As millions of Americans receive COVID-19 vaccines, data about the impacts of the pandemic is pouring in and it paints a challenging picture of the conditions our children have endured over the last year as well as the emerging needs they will have as the country recovers.

A new report, Medicaid Forward: Children’s Health, by the National Association of Medicaid Directors provides a close look at the realities the country is facing to aid the recovery of its children as well as the innovations Medicaid programs across the country have made and are continuing to make to help millions of these kids. Currently, about two in every five American children rely on Medicaid or the Children’s Health Insurance Program (CHIP) to get the healthcare they need. This number is even higher in Louisiana, where over half of all children, and about 60% of children under 5, rely on Medicaid or CHIP. Additionally, nearly half of all births in Louisiana are paid for each year by Medicaid.

"The pandemic has presented incredible challenges for children and adolescents in Louisiana and across the country, but kids are resilient and strong. With the help of caring adults and innovative systems, we can help to provide a healthy, bright future for them," said Dr. Courtney N. Phillips, Secretary of the Louisiana Department of Health.

Since the first days of the pandemic, Medicaid programs jumped in to support healthcare providers and patients. Through partnerships with the federal government, they streamlined membership processes, removed barriers to mental and physical care access, and came up with innovative solutions to improve efficiency and quality of care.

"Meeting the needs of children and adolescents today will pay off socially and economically in the long run," noted Dr. Amanda Dumas, Associate Medical Director of Louisiana Medicaid and a practicing pediatrician. "As we emerge from the pandemic and focus attention and resources on recovery, we have the opportunity to sustain and adapt successful strategies and lessons we learned during the pandemic. It is essential that we continue supporting children and families."

Mental and physical needs

With 77 million American students experiencing partial or total school closures due to the pandemic — and over 40% of children who are still not experiencing in-person learning as of April — the academic losses and the multi-dimensional impacts of social isolation are inevitable. But the impacts extend to other aspects of a child's life and well-being as well. The percent of U.S. households with children who are facing hunger — meaning they don't have reliable access to food — doubled from 14% to 28% since last fall. Depression and anxiety are on the rise. In June 2020, 14% of parents reported worsening behavioral health for their children compared to March 2019. And, a recent report estimates that about 40,000 children have lost a parent to COVID-19.

The picture for children of color is even more difficult. More than one in four children who are Black or Latino experienced food insufficiency in March 2021. And, while Black children represent just 14% of all children in the United States, they represent 20% of those children who lost a parent to COVID-19.

"The realities facing our kids are stark. And they won't be overcome quickly. But we have effective programs like Medicaid and CHIP that have been helping during the worst of the pandemic and are a critical piece of the recovery for millions of American children," said Matt Salo, the association’s executive director.

Data is also showing us these mounting mental and physical healthcare needs are likely going unmet. Children received 44% fewer child health-screening services from March to May 2020 compared to that period in 2019.

"We know we have a long way to go before we recover as a nation," Salo said. "But certainly, our first and best efforts to achieve that recovery must start with our children."

Medicaid Forward: Children’s Health, the second in a three-part series, identifies opportunities for action to address immediate and long-term challenges for children’s health emerging from the COVID crisis across communities. Specific focus areas for the series include children, older adults and those with mental health and addiction diagnosis. The first in the series focused on mental health and addiction across all populations served by Medicaid.