Following decades of expansions in children’s eligibility for Medicaid and the Children’s Health Insurance Program (CHIP) and efforts to enroll eligible children, by 2018, uninsured rates among children had declined substantially and more than a third of children younger than age 19 were served by public programs at some point during the year. Relative to being uninsured, children’s Medicaid/CHIP coverage has long been found to be associated with better access to care, greater utilization of health services, and improved health outcomes, with benefits that extend to later in life in health, educational attainment, and financial stability. However, being enrolled in Medicaid/CHIP coverage alone does not ensure that children receive high quality, timely, affordable, evidence-based care for all of their health needs in ways that are accessible and culturally effective for them and their families. Medicaid/CHIP coverage is comprehensive and includes no or generally low cost-sharing, but barriers such as lack of participating providers because of insufficient provider payments, inadequate access to specialty and mental health care services, and language and transportation issues may keep enrolled children from obtaining the care they need. As a consequence, racial, ethnic, socioeconomic, and other disparities in access to and receipt of high-quality care may exist among enrolled children. In this chartbook, we assess health care services receipt, unmet needs for care, and challenges families report with obtaining care for children covered by Medicaid/CHIP. We present both national and regional patterns, identify the subgroups of children who are at highest risk of not receiving needed care, and explore other material hardships and public benefits use.
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