NCPA - National Center for Policy Analysis

Two-Thirds of Medicaid Eligible Children Not Enrolled

September 9, 2010

Of the roughly 7.3 million children uninsured on an average day in 2008, 65 percent were eligible for Medicaid or the Children's Health Insurance Program (CHIP), but not enrolled, based on researchers' analysis of data from the 2008 American Community Survey, a yearly survey fielded by the U.S. Census Bureau.  

Nearly four in every 10 uninsured children who are eligible for public insurance live in just three states -- California, Texas and Florida -- according to a newly released article from Health Affairs.

  • Public insurance participation rates vary widely across states, from lows of 55 percent in Nevada to highs of 95 percent in both the District of Columbia and Massachusetts.
  • Seven of the 10 states with some of the lowest participation rates were in the West census region and the Mountain region.

Adolescents were less likely than younger children to participate in Medicaid/CHIP, according to the Census data.

  • African American children and those in the other/multiple race category had the highest participation rates among eligible children (around 87 percent).
  • Participation rates were higher among "citizen children" with parents who were citizens or at least one English-speaking parent than among "citizen children" with noncitizen parents or with no English-speaking parent.

The Health Affairs article came on the heels of a New England Journal of Medicine article that found that 23 percent of children with continuous insurance coverage were underinsured.  As compared with children who were continuously and adequately insured, uninsured and underinsured children were more likely to have problems with healthcare access and quality, according to the article.

Source:  Sandra Yin, "Two-thirds of Medicaid eligible children not enrolled," Fierce Healthcare, September 6, 2010.

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For New England Journal of Medicine report:


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