ArticleMaternal and child health journal2026
Effects of State Medicaid Expansions Affecting Parental Eligibility on Children's Healthcare Access and Health During the COVID-19 Pandemic.
Article in Maternal and child health journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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2 authors.
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Abstract
objectiveTo 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.
methodsThe 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.
resultsThere 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.
conclusionDuring 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.
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