Logo image
Back
Effects of State Medicaid Expansions Affecting Parental Eligibility on Children's Healthcare Access and Health During the COVID-19 Pandemic
Journal article   Open access   Peer reviewed

Effects of State Medicaid Expansions Affecting Parental Eligibility on Children's Healthcare Access and Health During the COVID-19 Pandemic

Joel M James and George L Wehby
Maternal and child health journal
08/07/2026
DOI: 10.1007/s10995-026-04292-x
PMID: 42566112
Appears in  UI Libraries Support Open Access
url
https://doi.org/10.1007/s10995-026-04292-xView
Published (Version of record) Open Access

Abstract

To examine whether pre-pandemic state Medicaid expansions for adults affected children's healthcare access and utilization, child health, and parental health during the COVID-19 pandemic. The sample includes children from households with incomes up to 138% of the Federal Poverty Level using data from the 2016-2023 National Survey of Children's Health. Child outcomes include insurance coverage, usual place for sick care, personal doctor or nurse, unmet healthcare needs, past 12-month utilization of any medical services, preventive medical and dental visits, mental health professional treatments, non-mental health specialist visits, emergency department visits, hospitalizations, and general/oral health ratings. Parent outcomes include physical and mental health ratings. Difference-in-differences models estimate year-by-year differences in outcomes between Medicaid expansion and non-expansion states. There is a decline in usual place for sick care, personal doctor or nurse, and preventive medical visits in the first or second pandemic year and in child health in 2020/2023 in expansion versus non-expansion states. In contrast, there is an increase in mental health professional treatments and other specialist visits in 2021-2023 in expansion states. Lastly, there are declines in maternal physical/mental health and father's mental health in 2020 but increase in father's mental/physical health in 2023 in expansion states. During the pandemic, children in low-income households had less care continuity and preventive care but more mental health treatments and non-mental specialist visits in Medicaid expansion versus non-expansion states. There were also declines in both child and parent health. Findings potentially reflect intertwined effects from greater parental coverage but more pandemic-related social mobility restrictions disrupting routine/preventive care and worsening mental health more in expansion states.
 Healthcare access and utilization Parent health State medicaid expansions Child health UIOWA OA Agreement

Details

Metrics

1 Record Views
Logo image