Projected number of children enrolled in Medicaid in the U.S. 2020-2027

The number of children enrolled in Medicaid was projected to reach 31 million by 2027, which would account for nearly 40 percent of total enrollment. Historically, children have been the largest group of Medicaid enrollees.

CHIP builds on Medicaid’s coverage

The Children’s Health Insurance Program (CHIP) provides insurance coverage to children in families with incomes too high to qualify for Medicaid but too low to pay for private health insurance – there were approximately 9.6 million CHIP enrollees in 2018. CHIP is jointly financed by states and the federal government, but each state can decide how to design its program: they can implement it by expanding Medicaid, creating a separate plan, or a combination of both approaches.

Income eligibility levels for children

The introduction of the Affordable Care Act (ACA) strengthened children’s health coverage by expanding eligibility levels in all states. For children of all ages, the ACA established a minimum Medicaid eligibility level of 138 percent of the federal poverty level (FPL), but many states have set higher income limits. In 2020, the median upper income eligibility level for children for Medicaid/CHIP was 255 percent of the FPL.