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Number and percentage of NC Children Insured at Record High in 2014; Still Nearly 120,000 Children Without Health Insurance

For Immediate Release–11/11/15

Last year nearly 95 percent of North Carolina children had health insurance, a record high, according to a new report by Georgetown University’s Center for Children and Families. More than 25,000 additional children got health insurance between 2013 and 2014, putting the state among the top 10 states that made big gains in child health insurance.

The number of uninsured children dropped from 144,194 in 2013 to 119,078 in 2014, for a decline from 6.3 percent uninsured to 5.2 percent.  Data is from the U.S. Census Bureau’s 2013-2014 American Community Survey.

However, nearly 120,000 kids remain uninsured–enough to fill 237 average elementary schools. That number has child advocates concerned because of the strong evidence linking access to health care and a child’s success in school and in life overall.

“Every child should have health care coverage,” said Michelle Hughes, executive director of NC Child.  “It’s not only good for our kids and their future, it’s good for our schools and economy. Research indicates that when children have health care coverage, they are able to show up for school healthy and ready to learn. They are able to see the doctor when they are sick so they don’t need more expensive care in a hospital.”

The report authors point to NC’s Medicaid program and NC Health Choice as the reasons North Carolina has been successful in reducing the number of uninsured children, and the fact that major provisions of the Affordable Care Act (ACA) took effect in 2014. Report authors attribute increased enrollment to several provisions of the ACA, including the “welcome mat” effect, which happens when parents who obtain coverage for themselves enroll their children who are already eligible for Medicaid or NC Health Choice.

Research shows that children who received Medicaid coverage were less likely to drop out of high school and were more likely to graduate from college.[i] They also had better health and economic success as adults, making them less reliant on safety net programs.[ii],[iii]

Child advocates urged the state to redouble its efforts to insure all children and they say if North Carolina closed the adult insurance coverage gap, more children would get health coverage.  The adult insurance coverage gap affects thousands of North Carolinians working in such lower-wage industries as farming, construction, food service and cleaning services, who do not receive employer-based health insurance and cannot afford to buy it on their own.

The ACA offers states an option to create a customized Medicaid plan for such adults, with the Federal government paying 90 percent of the cost. States that accepted the ACA’s Medicaid option saw nearly double the rate of improvement in the number of uninsured kids than other states, which is likely a result of an enhanced “welcome mat” effect.

“Extending Medicaid coverage to more low-income parents would help children by reducing the number of uninsured kids, boosting families’ financial security, and enabling children to get better care from healthier parents,”  said Joan Alker, executive director of the Georgetown University research center. “Children thrive when their parents are healthy and economically secure so improvements in health coverage for parents benefit the whole family.”

Even though North Carolina has not yet accepted funding to expand Medicaid, many uninsured children may already be eligible for Medicaid or NC Health Choice coverage.  Families who would like help enrolling should call their local DSS office or visit


[i] S. Cohodes, et al., “The Effect of Child Health Insurance Access on Schooling: Evidence from Public Health Insurance Expansion,” National Bureau of Economic Research, Working Paper 20178 (May 2014).

[ii] R. O’Brien, et al., “Medicaid and Intergenerational Economic Mobility,” University of Wisconsin- Madison Institute for Research on Poverty, No. 1428-15 (April 2015).

[iii] D. Brown, et al., “Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts?,” National Bureau of Economic Research, Working Paper 20835 (January 2015).

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