Medicaid Program and thanked former President Harry S. Truman and the many members of Congress from both parties who had laid the groundwork and worked tirelessly over many years to make the Medicaid program and its protections reality.

Past Child Watch® Columns about Children's Health