On the Road to Universal Children's Coverage: A Final Update on the KidsWell Campaign (Issue Brief)
- Children’s coverage rates reached an all-time high in 2014, the year in which the key coverage expansions authorized by the ACA took effect; 94 percent of children had some form of health insurance.
- States that expanded Medicaid coverage to low-income adults showed greater gains in children’s coverage compared to states that did not expand Medicaid coverage, but even non-expansion states made important strides in improving children’s coverage.
- Policy leaders in all seven KidsWell states agreed that the KidsWell groups play important roles in mitigating challenges to children’s health care coverage primarily by providing credible information to state officials and serving as a voice for underserved constituencies; policy leaders also believe grantees are effective at conducting various advocacy activities.
- Grantees attributed their successes in KidsWell to two prominent features of Atlantic’s grant-making approach: (1) providing multiyear funding and (2) trusting the grantees to deploy campaigns that would work in each state environment, rather than taking a prescriptive approach to advocacy campaigns.
The Patient Protection and Affordable Care Act (ACA), enacted in 2010, held great promise for expanding insurance coverage to millions of uninsured Americans. Starting in 2014, it expanded Medicaid eligibility to low-income adults with family income below 138 percent of the federal poverty level. It also offered premium subsidies to people with income up to four times the poverty level so they could purchase private insurance through federal or state health insurance exchanges. While most of those expected to gain insurance coverage for the first time are adults, children stand to gain as well, since children are more likely to have health care coverage when their parents do too (DeVoe et al. 2015). When KidsWell began in 2011, 7.5 percent of children nationwide were uninsured. This brief looks at the KidsWell Campaign, a multilevel effort designed to ensure access to health insurance for all children. It first reviews children’s coverage trends before and during the KidsWell grant period and then summarizes (1) state policy leaders’ views on the role of KidsWell advocates in shaping children’s health coverage policies, (2) KidsWell grantees’ effectiveness at various advocacy activities, (3) the ways in which KidsWell enhanced grantees’ work, and(4) sustainability following the end of the grant.