The State of America's Children® 2020

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The State of America’s Children 2020 – Child Health Tables2020-02-19T12:31:32-05:00

Table 13A: Uninsured Children—A Portrait Number and Percent of People Uninsured by Age, 2017 and 2018

2017 2018 Change 2017-2018
Number Percent Number Percent Number Percent
Total, All Ages 25,600,000 7.9 27,462,000 8.5 1,862,000 7.6
Under 19 3,856,000 5.0 4,281,000 5.5 425,000 10.0
Under 3 575,000 5.1 699,000 6.4 124,000 25.5
3 to 5 Years 475,000 4.0 515,000 4.3 40,000 7.5
6 to 11 Years 1,123,000 4.6 1,188,000 4.8 65,000 4.3
12 to 18 Years 1,682,000 5.7 1,878,000 6.3 196,000 10.5
19-64 21,248,000 11.0 22,690,000 11.7 1,442,000 6.4

Table 13B: Uninsured Children By Age, Race/Ethnicity, Poverty Level, Citizenship and Region, 2017 and 2018

Percent Uninsured in 2017 Percent Uninsured in 2018 Percent Change 2017-2018 One out of Every ___ Is Uninsured
All Children Under 19 5.0% 5.5% 10.0% 18
By Age
Under 3 5.1 6.4 25.5 16
3 to 5 Years 4.0 4.3 7.5 23
6 to 11 Years 4.6 4.8 4.3 21
12 to 18 Years 5.7 6.3 10.5 16
By Race/Ethnicity
White 3.7 4.2 13.5 24
Hispanic 7.7 8.7 13.0 11
Black 4.5 4.6 2.2 22
Asian 3.6 4.1 13.9 24
By Poverty Level
Below 100% of poverty 7.5 7.8 4.0 13
100%-399% of poverty 6.1 6.7 9.8 15
400%+ of poverty 1.9 2.6 36.8 38
By Citizenship
Native-born Citizen 4.7 5.1 8.5 20
Naturalized Citizen 6.4 8.6 34.4 12
Non-Citizen 15.6 18.3 17.3 5
By Region
Northeast 3.4 3.6 5.9 28
Midwest 4.1 3.8 -7.3 26
South 6.5 7.7 18.5 13
West 4.4 4.8 9.1 21

Notes: Uninsured is defined as not covered by any type of insurance (private or public) for the entire year. The White racial category does not include children of Hispanic ethnicity.

Source: Berchick, Edward, Jessica Barnett and Rachel Upton. 2019. “Health Insurance Coverage in the United States: 2018 Current Population Reports.” U.S. Census Bureau. https://www.census.gov/content/dam/Census/library/publications/2019/demo/p60-267.pdf.

