Children’s Insurance Stability and Coverage Inequities During the Covid-19 Continuous Coverage Provisions

Bibliographic Data

ID11023141
AuthorsErica L Eliason (0000-0002-5246-3176, At the time of conceptualization, Erica L. Eliason was with the Department of Health Services, Policy, & Practice, Brown University School of Public Health, Providence, RI. Aditi Vasan is with the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia. At the time of conceptualization, Daniel B. Nelson was with the Department of Population Medicine, Harvard Medical School, Boston, MA.), Aditi Vasan (0000-0001-8992-5672, At the time of conceptualization, Erica L. Eliason was with the Department of Health Services, Policy, & Practice, Brown University School of Public Health, Providence, RI. Aditi Vasan is with the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia. At the time of conceptualization, Daniel B. Nelson was with the Department of Population Medicine, Harvard Medical School, Boston, MA.), Daniel B Nelson (0000-0002-2716-7770, At the time of conceptualization, Erica L. Eliason was with the Department of Health Services, Policy, & Practice, Brown University School of Public Health, Providence, RI. Aditi Vasan is with the Department of Pediatrics, University of Pennsylvania Perelman School of Medicine and PolicyLab, Children’s Hospital of Philadelphia, Philadelphia. At the time of conceptualization, Daniel B. Nelson was with the Department of Population Medicine, Harvard Medical School, Boston, MA.)
Year2025
Volume115
Issue11
Pages1848-1857
Publication date2025-11-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2024.307900
PMID40146971
OpenAlexW4408905028
LanguageEN
Citations received2
References cited16

Objectives. To explore the association between the March 2020 Families First Coronavirus Response Act (FFCRA) Medicaid disenrollment freeze during the COVID-19 public health emergency (PHE) and children’s insurance coverage by family income, race/ethnicity, and language. Methods. We used 2015 to 2021 US Medical Expenditure Panel Survey data, comparing monthly coverage for publicly insured children before (2015–2019) and during (2020–2021) the PHE. Outcomes included continuous public coverage, private coverage, no coverage, total months of public coverage, and total number of uninsured months. We estimated weighted multivariable linear regression models with a PHE period indicator. Results. The PHE was associated with an increase in continuous public coverage among children of 4.2% percentage points, reduced transitions to private coverage (−2.3 percentage points) and no insurance (−1.9 percentage points), and increases in months of public coverage. The largest continuous public coverage improvements were among children from families with incomes between 200% and 399% of the federal poverty level (FPL), non-Hispanic White children, and Hispanic children. Conclusions. The FFCRA improved children’s public coverage continuity, particularly among children from families with incomes between 200% and 399% of the FPL, non-Hispanic White children, and Hispanic children, who may face coverage loss with disenrollment resuming. ( Am J Public Health. 2025;115(11):1848–1857. https://doi.org/10.2105/AJPH.2024.307900 )

Coronavirus disease 2019 (COVID-19) · Economic growth · Economics · Ethnic group · Health care · Health insurance · Medicaid · Medical Expenditure Panel Survey · Political science · Poverty · Public health · Public health insurance · Demography · Food Security and Health in Diverse Populations · Healthcare Policy and Management · Medicine · Primary Care and Health Outcomes

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