Uninsured Children in America
Approximately 6% of all children, ages 0 to 18, nationwide lacked health insurance in 2024. The share of uninsured children in America has not been this high since 2014, according to an analysis by Georgetown University.
The benefits of health insurance for children are well documented. When compared to their uninsured peers, kids with health care coverage are more likely to:
- have visited a health care provider within the last year;
- have their medical issues identified earlier;
- finish a multi-dose vaccine series;
- attend school; and
- grow into healthy adults.
How Many Children Are Uninsured in the United States?
Census data tracks how many uninsured children are living in the United States. While the number of kids without health insurance has fluctuated over time, the current uninsured rate of 6% translates to about 4.6 million children without health care coverage nationwide.
From 2022 to 2024, the total number of children without health insurance grew by 18%; this increase equates to 716,000 more children without health care coverage nationwide.
Which Children Lack Health Insurance?
Certain child populations are more likely than others to lack health insurance. For example:
- Kids living in rural communities are less likely to have continuous health insurance coverage relative to their urban peers, according to researchers from the University of South Carolina.
- Children from low in-come families are more likely to lack health care coverage when compared to their general population peers. In 2024, 8.5% of low-income children were uninsured relative to just 6% of kids nationwide.
The share of kids without health care coverage also varies across the nation’s major racial and ethnic groups. This rate is:
- 12.4% for American Indian/Alaska Native children.
- 9.7% for Hispanic/Latino children.
- 5.5% for Black children.
- 4.9% for white children.
- 3.8% for Asian children.
Uninsured Children by State
The 2024 U.S. Census Bureau’s American Community Survey gathers data on health care insurance rates. The survey’s findings reveal that a child’s likelihood of being uninsured varies widely by state.
Massachusetts reports the lowest rate for children without health insurance (2.1% of kids statewide) followed by New Hampshire (2.3%), Michigan (3.5%) and Washington (3.9%).
Texas reports the highest rate of children without insurance (13.6% of kids statewide) followed by Oklahoma and Florida (8.5% for each).
Comparing survey results from 2022 and 2024 reveals that the rate of uninsured children increased significantly in 22 states. During this period, Texas alone added 246,000 children without health insurance coverage for a total of 1.1 million uninsured kids statewide. Only one state reported meaningful improvements: New Hampshire’s rate of uninsured children dropped from 3.4% to just 2.3%.
Health Insurance Programs for Children
Two state-run programs provide health insurance to nearly half of all kids in the United States. These programs are:
- Medicaid, established in 1965, is a health insurance program serving low-income earners and families as well as people with disabilities pay for health care.
- Children’s Health Insurance Program (CHIP), signed into law in 1997, supports children in families who do not qualify for Medicaid and cannot afford private health insurance.
Both programs offer important health services — routine and emergency care, immunizations, dental and vision care, mental health support and more — to help children as they grow and develop. In September 2025, Medicaid and CHIP combined covered nearly 37 million children, ages 0 to 18.
In 2010, Congress enacted the Affordable Care Act (ACA; also referred to as “Obamacare”) to expand and improve health care access nationwide. Some of the law’s key objectives include:
- Establishing essential health insurance benefits that must be covered.
- Providing subsidies to make the coverage more affordable.
- Prohibiting insurers from denying health care coverage on the grounds of a pre-existing condition.
- Incentivizing states to expand their Medicaid coverage to more low-income families.
- Extending coverage to age 26 for young adults on a parental plan.
- Creating new health insurance marketplaces and regulations.
By the close of 2024, a record high of 2.6 million children were enrolled in ACA Marketplace coverage nationwide. As of September 2025, all but 10 states had adopted the ACA’s Medicaid expansion. These 10 states are: Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.
Trends in Uninsured Children
Prior to the ACA’s passage, programs like Medicaid and CHIP helped reduce the number of uninsured children. In the 1980s and 1990s, Medicaid expanded to include more children and pregnant people, and CHIP gave coverage to kids whose families earned too much for Medicaid. States also made it easier for families to sign up, lowering the rate of uninsured children.
Following the passage of the ACA in 2010 and the rollout of the coverage provisions, the share of uninsured children continued to fall nationwide. In 2010, 6.7 million children (8.5% of all kids) lacked health care coverage. By 2016, this total had dipped to an all-time low of 3.6 million uninsured children (4.7% of all kids).
From 2017 to 2019, the nation’s uninsured rate rose and, with it, the share of children without health care coverage rose. These changes occurred alongside several federal policy changes, such as cutting outreach funding, adding barriers to Medicaid renewal, changing immigration policies and limiting enrollment.
During the COVID-19 pandemic, which began in late 2019, the federal government passed new policies to help people retain their health care coverage. The Families First Coronavirus Response Act required states to keep Medicaid participants enrolled, and the American Rescue Plan Act made health insurance subsidies under the ACA more affordable. These subsidies, extended by the Inflation Reduction Act, expired on Dec. 31, 2025.
From 2019 to 2022, the nation’s rate of uninsured children fell. More recently, however, this progress has stalled. Both the number and share of uninsured kids increased from 2022 to 2024 — growing from 3.9 million uninsured kids (5.1% of all kids) in 2022 to 4.6 million uninsured kids (6% of all kids) in 2024. This change represents an 18% increase in the number of uninsured children nationwide in just two years.
Consider these uninsured children trends for different child population groups from 2022 to 2024:
- Younger children, ages 0 to 5: Increased from 4% (958,000 kids) to 5% (1.2 million kids).
- School-aged children, ages 6 to 18: Increased from 5% (3 million kids) to 6% (3.5 million kids).
- American Indian or Alaska Native children: Increased from 11% (95,000 kids) to 12% (111,000 kids).
- Hispanic or Latino children: Increased from 8% (1.6 million kids) to 10% (2 million kids).
- Black children: Increased from 4% (440,000 kids) to 6% (563,000 kids).
- Asian and Pacific Islander children: The rate remained steady at 4% while the total number of uninsured kids increased from 161,000 to 164,000.
- Non-Hispanic white children: The rate remained steady at 4% while the total number of uninsured kids increased from 1.4 million to 1.6 million.
Experts also pay attention to where children live. Children living in rural areas are more likely to be uninsured when compared to their urban peers. The child uninsured rate is 6.6% in rural areas versus 5.1% in urban areas, according to 2024 American Community Survey results. Children living in rural areas also less likely than their urban peers to have private or employer-based health insurance and more likely to get coverage through public programs like Medicaid.
Why Child Health Insurance Matters
The Annie E. Casey Foundation — as well as a robust body of research — supports providing consistent, adequate health care coverage to all children.
When children stay insured, they are more likely to go to regular checkups, have a regular doctor and get the care they need when they need it. Health care coverage that pays for necessary services and visits helps prevent unmet medical needs and improves the quality of care a child will receive, according to researchers. The positive effects of having health insurance as a child can last into adulthood, leading to better health and fewer hospital stays or chronic issues later in life.
Children eligible for public insurance are especially likely to see the benefits of health coverage, including increased economic stability for their families. For instance, when a family receives Medicaid, they can use more of their income on other basic needs like food and housing. Medicaid has also been linked to reduced medical debt and bankruptcies, and it is considered one of the nation’s leading anti-poverty programs. Insuring parents helps children, too. It increases the likelihood of parental health and strengthens parents’ ability to care for their children.
