Uninsured Children

Uninsured Children in Tennessee

Tennessee

Health insurance is a critical factor in ensuring children receive the preventive and acute medical care they need to achieve and maintain good health. Benefits of health insurance coverage include improved access to and use of preventive, primary and specialty health care, improved quality of health care and improved health outcomes.

When compared with privately insured children, uninsured children have more health disadvantages, including:

• Unmet medical or dental care needs.
• More hospitalizations.
• Higher in-hospital mortality rates. 
• In 2021, among children ages 0-17 who had insurance, 53.1% had coverage through private plans and 44.7% had coverage through public plans, including Medicaid, Children’s Health Insurance Program (CHIP) and other government-sponsored health plans.

The prevalence of uninsurance is higher among:

• Hispanic children compared with non-Hispanic white, non-Hispanic Black and Asian children.
• Children from lower-income families compared with those from higher-income families. The high cost of insurance is often cited as the reason for lack of coverage. 
• Children living in states that did not expand Medicaid compared with children living in expansion states.

While the percentage of children covered by private plans has decreased in recent decades, the percentage covered by public programs has increased. Public programs such as Medicaid and CHIP have made significant strides in increasing access to and quality of care and improving health status for low-income children. More than 9 million children were enrolled in CHIP in 2020. Expanding Medicaid eligibility to those living below 138% of poverty through the Patient Protection and Affordable Care Act has resulted in fewer uninsured children compared with states that have not expanded Medicaid eligibility.

Increasing the proportion of Americans with health insurance is a Healthy People 2030 leading health indicator.

Abdullah, Fizan, Yiyi Zhang, Thomas Lardaro, Marissa Black, Paul M. Colombani, Kristin Chrouser, Peter J. Pronovost, and David C. Chang. 2010. “Analysis of 23 Million US Hospitalizations: Uninsured Children Have Higher All-Cause in-Hospital Mortality.” Journal of Public Health 32 (2): 236–44. https://doi.org/10.1093/pubmed/fdp099.

Cohen, Robin, Michael Martinez, Amy Cha, and Emily Terlizzi. 2021. “Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January–June 2021.” National Center for Health Statistics. https://doi.org/10.15620/cdc:110854.

“Health, United States, 2018.” 2019. Hyattsville, MD: National Center for Health Statistics. https://www.cdc.gov/nchs/data/hus/hus18.pdf.

Marks, Caryn, Cathy Hoffman, and Julia Paradise. 2009. “The Impact of Medicaid and SCHIP on Low-Income Children’s Health.” Issue Brief. KFF. https://www.kff.org/medicaid/issue-brief/the-impact-of-medicaid-and-schip-on/.

Paradise, Julia. 2014. “The Impact of the Children’s Health Insurance Program (CHIP): What Does the Research Tell Us?” Issue Brief. KFF. https://www.kff.org/report-section/the-impact-of-the-childrens-health-insurance-program-chip-issue-brief/.

Racine, Andrew D., Thomas F. Long, Mark E. Helm, Mark Hudak, Budd N. Shenkin, Iris Grace Snider, Patience Haydock White, Molly Droge, and Norman "Chip Harbaugh " Jr. 2014. “Children’s Health Insurance Program (CHIP): Accomplishments, Challenges, and Policy Recommendations.” Pediatrics 133 (3): e784–93. https://doi.org/10.1542/peds.2013-4059.

Szilagyi, Peter G., Mark A. Schuster, and Tina L. Cheng. 2009. “The Scientific Evidence for Child Health Insurance.” Academic Pediatrics 9 (1): 4–6. https://doi.org/10.1016/j.acap.2008.12.002.

Tolbert, Jennifer, Kendal Orgera, Natalie Singer, and Anthony Damico. 2019. “Key Facts about the Uninsured Population.” Issue Brief. KFF. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/.