Children's Coverage Climb Continues

Father holds young child at doctor's office.

Nearly 1 million kids gained coverage in health reform’s first year.

The Issue

The number of uninsured kids dropped from 5.4 million to 4.5 million in the first year of the Affordable Care Act’s (ACA) full implementation. Report authors found an increase in the percentage of kids eligible for Medicaid/Children’s Health Insurance Program (CHIP) who are now enrolled.

Key Findings

  • Nationwide, more than 90 percent of kids eligible for Medicaid/CHIP were enrolled as of 2014—up from 88.7 percent in 2013, and 81.7 percent in 2008.

  • More than half of states have Medicaid/CHIP participation rates of over 90 percent.

  • The largest gains in Medicaid/CHIP participation were in states that expanded Medicaid for adults.

  • More than 60 percent of the nation’s remaining 4.5 million uninsured kids were eligible for Medicaid/CHIP in 2014.

  • Approximately 4.9 percent of eligible children were uninsured in 2014 in states that expanded Medicaid, compared with 8.0 percent in non-expansion states.


The authors say parents newly eligible for Medicaid may have also enrolled their children in Medicaid or CHIP after learning their options.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.

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Nearly 1 million kids

gained coverage in health reform’s first year. #ACAnumbers