Congress must act urgently to eliminate gaps in children’s health care coverage and ensure the long-term stability of high-quality, affordable coverage for children.

After decades of steady progress, the rate of children’s uninsurance is on the rise and set to worsen as three critical sources of children’s coverage — Medicaid, the Children’s Health Insurance Program (CHIP), and the Affordable Care Act (ACA) Marketplaces — face major threats:

  • In 2024, after decades of progress, the rate of children’s uninsurance rose to 6%.
  • Marketplace premiums and out-of-pocket costs are becoming increasingly unaffordable for many families, as a result of the expiration of enhanced premium tax credits in December 2025 and the expansion of catastrophic plans with extremely high deductibles for 2027 and 2028.
  • Despite targeting the adult expansion population, H.R. 1’s Medicaid cuts are already impacting children, with the Congressional Budget Office projecting another 3 million children will be disenrolled by 2036 as a result.1
  • The Children’s Health Insurance Program (CHIP) is a bipartisan success story but remains the only federal health coverage program that must be extended by Congress, and it is set to expire in FY 2029.

In the past year, more than 2 million children have lost their Medicaid or CHIP coverage.2

Universal coverage for children is an achievable, overdue national commitment. Child advocates envision a future for children’s coverage that builds on past successes and ensures that no child goes without health coverage simply because of where they were born, what their parents earn, or whether their family can navigate a complex and fragmented health care system.

We urge Congress to secure the future of children’s coverage by making CHIP a permanent program before it expires and strengthening Medicaid by:

  • Providing automatic enrollment and continuous coverage for children through age 26, regardless of immigration status or changes in family income
  • Ensuring comprehensive, child-focused benefits, affordability protections, and an accessible, robust network of pediatric providers

Universal coverage for children requires urgent action from Congress. First Focus Campaign for Children urges lawmakers to make CHIP permanent, reverse Medicaid cuts, and expand access so that every child in America has the health coverage they need and deserve.

For more information, visit campaignforchildren.org

Sources

  1. Swagel, P.L., Dunbar, S., Masi, S., & Sajewski, S. (2026, May 11). CBO’s baseline projections of federal subsidies for health insurance [Presentation]. Congressional Budget Office. https://www.cbo.gov/system/files/2026-05/62380-Federal-Health-Subsidies.pdf
  2. Georgetown University Center for Children and Families. (n.d.). State by state Medicaid and CHIP enrollment data. Retrieved June 4, 2026, from https://ccf.georgetown.edu/feature/state-by-state-medicaid-enrollment-data/

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