Most American Kids Rely On Medicaid, CHIP Insurance

Key Takeaways

The majority of U.S. kids are covered by federal health insurance at some time during their childhood.More than 3 in 5 American children enroll in Medicaid or CHIP by age 18Gaps in coverage are more common among kids in states that didn't expand Medicaid

MONDAY, Sept. 29, 2025 (HealthDay News) — Most American kids rely on federal health insurance plans like Medicaid or the Children's Health Insurance program at some point during their childhood, a new study says.

About 61% of U.S. children, or 3 in 5, have been covered by a federal insurance program by age 18, researchers reported Sept. 24 in the Journal of the American Medical Association.

Further, about 42%, or 2 in 5, have experienced one or more gaps in their coverage that left them without affordable health care, especially if they live in a state that hasn't expanded its Medicaid program, researchers said.

These kids could be hung out to dry by Medicaid cuts recently approved by the Trump administration, researchers said.

"Upcoming changes to Medicaid could affect a significant portion of children and worsen already substantial insurance gaps," said senior author Nicolas Menzies, an associate professor of global health at the Harvard T.H. Chan School of Public Health in Boston.

"We're particularly worried about explicit loss of public insurance eligibility for noncitizen children; spillover effects through parental Medicaid coverage losses due to work requirements and more eligibility checks; and state-level cuts to Medicaid," he added in a news release.

This is the first study to estimate insurance coverage over the full course of childhood, researchers said, and highlights the broad reach of Medicaid and CHIP in supporting the health of American children.

The Trump administration and Republican-led Congress cut Medicaid funding by $1 trillion in July, which is expected to reduce enrollment by 10 million to 15 million people, researchers said in background notes.

In July, the Centers for Medicare and Medicaid services stopped approving waivers that allow for continuous public insurance eligibility for children across a number of years, researchers said.

"Our study provides a valuable baseline for understanding the extent to which U.S. children's long-term insurance coverage may be affected by these sweeping changes," lead researcher Ye Shen, a doctoral student in health policy at Harvard University, said in a news release.

For the new study, researchers used federal data on American families and health insurance to create a model that would track children's coverage from birth through age 18.

The team then estimated insurance coverage based on federal policies that were in effect between 2015 and 2019, after the Medicaid expansions provided by the Affordable Care Act (ACA) but before the COVID-19 pandemic required temporary policies driven by the public health emergency.

Results showed that in states that didn't expand Medicaid under the ACA, 59% of children experienced periods when they were uninsured. By comparison, only 36% of kids in expansion states had periods when they weren't covered.

"These estimates indicate Medicaid and CHIP's critical role in childhood, but insurance gaps are frequent nevertheless," researchers concluded in their study. "Recent policy changes may worsen existing gaps."

More information

The Children's Hospital Association has more on kids' health coverage in the United States.

SOURCES: Harvard T.H. Chan School of Public Health, news release, Sept. 24, 2025; Journal of the American Medical Association, Sept. 24, 2025

What This Means For You

Federal health insurance programs are an important means of coverage for most American families with children.