Table 14: Children Uninsured and Enrolled in Medicaid/CHIP, 2018a

Uninsured, Ages 0-18 Children Enrollment in Medicaid and CHIP
Uninsured, Under Age 6 Uninsured, Ages
6-18
Uninsured, Ages
0-18
Change in Coverage 2017-2018b State Rank by Percent Uninsuredc Dec 2017 Dec 2018 Change in Enrollment 2017-2018 State Expandedd
Number % Number % Number % Number Number Number Number % Y/N
Alabama 10,358 3.0 30,360 3.7 40,718 3.5 -4,669 17 637,705 650,406 12,701 2.0 No
Alaska 5,803 9.2 12,372 9.5 18,175 9.4 547 49 91,360 94,469 3,109 3.4 Yes
Arizona 35,517 6.8 110,767 9.0 146,284 8.4 -13,140 48 771,821 759,466 -12,355 -1.6 Yes
Arkansas 7,929 3.5 25,786 4.9 33,715 4.5 -315 24 436,335 426,599 -9,736 -2.2 Yes
California 64,883 2.2 233,816 3.5 298,699 3.1 1,933 10 5,124,031 4,971,516 -152,515 -3.0 Yes
Colorado 16,213 4.0 46,019 4.9 62,232 4.6 -4,749 25 610,867 588,054 -22,813 -3.7 Yes
Connecticut 5,285 2.5 15,087 2.6 20,372 2.6 3,984 5 331,812 330,253 -1,559 -0.5 Yes
Delaware 1,532 2.4 6,306 4.1 7,838 3.6 -193 19 105,969 105,732 -237 -0.2 Yes
District of Columbia 820 1.6 1,609 1.9 2,429 1.8 -854 90,716 90,881 165 0.2 Yes
Florida 76,033 5.6 263,011 8.4 339,044 7.6 -14,184 44 2,556,257 2,487,155 -69,102 -2.7 No
Georgia 54,841 7.1 162,449 8.5 217,290 8.1 -17,661 46 1,266,151 1,245,555 -20,596 -1.6 No
Hawaii 2,690 2.6 5,620 2.6 8,310 2.6 -1,272 7 144,476 140,392 -4,084 -2.8 Yes
Idaho 6,841 4.9 21,957 6.6 28,798 6.1 -7,161 40 216,479 202,303 -14,176 -6.5 No*
Illinois 25,912 2.9 76,554 3.6 102,466 3.4 -13,117 15 1,424,819 1,356,850 -67,969 -4.8 Yes
Indiana 30,734 6.1 78,260 6.7 108,994 6.6 -3,209 41 798,671 800,565 1,894 0.2 Yes
Iowa 6,385 2.7 14,637 2.7 21,022 2.7 3,022 8 324,934 334,623 9,689 3.0 Yes
Kansas 10,820 4.9 27,317 5.2 38,137 5.1 1,339 30 269,068 270,256 1,188 0.4 No
Kentucky 12,973 4.0 27,051 3.7 40,024 3.8 882 20 576,740 564,123 -12,617 -2.2 Yes
Louisiana 10,298 2.8 28,906 3.6 39,204 3.4 -3,137 14 739,852 713,819 -26,033 -3.5 Yes
Maine 3,896 5.0 10,616 5.7 14,512 5.5 -1,087 35 110,245 104,796 -5,449 -4.9 No*
Maryland 11,974 2.8 34,796 3.5 46,770 3.3 7,306 12 614,353 618,583 4,230 0.7 Yes
Massachusetts 4,455 1.0 13,501 1.3 17,956 1.2 3,929 1 708,729 685,233 -23,496 -3.3 Yes
Michigan 21,158 3.1 56,701 3.5 77,859 3.4 -8,682 16 950,347 948,635 -1,712 -0.2 Yes
Minnesota 10,436 2.5 34,758 3.7 45,194 3.3 2,011 11 533,361 536,246 2,885 0.5 Yes
Mississippi 8,021 3.7 27,408 5.1 35,429 4.7 1,564 26 442,959 420,209 -22,750 -5.1 No
Missouri 23,431 5.3 59,102 5.9 82,533 5.7 -8,027 36 620,110 564,476 -55,634 -9.0 No
Montana 3,707 5.0 11,210 6.6 14,917 6.1 -1,053 39 128,671 127,863 -808 -0.6 Yes
Nebraska 8,496 5.4 17,732 5.2 26,228 5.2 -513 32 162,432 164,913 2,481 1.5 No*
Nevada 14,288 6.5 43,252 8.6 57,540 8.0 13 45 304,036 303,343 -693 -0.2 Yes
New Hampshire 1,452 1.9 5,804 2.8 7,256 2.6 -918 6 93,672 91,337 -2,335 -2.5 Yes
New Jersey 19,241 3.1 60,520 4.2 79,761 3.9 -1,561 22 842,208 826,159 -16,049 -1.9 Yes
New Mexico 6,148 4.4 20,661 5.6 26,809 5.3 -355 33 342,450 330,359 -12,091 -3.5 Yes
New York 32,491 2.4 74,890 2.5 107,381 2.5 10,122 4 2,495,945 2,504,152 8,207 0.3 Yes
North Carolina 28,389 4.0 101,673 5.9 130,062 5.3 -11,496 34 1,462,960 1,476,805 13,845 0.9 No
North Dakota 4,126 6.6 7,049 5.7 11,175 6.0 2,643 38 44,054 43,094 -960 -2.2 Yes
Ohio 41,642 5.0 90,925 4.7 132,567 4.8 -7,172 28 1,199,240 1,143,206 -56,034 -4.7 Yes
Oklahoma 20,191 6.5 63,225 9.0 83,416 8.2 -1,020 47 507,980 507,792 -188 0.0 No
Oregon 9,183 3.3 23,708 3.7 32,891 3.6 83 18 419,719 414,548 -5,171 -1.2 Yes
Pennsylvania 41,652 5.0 82,129 4.1 123,781 4.4 1,136 23 1,402,983 1,390,084 -12,899 -0.9 Yes
Rhode Island 1,697 2.5 3,088 2.0 4,785 2.2 -152 3 123,138 122,710 -428 -0.3 Yes
South Carolina 13,465 3.9 42,211 5.1 55,676 4.7 4,523 27 649,599 653,431 3,832 0.6 No
South Dakota 3,756 5.2 9,555 6.2 13,311 5.9 537 37 80,698 78,791 -1,907 -2.4 No
Tennessee 20,741 4.3 62,183 5.6 82,924 5.2 -12,145 31 876,131 787,826 -88,305 -10.1 No
Texas 198,014 8.3 674,780 12.4 872,794 11.2 -38,124 50 3,552,079 3,406,298 -145,781 -4.1 No
Utah 19,624 6.6 52,634 7.7 72,258 7.4 -1,071 43 210,398 195,061 -15,337 -7.3 No*
Vermont 445 1.2 2,018 2.3 2,463 2.0 -435 2 63,873 63,270 -603 -0.9 Yes
Virginia 27,337 4.5 74,231 5.3 101,568 5.1 -150 29 683,182 702,460 19,278 2.8 Yes
Washington 12,993 2.4 34,489 2.9 47,482 2.7 -1,384 9 844,862 829,464 -15,398 -1.8 Yes
West Virginia 3,852 3.4 9,248 3.4 13,100 3.4 -2,567 13 220,127 214,948 -5,179 -2.4 Yes
Wisconsin 13,999 3.5 37,098 3.9 51,097 3.8 1,633 21 487,265 480,642 -6,623 -1.4 No
Wyoming 3,213 7.7 6,911 6.9 10,124 7.1 3,806 42 40,929 38,918 -2,011 -4.9 No
United States 1,019,380 4.3% 3,035,990 5.6% 4,055,370 5.2% -130,560 37,736,798 36,908,669 -828,129 -2.2%

