Nearly Half of American Children Rely on Medicaid and CHIP
Medicaid and the Children's Health Insurance Program together provide health coverage to approximately 40 million children — nearly half of all kids in the United States. This coverage ensures that children from low-income and working families can access pediatricians, immunizations, dental care, vision screenings, and mental health services regardless of their parents' employment status or income level.
Before Medicaid and CHIP, millions of American children went without basic health coverage, leading to delayed diagnoses, untreated conditions, and worse long-term health outcomes. Today, the child uninsured rate stands near historic lows, and Medicaid is the primary reason. Cutting the program would reverse decades of progress in children's health and push millions of kids back into the ranks of the uninsured.
Children covered by Medicaid are more likely to receive well-child visits, stay up to date on vaccinations, and have access to a regular source of care. These are not luxuries — they are the building blocks of healthy development that every child deserves.
Developmental and Specialty Services for Children
Medicaid's Early and Periodic Screening, Diagnostic, and Treatment benefit — known as EPSDT — is one of the most comprehensive pediatric health care packages in the world. It requires states to provide children with regular screenings and any medically necessary treatment identified through those screenings, including physical therapy, speech therapy, behavioral health services, and care for developmental delays.
For children with disabilities or special health care needs, EPSDT is often the only source of coverage for the intensive and specialized services they require. Occupational therapy, assistive devices, applied behavior analysis for autism spectrum disorder, and early intervention programs are all covered under Medicaid when they are medically necessary. Families of children with complex conditions depend on this coverage to give their kids the best possible chance at reaching their full potential.
Proposals to convert Medicaid into a block grant or impose per-capita caps would almost certainly result in states reducing these services, as they would no longer be required to provide the full range of EPSDT benefits. The children who would be most affected are those with the greatest needs.
Working Families Depend on Medicaid
The majority of children covered by Medicaid live in working families. Their parents hold jobs in industries like retail, food service, child care, and agriculture — sectors that frequently offer low wages and limited or no employer-sponsored health insurance. For these families, Medicaid is not a substitute for work — it is what makes work possible by ensuring that their children can see a doctor when they are sick.
Medicaid coverage for children also produces significant economic benefits for families. Research shows that children who gain Medicaid coverage have lower rates of medical debt, are more likely to complete high school and college, and earn higher wages as adults. Investing in children's health through Medicaid is one of the highest-return investments the nation can make.
The Unwinding Crisis and What Comes Next
The end of the pandemic-era continuous enrollment requirement in 2023 resulted in millions of children losing Medicaid coverage — many due to administrative barriers rather than ineligibility. States reported that the majority of children disenrolled during the "unwinding" were dropped for procedural reasons, such as unreturned paperwork, rather than because they no longer qualified for the program.
As states continue to work through the unwinding backlog, proposals to cut $1 trillion from Medicaid would compound the damage. Adding work requirements, reducing eligibility, or capping federal funding would push even more children off the rolls at a time when the system is already struggling to maintain coverage for those who qualify.
Every child who loses Medicaid coverage is a child who may miss a critical screening, go without treatment for an ear infection or asthma attack, or fall behind developmentally because their family cannot afford to pay out of pocket. Protecting Medicaid means protecting the health and future of the next generation.