Access to comprehensive, affordable healthcare coverage proved to be more essential than ever at the inception of the COVID-19 pandemic. Young people needed preventative care as well as diagnostic care as the coronavirus spread nationwide. Beyond controlling the virus’s spread, our national response increased access to the services that more broadly help us stay well, particularly access to health care insurance coverage.
Before the pandemic, in 2019, 4.4 million32 children were uninsured in the United States—800,000 more uninsured children than 2016’s historic low of 3.6 million. Coverage rates rebounded some during the pandemic to 3.9 million in 2021.
- In 2021, 8.3% of Americans were uninsured, down 0.3% from the 8.6% in 2020. Seemingly small, this decrease represents 1.1 million people who had healthcare coverage (see Table 13a).
- In 2021, the number of uninsured people under age 19 decreased to 3.9 million from 4.4 million in 2020.
- In 2021, 4.3% of Black children were uninsured, down significantly from 5.8% in 2020.
- Some of the largest shifts in coverage were seen in the Southern region of the U.S. The percentage of uninsured young people under 19 declined from 7.7% in 2020 to 6.8% in 2021.
- Doctor visits are often associated with diagnosing illness and offering treatment if needed. Yet pandemic-era access to adequate health care highlighted the value of preventative services as well. For many families, the opportunity to access and receive healthcare services on a consistent schedule for preventive services or before an illness became acute was a new experience.
Though advances have progressed through expanded healthcare coverage options available during the pandemic, millions of young people still need coverage to support their health and overall well-being. Federal programs such as Medicaid and CHIP are the foundation for a future society where all young people have access to adequate healthcare coverage. The nation demonstrated this goal could be reached, over time, with a significant increase in individuals who received pandemic-related healthcare coverage from federal programming. More than 41 million children under 19 received comprehensive, pediatric-appropriate, and affordable healthcare coverage under Medicaid and CHIP—5 million more than before the pandemic.
While it is common to acknowledge the impact federal healthcare coverage programs have on children during their adolescent and young adult years, Medicaid also covered more than 40% of births in the most recent years (see Table 16). Though a large percentage of live births were covered, in 2020 the Black infant mortality rate was still more than twice that of White and Hispanic infants. Access to adequate prenatal health care options is essential to life for both the birthing parent and unborn baby.
- In 2020, 1.5 million births were covered by Medicaid. Black and Hispanic children accounted for 1.4 million of the total live births reported for that year33 .
- In 2020, Black infant mortality rates were almost two times higher than the national average for all races/ethnicities. Of every 1,000 births, 10.3 Black children are not born alive in comparison to 4.3 White babies, 4.9 Hispanic babies, and 5.4 children for all races/ethnicities’ babies (see Table 16).
As the nation braces for the end of the Federal Public Health Emergency, millions of families must also prepare for Medicaid and CHIP eligibility redeterminations. Redeterminations, some beginning as early as February 2023, can be the difference between 5 million more young people receiving the coverage they need or millions of young people searching for coverage options in times that are still very uncertain for many people. States have the option to expand healthcare options to support their citizens’ healthcare coverage needs.
Florida, Georgia, Texas, South Carolina, Alabama, and North Carolina did not opt to expand healthcare to their citizens. This means that eligibility redetermination is crucial for the future coverage of young people in these states. Washington D.C., New York, California, and Ohio are among the few who offered expanded healthcare coverage to young people. In all states, however, healthcare coverage for young people increased.
As a nation, we have collectively witnessed and experienced young people’s urgent need for quality, accessible, and affordable healthcare. Parents, including people ineligible for Medicaid, CHIP, or any of their state’s equivalent options, must have access to healthcare options that meet the needs of the current time. Yet it’s even more important now to provide consistent, affordable, and accessible healthcare coverage for young people as we prepare for sweeping changes in healthcare coverage. Many states have already prepared to “unwind” healthcare or to resume eligibility redeterminations at the end of the Federal Public Health Emergency. Changes in healthcare coverage could result in millions of young people left without access to the services they need to be well.
The mental health status of young people—a growing concern identified by several federal agencies including the Centers for Disease Control and Prevention (CDC)34—has seen a consistent decline since the pandemic.
- In teens, mental health disparities resulting in long-lasting feelings of sadness or hopelessness spiked upward 69% for LGBTQ+ students.35
- Black students who experienced intense feelings of hopelessness or persistent sadness were more likely than their White peers to not have been diagnosed with a mental illness.36
Ensuring young people have access to the healthcare coverage necessary to access the various services they may need is a step toward ensuring that young people are well enough to lead in the various endeavors they approach at different points in their lifetime. During the COVID-19 pandemic, we saw historic rates of young people enrolled in adequate healthcare coverage. As they continue to work toward a post-pandemic era, we must consider the current reality’s health needs.