How Does the Coverage Gap Impact Parents and Kids in States Turning Down Medicaid Expansion Funds?

We know that thanks to Medicaid and the Children’s Health Insurance Program, America’s children are – overall – benefiting from historically high rates of health coverage (over 90% of U.S. children are now covered) even through some states still lag behind.  However, low-income parents of dependent children around the country are not so fortunate if they live in a state that hasn’t expanded Medicaid as they aren’t receiving the help intended by the Affordable Care Act.  Lacking this health coverage doesn’t just have a detrimental effect on parents – it hurts kids too.

This shouldn’t be that much of a surprise.  After all, looking at low-income adults in general, my colleague Tricia Brooks noted recently the large discrepancy in Medicaid enrollment between states linked to their state leaders’ expansion decisions.  I’ve detailed the two health care Americas quickly emerging where our country is split between the majority of states that have expanded Medicaid and accepted federal funding under the Affordable Care Act and the twenty-four states that continue to refuse to do so.  Reports also have noted the harm to children in some non-expansion states that have actually eliminated some parent coverage, and our CCF team has written extensively about the benefits if states close the coverage gap for parents through Medicaid expansion under the Affordable Care Act:

“Covering parents is expected to improve their own health status while also likely promoting the well-being of their children. Uninsured parents have more difficultly accessing needed care, potentially compromising their ability to work, support their families, and care for their children”

The twenty-four states reluctant to expand Medicaid coverage are refusing to expand coverage not only to low-income adults ages 19-64 but also, in twenty states, to low-income parents of dependent children.  While all states provide some Medicaid coverage to very, very low-income parents, this coverage is generally only provided to a minority of parents living in poverty.  The twenty states that don’t cover all parents in poverty with Medicaid set an average income limit of 41.5% of the poverty level – or $8,213 in annual income for a family of three.  Only four states that have so far refused Medicaid expansion provide coverage to parents at least to the poverty level – Alaska, Maine, Tennessee, and Wisconsin.

This means that most states still refusing to consider Medicaid expansion are denying many parents an essential tool they need to raise their kids – their own health.

Written by Adam Searing, Center for Children and Families. Cross-posted from the Say Ahhh! Children's Health Policy Blog.