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Historic Drop in Rate of Uninsured Children Linked to the Affordable Care Act

By Shannon Attanasio,


Great news this week out of Georgetown’s Center for Children and Families about how the Affordable Care Act is affecting health insurance for children. Based on analysis of data from 50 states, they found that the rate of children without health insurance has plummeted to a new record low.

As their Executive Director Joan Alker explained in her blog, the new report attributes this historic drop in the rate of uninsured children in large part to the ACA, “which for kids was building on more than a decade of success by Medicaid and CHIP working together.”

Alker credits several important policy changes created by the ACA as contributing to the decline in the rate of children without health insurance:

“The maintenance-of-effort provision, which meant states were not able to roll back their eligibility levels for kids, is certainly at the top of my list for ensuring that kids coverage levels continue to move in the right direction. In addition, the removal of premiums for some “stairstep” kids between 100-138% FPL when they moved from separate CHIP programs to Medicaid likely helped in some states.

The ACA also removed other red-tape barriers like asset tests and in-person interviews. The health reform law encouraged states to streamline the application and renewal process through generous financial support toupgrade IT systems. It also required states to attempt to verify eligibility through trusted data sources, like the Social Security Administration, before requesting paperwork from applicants which not only simplifies the process for families, but is also more efficient administratively. These policies have had positive benefits for kids already and hopefully more will benefit as states continue to remove barriers and simplify their enrollment and renewal processes.

Then of course there is the “welcome mat” effect as we like to call it. Because the Affordable Care Act drew so much attention in 2014 (good and bad!), and there were so many outreach and enrollment activities, parents who came in for coverage often found out that their kids were eligible for Medicaid or CHIP and signed them up.”

Among many encouraging findings, the report found that the share of children without health insurance in Medicaid expansion states declined more than it did in non-expansion states. This is further evidence that extending health coverage to low-income parents increases coverage for children.

Read the rest of Alker’s blog or view the entire report, Children’s Health Insurance Rates in 2014: ACA Results in Significant Improvements.