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.

Children's Group Letter to House: Do No Harm

March 22, 2017

The President’s FY 2018 Budget Blueprint, Part I: “Skinny” in Stature and Details, But Huge in Harms For Low-income Children and Adults

The President’s 2018 Budget Blueprint may be “skinny” in stature and by virtue of its dearth of detail, but it is huge in the harm it portends for our country’s most vulnerable children and adults — and a bad sign of what is still to come later this spring when the full budget (Part II) is presented.

March 22, 2017

Marian Wright Edelman Speaks Out Against the American Health Care Act

The Children’s Defense Fund has made giving every child a healthy start a core part of our mission for all of our 44 years. We are extremely concerned that the American Health Care Act under consideration by your committee would undo more than 50 years of progress made expanding comprehensive child-appropriate health coverage to millions of children. Today, thanks to the Affordable Care Act (ACA), Medicaid, and the Children’s Health insurance Program (CHIP), 95 percent of children in America have health coverage – an historic high. The American Health Care Act threatens progress at a time when we must continue to move forward, not backwards for children. We urge you not to move the act out of committee without major revisions for children.

March 7, 2017

What Does A Medicaid Block Grant or Per Capita Cap Mean for Children and Families

Thanks to Medicaid, the Children’s Health Insurance Program (CHIP) and the health insurance marketplace, today more than 95 percent of children in America have health coverage. Medicaid is lean and efficient, serving millions of low-income children, pregnant women, children and adults with disabilities, and seniors. Children constitute 43 percent of all enrollees. Without Medicaid’s strong protections, coverage guarantee, and comprehensive, age-appropriate health and mental health coverage, many children would go uninsured or underinsured, increasing short and long term costs for states and local communities while jeopardizing children’s academic performance and their futures. Our nation’s leaders must reject structural changes and cuts to Medicaid that would undermine its critical protections, hard-earned coverage and resulting health gains for children made over more than 50 years.

January 4, 2017

Protect the ACA for Children and Families

Since the Affordable Care Act (ACA) was enacted in 2010, 20 million people previously uninsured have gained health coverage. Under the ACA, millions of children and adults are now receiving preventive services such as immunizations at no cost, and can no longer be denied coverage because of pre-existing conditions or face lifetime limits on coverage. Women can no longer be charged more for coverage than men and states cannot cut or scale back health coverage for children. Most Americans, regardless of source of coverage, have seen significant new protections under the ACA. All of this is at risk if the ACA is repealed.

January 4, 2017

Medicaid Primer

Thanks in large part to Medicaid and its partner, the Children’s Health Insurance Program (CHIP), more than 95 percent of all children in American now have health insurance. Medicaid is a lean, efficient program that has historically served primarily low-income children and seniors, and children and adults with disabilities, such as Down syndrome. Forty-three percent of all Medicaid beneficiaries are children. Without Medicaid’s strong protections, coverage guarantee and comprehensive, age-appropriate health and mental health coverage, millions of children would go uninsured or underinsured, substantially increasing short and long term costs for states and local communities while jeopardizing children’s futures. Children who are insured are more likely than their uninsured counterparts to be healthy, graduate from high school, attend college and earn more/pay more taxes as adults. As our nation’s leaders make critical decisions about America’s future, Medicaid must remain exempt from structural changes or cuts that would undermine its ability to serve children and other vulnerable populations.

January 4, 2017

Congress Must Not Repeal the Affordable Care Act without a Replacement That Protects Children and Families

Republican congressional leaders have stated their intent to move quickly in early January to repeal as much of the Affordable Care Act (ACA) as they can without enacting a full replacement plan immediately. This action would result in loss of coverage for millions who gained affordable health coverage through the ACA and would destabilize the entire individual health care market.

January 4, 2017

More Children's Health Data

Child Watch® Columns

Child Watch Columns: Children's Health

  • 03/10/17
    Child Watch® Column:
    Congress: Don’t Hurt Children
    The Children’s Defense Fund has made giving every child a healthy start a core part of our mission for all of our 44 years. We are extremely concerned that the American Health Care Act under consideration by Congress right now would undo more than 50 years of progress made expanding comprehensive child-appropriate health coverage to tens of millions of children.
  • 02/03/17
    Child Watch® Column:
    Ripping America Apart
    If you are reeling from the series of Executive Orders and Memoranda issued by President Trump in his first two weeks in office, and horrified by what clearly seems to be an unconstitutional, un-American and unjust ban on Muslims from seven countries that has caused outrage at home and abroad, keep reading.
  • 01/27/17
    Child Watch® Column:
    Leslie Dunbar: An Indispensable One
    A number of years ago, I heard a deeply moving story at a Children’s Miracle Network event, a charity that raises money in partnership with children’s hospitals around the country and helps serve sick and injured children in their local communities. A speaker shared this heart-wrenching story of a father and son with the audience and agreed to let me share it with others after I requested a copy.
  • 11/23/16
    Child Watch® Column:
    A Prayer of Thanksgiving for Our Nation to Stand Up for All Our Children
    Lord I can’t preach like Martin Luther King, Jr. or turn a poetic phrase like Maya Angelou but I care and am willing to serve and stand with others to move our children forward and save our children in this time of Thanksgiving.
  • 11/11/16
    Child Watch® Column:
    Bringing America Together for Our Children's Sake
    What kind of people do we want to be? What kind of people do we want our children to be? What kind of moral examples, teachings, choices — personal, community, economic, faith, and political — are we parents, grandparents, community adults, political leaders, and citizens prepared to make in this new century and millennium to make our children strong inside and empower them to seek and help build a more just, compassionate, and less violent society and world?

Past Child Watch® Columns about Children's Health