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Schools across the country are focusing keenly on two key priorities: teaching children to read and bringing down high chronic absenteeism rates that undermine learning.

Both these goals could be scuttled by an alarming increase in the number of young children who lack access to healthcare. Our new shows that nearly 1.2 million children under age 6 were uninsured in 2024, and that number has been on the rise, with about 220,000 of them losing coverage between 2022 and 2024. That’s a 23% hike, larger than the increase seen for older children. It brings the rate of uninsured youngsters to its highest level in nearly a decade.Ìý

Drawn from U.S. Census Bureau data, the numbers are a harbinger of what’s to come, given the nearly $1 trillion in Medicaid cuts that Congress approved in 2025. Some under age 19 have been disenrolled since January 2025, signaling real potential for these trends to grow worse.  

The children under age 6 include newborn babies, toddlers, preschoolers and kindergartners — all going through key stages of brain development that require regular well-child visits and follow-up appointments to assess their physical and social-emotional health. The American Academy of Pediatrics’ evidence-based recommend 12 check-ups by age 3 to help ensure that children are developing properly and receiving necessary preventive care.

links expanding Medicaid eligibility to improved fourth and eighth grade reading scores on the National Assessment of Educational Progress. That likely means that health providers are identifying the sort of developmental delays and disabilities that can keep young children from learning to read — and that youngsters are receiving early interventions that can help to turn these problems around before kindergarten. These issues become harder and more expensive to address when children are older. 

Access to medical care can also ensure that children miss fewer days of school. — even in preschool and kindergarten — add up to weaker reading skills and math skills later. National trends show that young students miss the most school days in these early grades.

Our analysis found that more than half of states saw in the number or rate of uninsured young children between 2022 and 2024. Connecticut actually saw its rate drop during that period. But 16 states saw significant increases. More than 73,000 children under age 6 joined the ranks of the uninsured in Texas, where 253,000 youngsters — 1 in 10 —  lack coverage. In Florida, 27,000 young children became uninsured, bringing the state’s total to nearly 104,000. In North Dakota, the number of young children is far smaller, but the rate of those uninsured jumped from 5.3% to 9.8% in just two years.

Much of the change can be attributed to the end of pandemic-era protections that kept children enrolled in Medicaid and the Children’s Health Insurance Program. When the federal requirement for continuous coverage expired, hundreds of thousands of children lost their insurance. 

In some cases, their families no longer qualified for the healthcare programs offered for lower-income children. But in far more instances, children lost coverage because of administrative hurdles, red tape or even .Ìý

Most of those who lost coverage are U.S. citizens. While we do not yet have data to show trends in 2025 and 2026, we are concerned about the ways stricter immigration enforcement is creating a on Medicaid enrollment. In some places, families with children who are citizens declined to enroll them for fear that their participation could endanger family members. The Trump administration’s aggressive seem likely to exacerbate that trend. 

So will a new requirement that all low-income adults on Medicaid prove that they are looking for work. It may seem counterintuitive that a provision aimed at adults would affect health access for children, but past show that when parents lose access to Medicaid, their kids as well.

So what can states do to turn these trends around?

The first step is to ensure more young children don’t lose their health coverage. That means paying careful attention to Medicaid and CHIP, which currently cover nearly three-fourths of all low-income children under age 6. of the nation’s uninsured children were likely eligible but not enrolled in these programs in 2019, the most recent year for which data is available. Historically, that number is closer to two-thirds.

Keeping kids enrolled in Medicaid helps parents afford and needed interventions for physical and emotional health concerns in the early years. These steps pay dividends later on by preventing children from needing special education services and other costly support when they’re older.  

State leaders should review their rules to ensure new enrollment and renewal requirements for adults don’t affect their children’s coverage. They and their community partners can help families understand that changes to parents’ coverage need not affect children. 

Unlike adults, children in every state are entitled to 12 months of uninterrupted coverage. State lawmakers can take that a step further by monitoring children’s enrollment to ensure the state is correctly implementing for all children covered by Medicaid, and by investing in community-based outreach and enrollment assistance. 

allow continuous eligibility for young children for up to five years, keeping them covered from birth to kindergarten; many cite school readiness among their objectives. Unfortunately, the Trump administration has said it will not policies, effectively taking this promising tool off the table. 

that young children with access to health coverage are more likely than those without to graduate from high school and college, and even grow up to earn more money and pay more in taxes. Medicaid is a smart investment that can keep young children on track to learn and succeed in life, providing long-term benefits for families and society as well. States should take every possible step to protect coverage for infants, toddlers and preschoolers to maximize this investment.

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