What the New Census Data Actually Shows About Children's Health Coverage

Children's health coverage through Medicaid and the Children's Health Insurance Program (CHIP) remains at near-record levels, according to new data from the U.S. Census Bureau — directly contradicting recent claims that coverage rates for kids are in significant decline. For families navigating tight budgets, this is practical news: these programs may still be available to your child, even if your household income has changed, even if you've applied before and been turned down, and even if you're unsure where to start.

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Data Snapshot

According to the Centers for Medicare & Medicaid Services (CMS), as of federal fiscal year 2023, more than 41 million children were enrolled in Medicaid and CHIP combined — representing approximately one in three children in the United States. The uninsured rate for children stood at 5.4% as of the most recent American Community Survey data published by the Census Bureau (census.gov), a figure that has remained relatively stable despite the end of the COVID-era continuous enrollment protections that concluded in 2023. CHIP alone served approximately 7.2 million children in an average month during fiscal year 2023, according to CMS enrollment data available at medicaid.gov. These numbers matter because they reflect real program capacity — and real families who found a path to coverage.

Source: CMS Medicaid/CHIP Enrollment Data — https://www.medicaid.gov/medicaid/program-information/medicaid-and-chip-enrollment-data/report-highlights/index.html

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Understanding the Difference Between Medicaid and CHIP for Children

Both programs are administered at the state level with federal funding, but they serve slightly different income ranges and operate under different rules. Knowing which one your child may be eligible for helps you apply to the right program from the start.

Medicaid for Children

Medicaid covers children in lower-income households. Under federal law, states must cover children up to at least 133% of the Federal Poverty Level (FPL), and many states have expanded that threshold significantly higher. Coverage is comprehensive: doctor visits, hospital care, dental, vision, mental health services, and prescriptions are typically included at little or no cost to the family.

Children's Health Insurance Program (CHIP)

CHIP was created specifically for children whose families earn too much to qualify for Medicaid but still cannot reasonably afford private insurance. Most states set CHIP eligibility somewhere between 200% and 300% of FPL, though some states go higher. In a handful of states, CHIP has been expanded to cover pregnant women as well.

Because income thresholds vary so significantly by state, a family that doesn't qualify in one state might qualify in another — and thresholds are adjusted annually. Always check your specific state's current limits rather than relying on general figures.

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Who May Be Eligible: A Plain-English Breakdown

Your child may be able to access Medicaid or CHIP coverage if:

  • They are under age 19 (some states cover up to age 21 in certain circumstances)
  • Your household income falls within your state's eligibility range — which could be anywhere from 133% to over 300% of FPL depending on the program and state
  • Your child is a U.S. citizen or meets qualified immigration status requirements — note that many states also cover lawfully present immigrant children, and some states use state-only funds to cover children regardless of immigration status
  • Your child is not already enrolled in qualifying employer-sponsored insurance — though some states allow CHIP enrollment even when other insurance is available

Important: You do not need to be employed, and you do not need to have a permanent address to apply. Families experiencing housing instability can still apply on behalf of their children.

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What Documents You'll Likely Need

Gathering documents before you apply can significantly speed up the process. While exact requirements vary by state, most applications will ask for:

  • Proof of your child's age — birth certificate, hospital record, or passport
  • Proof of identity for the applying parent or guardian — driver's license, state ID, or passport
  • Proof of household income — recent pay stubs (typically the last 30–60 days), most recent tax return, or a letter from an employer; if self-employed, bank statements or a self-employment ledger
  • Proof of residency — a utility bill, lease agreement, or official mail showing your current address
  • Social Security numbers — for the child and, in most cases, for the parent or guardian applying (some states do not require SSNs for all household members)
  • Current health insurance information — if your child has any existing coverage, bring that documentation as well

If you're missing any of these documents, don't let that stop you from starting the process. Many state agencies can work with you to gather what's needed, and some documents can be submitted after the initial application.

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How to Apply: Step-by-Step

Step 1: Find Your State's Program

Every state runs its own Medicaid and CHIP program, sometimes under a different name. For example, California's program is called Medi-Cal, Texas runs CHIP under the Texas Children's Health Insurance Program, and New York has Child Health Plus. Start at InsureKidsNow.gov (a federal resource from HHS) or Benefits.gov to find your state's specific program and application portal.

