Medicaid/CHIP Income Thresholds And Health Services Use Among Children In Low-Income Households, 2016-23

Children in low-income households face health care barriers shaped by state Medicaid and Children's Health Insurance Program (CHIP) income eligibility thresholds. Using 2016-23 National Survey of Children's Health data (N = 124,250) merged with state data, we assessed associations between income thresholds and binary outcomes: insurance status, preventive care use, and unmet medical needs. A 1-standard-deviation increase in a state's income threshold (mean: 260 percent of the federal poverty level) was associated with a 1.10-percentage-point increase in consistent insurance and 0.78-percentage-point increase in preventive care use likelihood, with the latter explained by insurance status. Secondary analyses confirmed this pathway: Children with consistent coverage had a higher likelihood of preventive care use compared to children with a gap in insurance coverage or those who were consistently uninsured. No association was found with unmet medical needs. Findings suggest that federal Medicaid cuts that may lower income thresholds could contribute to child uninsurance and reduce preventive care use.