Health Insurance Coverage Improves Child Well-Being

One remarkable social achievement in recent decades has been the expansion of health insurance coverage for U.S. children. The coverage rate for this group was 95 percent in 2015,[1] an all-time high. Coverage for Latino children (whose rates have historically lagged behind those of white or black children) reached a record high as well—93 percent in 2015.[2]

While the majority of U.S. children (52 percent, as of 2015) are covered by private insurance plans, 43 percent—primarily those in low-income families—are covered by government-sponsored programs, the largest of which are Medicaid and the Children’s Health Insurance Program (CHIP).[3] (For state-level breakdowns, see the map below, and the appendix.) Medicaid care for children is a relative bargain: per-child costs are about three quarters of what they are for non-disabled adults.[4] In fact, children comprise about 40 percent of the Medicaid population, but account for less than one fifth of all Medicaid expenditures.[5]

Children with health insurance are more likely than those who are not covered to receive early care for health problems, and they are at lower risk for hospitalization.[6] However, insurance coverage by itself does not guarantee that children will receive appropriate and timely care. Based on their knowledge and attitudes, families make decisions about when and from where to seek formal care for their children. Multiple barriers may inhibit access to care, including time constraints, out-of-pocket costs, possible lost wages, transportation availability, the supply of providers who accept a child’s insurance plan, and actual or perceived prejudice (on the basis of race/ethnicity or income, for example).[7]

There is growing evidence that when children (particularly those eligible for public health care insurance[a]) have coverage, they are not only more likely to get care[b] but also more likely to have improved outcomes—in health, of course, and in other important areas of life as well.