Spotlight on Health: Access to health insurance and health care for families with young children in New York City

The COVID-19 pandemic highlighted long-standing disparities in access to health insurance and health care. Drawing on three years of data for families in the Early Childhood Poverty Tracker (ECPT), this report examines health insurance coverage and health care access for parents and young children in New York City. This longitudinal perspective is critical because people may experience disruptions in health coverage over time because of changes in employment, relationship status, or eligibility for public benefits. 

Key Findings

  • Almost all children in New York City have health care coverage. However, coverage for parents is much less certain. 

  • Two out of five parents experienced a gap in health insurance coverage in at least one of the past three years (2017-2019). 

  • Parents who reported that they were in fair or poor health were more likely than those with good to excellent health to face gaps in health insurance coverage.

  • Public insurance programs like Medicaid and Child Health Plus (CHIP) are vital supports for low-income families but the recertification requirement can lead to interruptions in coverage. 

  • Parents who experienced gaps in coverage were more likely to forgo medical care (39%) and not fill prescriptions because of the cost (28%) compared to parents with stable coverage. 

  • Even if children have insurance, they may face barriers to accessing health care. 

Together, New York State’s Medicaid and CHIP offer public health insurance to all children living in the state, regardless of income or immigration status. As a result, health coverage is nearly universal among young children living in New York City. Health coverage for adults is more uneven, however. Two aspects of public insurance programs—restricted eligibility based on immigration status and the annual recertification process—may contribute to these disruptions in coverage. Expanding public insurance for undocumented immigrants and making Medicaid recertification less burdensome19 would likely improve access to health insurance for New York City adults. In addition, expanding free or low-cost health care for those who cannot afford or qualify for insurance would allow more New Yorkers to access the health care they need.

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Spotlight on Child Tax Credit: Transforming the Lives of Families

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Spotlight on Mental Health: Disparities in psychological distress among parents of young children in New York City