Step 2: Choose Your Application Method

Most states offer multiple ways to apply: - Online through your state's Medicaid or CHIP portal (often the fastest option) - By phone — call your state Medicaid agency directly - In person at a local Department of Social Services, community health center, or enrollment assistance site - Through HealthCare.gov — if you're applying during open enrollment, the marketplace can screen your child for Medicaid/CHIP eligibility automatically

Step 3: Complete the Application Accurately

List all household members and all sources of income, even irregular income. Underreporting income can cause problems later, including potential repayment requirements. If your income fluctuates (gig work, seasonal employment), most states have guidance on how to estimate annual income — ask the caseworker if you're unsure.

Step 4: Submit and Track Your Application

After submitting, you should receive a confirmation number or letter. Federal rules require most states to process CHIP applications within 45 days (or 90 days if verification requires additional steps). Medicaid applications for children are often processed faster — sometimes within a few weeks.

Step 5: Respond Promptly to Any Requests

If the agency needs additional documentation, respond as quickly as possible. Missing a deadline for additional information is one of the most common reasons applications are delayed or denied.

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What Happens After the Continuous Enrollment Unwinding

From March 2020 through early 2023, federal law prevented states from disenrolling anyone from Medicaid during the public health emergency. When that protection ended, states began a process called "unwinding" — reviewing all enrollees to confirm ongoing eligibility. Millions of children were disenrolled during this period, in many cases due to administrative reasons (outdated addresses, paperwork not returned) rather than actual ineligibility.

If your child lost Medicaid or CHIP coverage during 2023 or 2024 for any reason, they may still be eligible. Many states have re-enrollment pathways specifically for families affected by the unwinding. Contact your state Medicaid agency directly or visit Benefits.gov to explore options.

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If Your Child Was Denied: What to Do Next

A denial is not necessarily the final word. You have the right to appeal any Medicaid or CHIP decision. The denial notice you receive must include: - The specific reason for denial - Instructions for how to file an appeal - The deadline to appeal (typically 30–90 days from the date of the notice)

You can also request a fair hearing — a formal review process where you can present your case. Free legal aid organizations in most states can help you navigate an appeal at no cost.

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People Also Ask

Q: Does my child need a Social Security number to apply for CHIP or Medicaid? A: In most states, children applying for Medicaid or CHIP need a Social Security number, but there are exceptions. Some states cover children using state-only funds regardless of immigration or SSN status. Contact your state Medicaid agency directly to ask about options for children without SSNs — don't assume a denial before you apply.

Q: Can my child get Medicaid or CHIP if I have a job with health insurance available? A: Possibly. If your employer's plan is considered unaffordable or doesn't meet minimum coverage standards, your child may still qualify for CHIP in many states. Some states also allow CHIP enrollment even when employer coverage is available. Eligibility depends on your state's specific rules and your household income relative to FPL.

Q: How long does CHIP or Medicaid coverage last once approved? A: Once approved, coverage is typically granted for 12 months before a renewal review. During that period, you should report significant changes in income or household size. At renewal, you'll need to confirm your child still meets eligibility requirements. Many states now conduct renewals automatically using existing data when possible.

Q: What does CHIP actually cover for children? A: CHIP coverage varies by state but generally includes routine checkups, immunizations, doctor and specialist visits, hospital care, dental care, vision care, prescription medications, and mental health services. Some states also cover hearing services and physical therapy. There may be small copayments for some services depending on your income level and state rules.

Q: My child lost CHIP coverage during the Medicaid unwinding. Can they re-enroll? A: Yes, in most cases. If your child lost coverage during the 2023–2024 unwinding period — especially for administrative reasons — they may be able to re-enroll if they still meet income and eligibility requirements. Contact your state Medicaid agency or visit Benefits.gov to start the process. There is no penalty for re-applying.

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Program eligibility and availability vary by state. Not affiliated with any government agency.

Last reviewed: October 2026