Key Findings. (1) The nation's rate and number of uninsured young children (under age 6) increased significantly between 2016 and 2018, following many years of steady decline. This reversal put the number of uninsured young children back above 1 million by 2018 for the first time since the full implementation of the Affordable Care Act in 2014. The rate of uninsured children under age 6 increased significantly between 2016 and 2018, from 3.8 percent in 2016 to 4.3 percent in 2018. (2) Coverage losses were widespread from 2016-2018, with 13 states showing statistically significant increases in the rate and/or number of young, uninsured children. Eleven states (Alabama, Florida, Georgia, Illinois, Kentucky, Missouri, Ohio, Tennessee, Texas, Washington, West Virginia) showed a significant increase in both the rate and number of uninsured children. Kansas and New York saw a significant rise in the rate alone. No state experienced a significant decrease in the rate of uninsured young children during the two-year period. Only Minnesota saw a significant decrease in the number of uninsured young children. (3) Young children are more likely to be uninsured in states that have not expanded Medicaid to parents and other adults under the Affordable Care Act, and the gap is growing. Between 2016 and 2018, non-expansion states saw an increase in the rate of uninsured children under age 6 that was more than double the growth in expansion states. Covering parents and caregivers is important for all children, but especially so for young children during their critical developmental years. States that expand Medicaid to parents and other adults can expect to see an improvement in their child coverage rates, as well. (4) Lack of health care coverage makes it more difficult for young children to get recommended check-ups, and families may miss out on opportunities for support. From birth to age 6, the American Academy of Pediatrics recommends that children have 15 well child check-ups. Access to this routine and necessary care is compromised when a child does not have health insurance. More frequent well-child visits for young children offer one of the best means to reach children and their families before school begins. In addition to providing needed immunizations and other preventive care, well-child visits are also increasingly seen as avenues to support and engage parents and other caregivers in their own health and successful parenting, since positive relationships are the foundation of healthy development for young children.
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