Medicaid funding cuts and freezes directly impact children’s health. Because children comprise nearly half of all Medicaid and CHIP enrollees — 47.6% — states have little choice but to reduce children’s eligibility, children’s benefits, and pay for pediatric providers when the federal government withholds or reduces federal Medicaid funds.
The impact on children from the Medicaid provisions of Public Law 119-21, known as H.R. 1, is already becoming clear through new data:
Citing Medicaid cuts, some hospitals in rural areas have laid off employees providing labor, delivery, and postpartum care. Most states — 44 and the District of Columbia — have at least one hospital at heightened risk of closure due to the loss of federal funds, with 446 hospitals at risk of closure or reducing services, disproportionately affecting Black, Hispanic, and low-income families.
Combined Impact of Selected H.R. 1 Provisions on State Budgets (2025-2034)
Source: Rao, P., Baker, L., Girosi, F., Li, E., Kerber, R., & Eibner, C. (2026, February 26). State-level impacts of key Medicaid provisions in the One Big Beautiful Bill Act. RAND Corporation. https://www.rand.org/pubs/research_reports/RRA4098-1.html. Reproduced with permission.
Together, Medicaid and CHIP provide nearly half of the nation’s children with comprehensive, high-quality, and cost-effective health care coverage that meets children’s needs. As states now grapple with substantial losses of federal funds and rush to implement programmatic changes required by H.R. 1, stability in federal funding is especially critical. Congress must work to reverse the harms to children from H.R. 1 and protect Medicaid from any further cuts or funding freezes that could lead to additional losses in children’s eligibility for coverage, benefits, or access to care.