Q&A: What’s next for states that have coverage for all kids?

Since the onset of the COVID-19 pandemic in 2020, the number of uninsured children has increased dramatically, having a profound impact not only on their wellbeing but also on their families as a whole. Our state advocates know that to achieve health justice – all children must have access to quality affordable care. This week, we featured state partners from across the country at various stages of a Cover All Kids campaign – from planning to implementation. Today we spotlight two partners whose states have fully implemented Cover All Kids programs, including one state that passed Cover All Kids legislation almost two decades ago. Here, Kathy Kilrain del Rio of Maine Equal Justice and Stephanie Altman of the Shriver Center on Poverty Law in Illinois discuss the steps their states have taken since passing Cover All Kids legislation and share what’s next in their efforts to get even more people access to health care. 

Kilrain del Rio (ME): Our kids – all of our kids – should always be able to get the health care they need, no matter where they were born or how they ended up making Maine their home. As of July 2022, MaineCare covers all income-eligible children under age 21, regardless of their immigration status. With this change, and with improvements to CHIP to increase eligibility to 300% FPL and removing waiting periods and premiums that will go into effect in 2023, we have an opportunity to make significant progress toward ensuring all children in Maine have health care. 

Altman (IL): The passage of the Covering All Kids Initiative in 2005 marked Illinois as the first state to expand Medicaid coverage to all children regardless of immigration status. It has been invaluable to ensuring all children in Illinois have access to the care they need. 

Kilrain del Rio (ME): Maine's population is small so it can be challenging to estimate impact. There are approximately 15,000 uninsured children in Maine, and it is likely that the number increased over the course of the COVID-19 pandemic. However, passing coverage for pregnant people and people under 21 years old has already enabled grassroots and community-based organizations to help hundreds of children and pregnant people to apply for new coverage. 

Altman (IL): We cover nearly 1.5 million children in Illinois under Medicaid and CHIP (called AllKids), which will now be moved all into Medicaid as of July 2022. 

Kilrain del Rio (ME): We have a diverse coalition that includes grassroots community-based organizations, public health and health care focused organizations, and organizations with deep advocacy experience. Most of all, we have a Leadership Team made up of people who are directly impacted by the gaps in our health care system, and they guide our messaging, share stories and connect with legislators and the governor's office. Personal stories helped legislators, the governor, the media, and the public understand the importance of this coverage and encouraged action.  

Altman (IL): Illinois used coalition-building, business leaders and hospital leaders to push the campaign in the mid-2000s.  

Kilrain del Rio (ME): We are working to enroll everyone who is newly eligible for coverage. In 2023, we will continue working to ensure all Mainers with low-income have access to MaineCare, regardless of their immigration status. Kids and pregnant people getting coverage is a huge step forward, but we need all our families, friends, neighbors and community members to have coverage as well. Our communities and our collective health is stronger when everyone has the full range of health care they need. 

Altman (IL): We will continue to push for access to services for the 4% of Illinois children who remain uninsured, and for traditionally difficult services for children on Medicaid to access – including oral health. 

Further insights on recommended practices when implementing Cover All Kids can be found here. 

Since 2016, 29 states have seen significant increases in the rate of uninsured children. In the absence of federal legislation, grassroots organizations have been advocating for Cover All Kids at the state level. This blog series highlighted the range of experiences of state-advocates that are currently advocating for Cover All Kids, states that have recently passed Cover All Kids legislation and are working on implementation, and states that have fully implemented Cover All Kids initiatives. By sharing the experiences of state advocates, we hope that organizations may be able to learn from one another, and ultimately, ensure that all children in the United States are safe, healthy and insured.