Rates to rise further as Medicaid “unwinding” continues

The number of children without health insurance rose in 2022, according to government figures released today, making children the only group in the country to experience an increase in loss of coverage.

In 2022, more than 4 million children — or 5.4% of all U.S. children — did not have health insurance, according to the U.S. Census Bureau, with foreign-born children experiencing the highest uninsured rates. The 0.4 percentage point increase from the previous year came despite an extension of pandemic-era policies that prevented states from removing children from public health care programs such as Medicaid and the Children’s Health Insurance Program (CHIP). Together, those two programs insure 42 million U.S. children. These policies expired in April 2023.

“We are disturbed to see children once again taking the brunt of failures in our health care system,” said Bruce Lesley, president of First Focus on Children. “It’s especially concerning to see this loss of coverage even during the time states were prohibited from disenrolling children from Medicaid and the Children’s Health Insurance Program. Since those protective policies expired this spring, more than 1 million more children have lost their health coverage and more lose coverage every day. We hope lawmakers will use this information to create policies that secure the health and well-being of our nation’s kids going forward.”

The uninsured rate for non-Hispanic white children increased from 3.4% in 2021 to 4.1% in 2022, according to the Census report. However, the uninsured rate did not change for Black children, Asian children, or Hispanic children, who had uninsured rates of 4.7%, 4.1%, and 8.6%, respectively. Among foreign-born children, however, 20.6% were uninsured, including 6.9% of children who were naturalized citizens and 24.6% of children who were not citizens.

In 2021, the number of U.S. children without health insurance declined for the first time in at least four years, aided by government policies that helped maintain their access to medical care.

Since the so-called Medicaid “unwinding” began earlier this year, at least 1.2 million children have lost their health insurance,according to KFF. At least 5.7 million Medicaid enrollees have been disenrolled as of September 5, 2023, KFF reported. And although data are limited, children accounted for more than four in ten (43%) Medicaid disenrollments in the 15 states reporting age breakouts. The share of children disenrolled ranged from 81% in Texas, according to KFF, to 18% in Massachusetts. Overall, 73% of disenrollments are for procedural reasons, meaning the children losing their Medicaid or CHIP coverage are still eligible but are being disenrolled due to administrative issues.

Starting in January 2024, all states must provide 12 months of continuous eligibility for children enrolled in Medicaid and CHIP, meaning states must provide 12 months of continuous coverage for children in Medicaid and CHIP regardless of whether their household’s circumstances change. While this provision will do little to protect children from the coverage losses during the unwinding, its implementation in the long run will reduce the risk that children face periods of uninsurance throughout a year. This should help reverse some of the coverage losses during the unwinding and get kids connected back to comprehensive health care coverage.

To fully protect children, Congress also must make CHIP permanent. For more than 25 years, CHIP has ensured high-quality, affordable, pediatric-appropriate health care for children in families whose parents earn too much to qualify for Medicaid but too little to purchase private health insurance on their own. CHIP helped reduce the number of uninsured children by more than 68%, from an uninsurance rate of nearly 15% in 1997 to less than 5% in 2016. CHIP,together with Medicaid, plays a particularly important role for children of color: In 2021, more than half of Black, American Indian or Alaska Native, and Hispanic children relied on Medicaid and CHIP as their source of health coverage.

First Focus Campaign for Children supports the Children’s Health Insurance Program Permanency (CHIPP) Act, recently reintroduced by California Democrat Rep. Nanette Barragán. The CHIPP Act (H.R. 4771) would permanently fund CHIP and related programs that support the development of child health quality measures, as well as outreach and enrollment efforts.

First Focus on Children is a bipartisan advocacy organization dedicated to making children and families a priority in federal policy and budget decisions.