The Looming Equity Crisis in Children’s Health Care: Federal and State Action Is Needed to Prevent Millions of Children from Losing Medicaid

Research Report

The Looming Equity Crisis in Children’s Health Care

Unless federal and state policymakers take bold and effective action, our country will soon see the largest Medicaid losses in its history, disproportionately harming Latinos and other families of color.

COVID-19 legislation gave state Medicaid programs extra money, in exchange for a promise not to terminate anyone’s health care as long as public health emergency (PHE) continued. As a result, Medicaid enrollment rose 25%. When continuous coverage requirements end, states will need to assess income for 80 million people. Many are likely be terminated when states send notices asking families for information and the mail gets sent to the wrong address, goes unopened, or is not understood.

Even if terminations are no more common than they were before the pandemic, 6.7 million children are likely to lose Medicaid—significantly more than the largest previous one-year drop, when 1.4 million children lost Medicaid in 2019.

And even if terminations are no more likely for families of color than for non-Hispanic White families, 12% of all Latino children who live in America will lose health coverage, as will 12% of all children of color. Combining people of all ages, Medicaid will end for nearly 5 million Latinos, more than 3 million African Americans, and 1 million Asian Americans and Pacific Islanders.

The report outlines specific steps federal and state officials must take to prevent the coming “Medicaid tsunami” from deepening already severe health inequities that harm Latinos and other historically disadvantaged communities in America.


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