The big idea
When children get health insurance through Medicaid or the Children’s Health Insurance Program, known as CHIP, their families benefit, too.
That’s what I found through recent research conducted with two fellow health economists, Daniel S. Grossman and Barton Willage. And it was particularly true for the children’s mothers, who become 5% more likely to be in a stable marriage and experience a 5.8% reduction in stress levels. Moms are also less likely to smoke cigarettes and drink heavily.
We figured this out by comparing the rates for marriage, mental health conditions, and health behaviors of mothers whose children are eligible for Medicaid or CHIP — a joint effort by states and the federal government to cover kids in families with relatively modest incomes but that are too high for Medicaid eligibility — with mothers whose children are less eligible for these programs.
We also compared the employment status of low-income mothers of children who obtained health insurance eligibility with those who did not.
Why it matters
Some 4.3 million children under the age of 19, or 5.6% of all US kids, lacked health insurance coverage in 2020 — the most recent data available. President Joe Biden’s proposed Build Back Better Act, currently stalled in the Senate, would help close this gap.
States set their own eligibility requirements for Medicaid and CHIP, and these thresholds range widely. Eligibility usually depends on a child’s age, the number of people in the household, and the family’s income. For example, in Oregon, a 3-year-old in a family of three with an annual income of $ 33,000 would not be eligible. That same child living in Wisconsin, however, would be. And Wisconsin’s policies are not even the most generous in the nation.
Previously, researchers have primarily measured the effectiveness of the Medicaid and CHIP programs for children by assessing direct effects related to their own health. Our study shows that gaining access to government-provided health insurance coverage also affects a child’s household in positive ways.
One reason that’s important: Prior research has shown that growing up in a stable home benefits a child’s cognitive development.
What still is not known
Our study complements previous research suggesting that obtaining health insurance coverage through Medicaid and CHIP has long-term effects for children, such as through higher educational achievement. But how that happens remains unclear. That is, do these kids perform better in school because their health is typically better than it would have been — or something else?
Another question that remains is whether these patterns crop up when people gain access to other beneficial programs. For example, when children with special needs obtain the services they require, does it also benefit their parents? Or how does student loan-forgiveness improve the lives of people in a household beside the person who owed the money?
We focused on moms because maternal data was more readily available. In the future, we would like to do further research to see whether the benefits for the fathers of children who gain health insurance coverage through Medicaid and CHIP are similar to the boost that mothers get.
Sebastian Tello-Trillo is assistant professor of public policy and economics, University of Virginia.