West Virginia's youngest children are losing health care coverage

West Virginians understand that raising healthy children takes a village. Parents, grandparents, teachers, doctors, childcare providers and entire communities work together to give children the strongest possible start in life. But a troubling new report suggests that one of the most important building blocks for healthy childhood development — health insurance coverage — is slipping away from too many of our youngest children.

According to new data from the Georgetown University Center for Children and Families, the number of uninsured children under age 6 increased by 23% nationwide between 2022 and 2024, reaching the highest level in nearly a decade. While the national uninsured rate for young children rose from 4.3% to 5.3%, West Virginia's story reveals a different but equally concerning warning sign.

At first glance, West Virginia appears to be faring better than much of the country. In 2024, 3.7% of children under age six in West Virginia were uninsured, well below the national average. But looking only at that number misses the bigger story.

The Georgetown report found that West Virginia was one of just nine states where the increase in uninsured young children outpaced growth among older children. Even more alarming, West Virginia was one of only three states in the nation where children under age six were significantly more likely to be uninsured than school-aged children. In 2024, 3.7% of West Virginia's infants, toddlers, and preschoolers lacked health coverage, compared with just 2.5% of children ages 6 to 18.

That gap may appear small on paper, but it actually represents hundreds of West Virginia children missing access to regular checkups, developmental screenings, immunizations and early intervention services during the most critical years of brain development.

The first five years of life are a period of extraordinary growth. During this time, children develop the cognitive, emotional and physical foundations that shape their future health, educational achievement and economic success. The American Academy of Pediatrics recommends frequent well-child visits during infancy and early childhood because these appointments help identify developmental delays, hearing and vision concerns, behavioral health needs and other issues when they are most treatable.

For a state already struggling with some of the nation's poorest health outcomes, rising rates of uninsurance among our youngest children should concern all of us.

The most likely explanation for these trends is the Medicaid "unwinding" process that followed the end of the COVID-19 public health emergency. During the pandemic, families were able to remain continuously enrolled in Medicaid without repeated eligibility reviews. Once those protections ended, millions of Americans lost coverage. Many were no longer eligible, but many others lost insurance because of paperwork problems, missed notices, administrative errors, or confusing renewal requirements.

That reality carries particular consequences in West Virginia where Medicaid serves as the backbone of children's health coverage. In many rural communities, Medicaid and the Children's Health Insurance Program cover a substantial share of children and help sustain pediatric care providers. Employer-sponsored insurance is increasingly out of reach for many working families, and low-wage jobs often offer limited or unaffordable coverage options.

When health insurance disappears, parents are often forced into impossible choices. Do they pay the electric bill or schedule the doctor's appointment? Fill a prescription or buy groceries? Seek preventive care today or risk a costly medical crisis tomorrow? No parent should have to make those decisions.

West Virginia leaders frequently speak about strengthening families, improving educational outcomes, growing the workforce and reversing population decline. Those are worthy goals. But none of them can be achieved if children are falling behind before they even reach kindergarten.

Research consistently shows that children with continuous health coverage are healthier, perform better academically, and experience stronger economic outcomes as adults. The Congressional Budget Office has found that childhood Medicaid coverage increases future earnings, workforce participation and productivity. In other words, providing health coverage to children is not merely a health policy — it is workforce policy, education policy, and economic development policy.

If West Virginia is serious about building a stronger future, protecting children's health coverage must be part of that conversation.

The solutions are not complicated. We can strengthen automatic Medicaid renewals for eligible children, simplify enrollment processes, improve outreach to families, and invest in community-based navigators who help parents maintain coverage. Policymakers should also explore continuous eligibility protections that prevent children from losing insurance because of temporary income fluctuations or administrative mistakes. These are practical, bipartisan steps that would help ensure children receive the care they need when they need it.

West Virginia's uninsured rate for young children may still be lower than the national average. But the direction of the trend matters. When more babies, toddlers, and preschoolers are losing coverage while older children maintain it, we are receiving an early warning signal that something is wrong.

In a state working hard to secure its future, we cannot afford to leave our youngest children behind before their lives have truly begun.

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Courtesy of West Virginia Watch