Barriers to Medicaid and CHIP Coverage for Eligible but Uninsured Latinx Children: A Texas Case Study

Implementation of the Affordable Care Act (ACA), including expansion of Medicaid eligibility for adults in many states, has significantly reduced the number of uninsured children in the nation. "Welcome mat" effects of Medicaid expansion, whereby children already eligible for Medicaid become insured when parents seek or enroll in Medicaid as well, and improvements in outreach and enrollment processes are largely credited for the decrease. However, reductions in children’s uninsured rates under the ACA have not been equitable for all. Despite declining by nearly half between 2014 and 2018 nationwide, uninsured rates for Latinx children are the highest of all racial and ethnic groups and nearly double the national average.

Maximizing enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) among those eligible is one way to reduce uninsurance rates for Latinx children. To do that, it is important to consider barriers to enrollment as well as where families with Medicaid/CHIP-eligible uninsured children reside. In this memo, we examine these issues for children ages five to 16 in one state, Texas.

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