Medicaid and the Children’s Health Insurance Program (CHIP) are the heart of pediatric care in the United States. In tandem, these programs work behind the scenes to improve child health outcomes, preventing countless tragedies and creating pathways to healthier, more prosperous lives for children.
The National Bureau of Economic Research (NBER) recently released research about the reduction in mortality among adults in Medicaid expansion states. Although focused on adult mortality, the research provides an opportunity to reflect on Medicaid and CHIP’s role in children’s health. While the NBER study demonstrates that Medicaid expansion saved over 27,000 adult lives over just a few years, the evidence of Medicaid/CHIP’s impact on children is equally compelling.
Medicaid and CHIP currently cover over 37 million children. Since CHIP’s enactment in 1997, both programs have helped reduce the uninsured rate among children by over 60%. Children rely on Medicaid/CHIP for access to regular checkups, vaccines, developmental delay screenings, mental health support, vision and dental care, and even critical treatments for illnesses like childhood cancer. In fact, nearly a third of children diagnosed with cancer are covered by Medicaid or CHIP at the time of diagnosis.
Children with Medicaid/CHIP coverage are more likely to have a usual source of care, receive routine preventive services, and avoid delaying medical care due to cost. Kids with Medicaid/CHIP coverage also see lifelong benefits, including better adult health outcomes, higher graduation rates, and reduced rates of chronic conditions later in life.
But beyond these statistics lies a profound truth: Medicaid and CHIP do not just simply provide health coverage—they save lives, preserve families, and build stronger communities.
Studies dating back to Medicaid’s implementation in the 1960s show that the program reduced mortality among nonwhite children by 20 percent, leading to an 11 percent reduction in aggregate nonwhite child mortality rates. More recent research on Medicaid expansion demonstrates a 50% greater decline in infant mortality rates in expansion states compared to non-expansion states, with particularly striking improvements for African American infants.
Despite these clear benefits, Congress is actively considering legislation that would devastate children’s health coverage by cutting over $800 billion from Medicaid/CHIP. The budget reconciliation bill—cynically named the “One Big Beautiful Bill”—will be catastrophic for children and families. In analyzing the House-passed version of the bill, the Congressional Budget Office projected that nearly 8 million Americans would become uninsured from Medicaid cuts alone, with millions more losing Affordable Care Act (ACA) Marketplace coverage when enhanced premium tax credits expire.
The proposed changes will harm children through:
- Resurrecting barriers for enrolling in and maintaining CHIP coverage, such as waiting periods, lock-out periods, and annual/lifetime limits on benefits.
- Reducing retroactive coverage, from 90 days to 30 days, forcing families to worry about paperwork and costly medical bills rather than their child’s health.
- Provider tax restrictions that will force states to reduce support to pediatric health care providers and even cut eligibility or benefits.
- Penalizing states that provide coverage to children, regardless of immigration status, using only state dollars—14 states and D.C. currently use state-only funds to provide such coverage.
- Work requirements that jeopardize parent/caretaker coverage and threaten household financial security for children.
These cuts will cost children’s lives through policies that reduce access to preventive care, delay treatment, and create barriers to enrollment. For example, rural hospitals that serve many Medicaid/CHIP families are already struggling; cuts to Medicaid/CHIP funding will force closures, leaving entire communities without essential pediatric services.
Children deserve better.
As I see it, Congress has a clear choice: invest in children’s health or jeopardize it by pursuing tax cuts for the wealthy. One choice serves our children’s and the nation’s best interests.
Lawmakers should reject the budget reconciliation bill. Rather than making cuts, Congress should focus on efforts that will foster children’s health and well-being. Here are just three of the many policies that Congress could adopt to help improve children’s health:
For questions, please contact our Vice President, Medicaid and Child Health Policy, Abuko D. Estrada, J.D., at abukoe@firstfocus.org