This report analyzes recent trends in health insurance coverage for children at the state level between 2008 and 2010. The percentage of children with public coverage through Medicaid or the Children’s Health Insurance Program (CHIP) increased substantially, while rates of private coverage and uninsurance declined. However, these researchers found substantial variation across states. The main findings of this report include the following:

1. Between 2008 and 2010, while the rate of uninsurance for nonelderly adults increased from 19.4 percent to 21.4 percent nationally, the uninsurance rate for children actually fell from 9.7 percent to 8.5 percent. States with the biggest declines in the rate of uninsurance included: Florida, Mississippi, Delaware, Colorado, and Oregon.
2. The percentage of children with coverage through Medicaid or CHIP increased by 5.6 percentage points nationally. Although private health insurance remains the dominant source of coverage, the percentage of children with private insurance fell from 64.5 percent to 60.1 percent. States with the largest increases in public coverage included: Delaware, Mississippi, Vermont, Florida, and Oregon. States with the largest declines in private coverage included: Vermont, Hawaii, Wyoming, Wisconsin, and Delaware.
3. The increase in public coverage among children is likely tied to the effects of the economic recession. The percentage of children living in low-income families increased in most states, as did the percentage of children living in families with no employed adults.

The state-level analysis in this report shows that there is substantial variation across states in the trends that have affected health insurance coverage for children over the past few years. Although the coverage expansions in the Affordable Care Act are primarily aimed at adults, many provisions of the law will have impacts on children, and these impacts will vary by state. Because of variation in economic conditions and state policies, continued analysis of state-level trends is essential to understanding trends in health insurance coverage.