a Uninsured at the time of the survey, not necessarily for the entire year. These numbers are among children ages 0-18.

b Calculations were based on a comparison with data from 2017 American Community Survey 1-Year Estimates, Table S2701- Selected Characteristics of Health Insurance Coverage.

c States are ranked 1-50 with 1 meaning the highest percent of children who are uninsured and 50 meaning the lowest percent of children who are uninsured.

d These states had expanded Medicaid to 138 percent of the FPL for all eligible adults in the state as of January 2019. An asterisk (*) denotes the state has expanded Medicaid between January 2019 and January 2020. When parents are covered, their children are more likely to also be covered.

Note: Uninsured numbers and percents in this table cannot be directly compared to those from the Current Population Survey (CPS) as they come from different surveys.

Sources: U.S. Census Bureau. 2019. 2018 American Community Survey 1-Year Estimates, Table B27001 – Health Insurance Coverage Status by Sex by Age. https://data.census.gov/cedsci/; Brooks, Tricia, Edwin Park and Lauren Roygardner. 2019. “Medicaid and CHIP Enrollment Decline Suggests the Child Uninsured Rate May Rise Again.” Appendix Table 1. Georgetown University Health Policy Institute Center for Children and Families. https://ccf.georgetown.edu/wp-content/uploads/2019/06/Enrollment-Decline.pdf; Kaiser Family Foundation. 2020. “Status of State Action on the Medicaid Expansion Decision, as of January 10, 2020. https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/.

