Medicaid: The History of Children’s Health

Medicaid’s history is the history of children’s health in our country.

And its future is their future.

When Medicaid became law in 1965, it was a narrow program designed to provide health coverage for Americans who received welfare benefits.

Over the next 60 years, it grew into the largest source of health care coverage for kids in the U.S.

Along with the Children’s Health Insurance Program (CHIP), Medicaid insures roughly 50% of children nationwide. And on average, more than half of children’s hospital patients are covered by the programs.

This evolution came from realizing children covered by Medicaid are healthier and achieve better educational and economic outcomes than kids without health insurance — which means a healthier nation overall.

We make progress by remembering this, by strengthening this lifeline for kids, not by stripping it away.

Medicaid: Then and now

Created in 1965 alongside Medicare, Medicaid began as a joint federal-state program providing health coverage to Americans receiving cash welfare.

Two years later, federal law made a significant addition for kids: the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, requiring Medicaid to cover comprehensive screening, prevention, diagnosis, and treatment for children.

That meant earlier interventions and healthier children.

In Medicaid’s first full decade, infant mortality dropped 35% and early childhood mortality declined 24%. And research showed that coverage led to long-term adult health, economic stability, and educational success.

So the program grew.

Throughout the 1980s, Congress passed several laws expanding eligibility for children. Between 1987 and 1996, the number of children enrolled in Medicaid increased 85%, from 8.27 million to 15.34 million.

The creation of CHIP in 1997 extended coverage to families whose income was too high for Medicaid but too low to make private insurance affordable. This helped more than double the fraction of children eligible for public health insurance coverage from 1986 to 2004.

Then in 2010, the Affordable Care Act established a national minimum Medicaid eligibility floor for children and simplified enrollment, helping more families keep coverage.

Through Medicaid’s expansions, as many as 6 million more children began receiving preventive care. Child mortality and preventable hospitalizations declined, and mothers gave birth to healthier babies.

And over the long term, they led to higher levels of education and earnings.

In short, when Medicaid expanded, children’s health and our country’s economic outlook improved.

Medicaid’s future, our future

Today, Medicaid is the backbone of children’s health care in America. Along with CHIP, it covers nearly 35 million children.

Medicaid’s past shows us the path forward.

When we provide better public health care coverage for our kids, we build a better future for our nation.

Read more about Medicaid and how the Children’s Hospital Association is working to strengthen and protect it.