Youth Justice


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. Clearly the ACA has had positive effects on the uninsured. There were 8.8 million more people insured in 2014 than in 2013 and the percentage of people without health insurance coverage decreased from 13.3 percent to 10.4 percent. In 2014 nearly 1 million more children gained health coverage and 93.8 percent had health insurance coverage although they were covered at a lower rate than seniors. Adult gains in coverage mean extra gains for children because when parents are covered children are more likely to be covered and receive needed preventive care too. The high rate of coverage for children is also evidence that Medicaid and CHIP are working for children and should be preserved as we work to expand protections for children in private coverage.

Although progress was made for large numbers of children, some lag behind. Hispanic children were more likely to be uninsured than children of other races and ethnicities and the uninsured rate for noncitizen children in 2014 was 20.8 percent—about 3.5 times greater than the uninsured rate for native-born citizen children. Assuring universal coverage for children requires providing coverage to undocumented children and to citizen children of undocumented parents who fear deportation if they seek health coverage for their children.

This summer, California took an historic leap towards providing health coverage to every child – the culmination of more than a decade of relentless advocacy by the Children’s Defense Fund’s California office and other child health and immigrant advocates. Led by state Senator Ricardo Lara, the legislature and Governor expanded Medicaid coverage to all income eligible children regardless of immigration status. Starting May 1, 2016, more than 170,000 undocumented children will gain access to health coverage they need to survive and thrive and grow up ready to contribute fully to California’s workforce and economy. The progress in California reflects a bipartisan recognition that the state is stronger when everyone has access to health care including immigrant children and families. California child advocates know the fight is not over and are continuing the “Health for All” effort to ensure all Californians — adults and children — health coverage. With its recent advances California joins Illinois, Massachusetts, New York, Washington State, and Washington, D.C. in covering undocumented children. Every state should do so.

States that have taken the Affordable Care Act’s option to expand Medicaid to more low- and middle-income adults also saw important strides in 2014. Although all 50 states and Washington, D.C. had a decreasing number of uninsured people between 2013 and 2014, the greatest gains were in the states that took the ACA’s option to expand Medicaid. The uninsured rate in Medicaid expansion states was lower than in states that did not expand Medicaid. The largest drop in the uninsured rate was in a Medicaid expansion state, Kentucky (5.8 percent). Massachusetts had the lowest rate of uninsured people (3.3 percent); Texas, a non-Medicaid expansion state, had the highest (19.1 percent).

We can increase this good news for all who need health coverage. We need to push hard for Medicaid expansion in all 50 states and push all states to follow California, Illinois, Massachusetts, New York, Washington State, and Washington, D.C. in covering undocumented children. The progress made on reducing the number of uninsured people should inspire us to keep going until every child and adult has needed health coverage.

Marian Wright Edelman is President of the Children’s Defense Fund whose Leave No Child Behind® mission is to ensure every child a Healthy Start, a Head Start, a Fair Start, a Safe Start and a Moral Start in life and successful passage to adulthood with the help of caring families and communities. For more information go to

Mrs. Edelman’s Child Watch Column also appears each week on The Huffington Post.