Table 15: Selected Characteristics of State Medicaid and CHIP Programs, 2019

Upper-Income  Eligibility for Medicaid/CHIP   (Percent of FPL) CHIP Waiting Periodb 12-month Continuous Eligibilityc Lawfully-Residing Immigrant Children Covered without
5-Year Waitd
Medicaid Expansion Statee
Alabama 317% M, C No No
Alaska 208% M, n/a No Yes
Arizona 205% 90 days No Yes
Arkansas 216% 90 days C Yes Yes
California 266% M, n/a Yes Yes
Colorado 265% M, C Yes Yes
Connecticut 323% Yes Yes
Delaware 217% C Yes Yes
District of Columbia 324% n/a Yes Yes
Florida 215% 2 months C Yes No
Georgia 252% No No
Hawaii 313% n/a Yes Yes
Idaho 190% M, C No Yes
Illinois 318% 90 days M,C Yes Yes
Indiana 262% 90 days No Yes
Iowa 380% 1 month M, C Yes Yes
Kansas 240% 90 days M, C No No
Kentucky 218% Yes Yes
Louisiana 255% 90 days M, C No Yes
Maine 213% 90 days M, C Yes Yes
Maryland 322% n/a Yes Yes
Massachusetts 305% Yes Yes
Michigan 217% M, n/a No Yes
Minnesota 288% n/a Yes Yes
Mississippi 214% M, C No No
Missouri 305% No No
Montana 266% M, C Yes Yes
Nebraska 218% n/a Yes Yes
Nevada 205% C Yes Yes
New Hampshire 323% n/a No Yes
New Jersey 355% 90 days M, C Yes Yes
New Mexico 305% M, n/a Yes Yes
New York 405% M, C Yes Yes
North Carolina 216% M, C Yes No
North Dakota 175% 90 days M, C No Yes
Ohio 211% M, n/a Yes Yes
Oklahoma 210% n/a No No
Oregon 305% M, C Yes Yes
Pennsylvania 319% C Yes Yes
Rhode Island 266% n/a Yes Yes
South Carolina 213% M, n/a Yes No
South Dakota 209% 90 days No No
Tennessee 255% C No No
Texas 206% 90 days C Yes No
Utah 205% 90 days C Yes Yes
Vermont 317% n/a Yes Yes
Virginia 205% Yes Yes
Washington 317% M, C Yes Yes
West Virginia 305% M, C Yes Yes
Wisconsin 306% Yes No
Wyoming 205% 1 month M, C No No

a Highest level of income eligibility for Medicaid or CHIP as a percent of the federal poverty level (FPL).

b “Waiting period” refers to the length of time a state requires a child to be uninsured prior to enrolling in CHIP, although every state has exceptions. The ACA prohibited waiting periods longer than 90 days starting in 2014.

c “M” denotes 12-month continuous eligibility for Medicaid. “C” denotes 12-month continuous eligibility for CHIP. “n/a” denotes the state does not provide a separate CHIP program for uninsured children.

d These states cover immigrant children who have been lawfully residing in the U.S. for less than five years under the Immigrant Children’s Health Improvement Act (ICHIA) option with state funds.

e These states have expanded Medicaid to 138 percent of the FPL for all eligible adults in the state as of January 2020. When parents are covered, their children are more likely to also be covered.

Sources: Brooks, Tricia, Lauren Roygardner and Samantha Artiga. 2019. “Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Practices as of January 2019: Findings from a 50-State Survey.” Georgetown University Center for Children and Families and Kaiser Family Foundation. https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/; Kaiser Family Foundation. 2020. “Status of State Action on the Medicaid Expansion Decision, as of January 10, 2020. https://www.kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/.

Table 16A: Births Covered by Medicaid and Infant Mortality, Select Years

Births Covered by Medicaid, 2010 Infant Mortality, 2017
(Rate per 1,000 Births)
Percent Number All Races/ Ethnicitiesa White Black Hispanic
Alabama 52.5% 31,498 7.4 5.6 11.2 4.8
Alaska 52.6 6,053 5.7 4.4 n/a n/a
Arizona 53.3 46,393 5.7 4.2 11.3 6.0
Arkansas 67.1 25,659 8.2 7.2 12.9 5.9
California 47.6 242,732 4.2 3.3 8.4 5.0
Colorado 36.8 24,431 4.5 3.9 8.7 5.3
Connecticut 31.4 11,770 4.5 3.3 10.3 4.6
Delaware 48.6 5,529 6.6 n/a 12.8 n/a
District of Columbia 67.9 6,218 8.1 n/a 12.2 n/a
Florida 48.8 104,721 6.1 4.6 10.2 5.3
Georgia 41.9 56,009 7.2 4.9 11.5 5.1
Hawaii 24.0 4,551 5.3 n/a n/a 7.9
Idaho 38.6 8,954 4.6 4.4 n/a n/a
Illinois 52.0 85,978 6.1 4.4 13.3 5.4
Indiana 46.6 39,071 7.3 5.9 15.3 7.6
Iowa 40.5 15,582 5.3 4.8 10.6 6.2
Kansas 32.5 13,159 6.1 5.0 11.8 7.2
Kentucky 43.6 23,594 6.5 6.2 10.1 6.3
Louisiana 69.0 43,175 7.1 4.6 11.1 5.9
Maine 63.0 8,164 5.7 5.8 n/a n/a
Maryland 25.9 19,132 6.4 4.0 11.1 4.7
Massachusetts 26.8 19,485 3.7 2.9 6.8 5.2
Michigan 45.3 51,944 6.8 4.6 14.0 7.8
Minnesota 43.8 29,983 4.8 3.6 9.4 5.0
Mississippi 64.7 25,864 8.6 6.3 11.6 n/a
Missouri 42.2 32,411 6.2 5.2 13.0 n/a
Montana 35.0 4,225 5.4 4.4 n/a n/a
Nebraska 31.1 8,070 5.6 5.2 10.4 4.6
Nevada 44.1 15,737 5.8 4.9 10.4 5.4
New Hampshire 29.9 3,845 4.2 3.9 n/a n/a
New Jersey 28.1 28,499 4.5 3.0 11.0 4.5
New Mexico 53.4 14,832 5.9 5.0 n/a 6.1
New York 45.8 111,144 4.6 3.4 8.6 4.3
North Carolina 53.8 65,775 7.1 5.0 12.4 5.7
North Dakota 28.5 2,594 4.3 3.3 n/a n/a
Ohio 38.2 53,140 7.2 5.3 15.9 7.2
Oklahoma 64.0 33,125 7.7 5.9 14.3 8.5
Oregon 44.9 20,463 5.4 4.6 n/a 7.0
Pennsylvania 32.7 45,260 6.1 4.6 13.5 6.3
Rhode Island 46.1 5,142 6.2 5.6 n/a n/a
South Carolina 50.0 29,153 6.5 5.0 10.1 5.0
South Dakota 36.0 4,244 7.8 7.2 n/a n/a
Tennessee 51.3 40,703 7.4 6.0 12.7 6.5
Texas 47.6 187,140 5.9 4.9 10.7 5.5
Utah 30.6 15,911 5.9 5.6 n/a 6.6
Vermont 46.6 2,901 4.8 4.3 n/a n/a
Virginia 29.0 30,626 5.9 4.5 10.1 5.1
Washington 38.8 33,545 3.9 3.5 10.2 4.7
West Virginia 51.8 10,575 7.0 6.6 n/a n/a
Wisconsin 49.5 33,848 6.4 4.4 17.3 7.7
Wyoming 38.4 2,892 4.6 4.7 n/a n/a
United States 47.8% 1,805,151 5.8 4.6 11.5 5.4

Table 16B: National Maternal Mortality by Race, 2013-17 (Rate per 100,000 Live Births)

Race/Ethnicity Maternal Mortaliy Rate
All Races/Ethnicities 29.6
White 26.1
Black 63.8
Hispanic 19.6
Asian/Pacific Islander 17.0
American Indian/Alaskan Native 43.6

Notes: Infant mortality is defined as death before age 1. Race/ethnicity is based on the infant’s race/ethnicity. White and Black racial categories exclude infants of Hispanic ethnicity. Hispanic infants can be of any race. Data for other racial/ethnic groups were not available. “n/a” means data reported by state did not meet standard of reliability or precision according to the Center for Disease Control and Prevention.

Sources: Markus, Anne Rossier et al. 2013. “Medicaid Covered Births, 2008-2010, in the Context of the implementation of Health Reform.” Women’s Health Issues Journal 23-5; The Centers for Disease Control and Prevention. 2019. “Deaths: Final Data for 2017.” Table 15. National Vital Statistics Report 68 (9). https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf; United Health Foundation, America’s Health Rankings. 2019. “National Maternal Mortality.” CDC Wonder Online Database, 2013-2017. https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/maternal_mortality_a/state/ALL.