States with the most uninsured children under 6 years old

• Texas, Wyoming and South Dakota are the three states with the highest share of uninsured children under 6 years old.
• Massachusetts, Washington and California are the three states with the lowest share of uninsured children.
• Proposals to cut Medicaid would leave millions of more children uninsured.

Some states are dealing with higher rates of uninsured children, a situation that may worsen if proposed cuts to federal health programs go through.

The percentage of uninsured children under 6 years old ranged from as little as 1% to as much as nearly 9% among U.S. states in 2023, according to the latest U.S. Census data compiled by pediatric genetic testing company Fore Genomics.

That compares with nearly 5% of children under 6 who are uninsured in the entire U.S., who total more than 1 million.

Texas had the highest share of uninsured children under 6 years old, with 8.9%, followed by Wyoming (8.6%), South Dakota (7.6%) and Arizona (7.1%) as the rest of the five worst states for uninsured children.

On the other hand, Massachusetts had the lowest share of uninsured children under 6 years old, with 1.2%, followed by Washington (2.3%), California (2.5%), North Dakota (2.6%) and New Jersey (2.6%) as the rest of the five best states for having insured children.

Uninsured children vary by state due to various factors, including economic conditions and state programs and funding for health insurance.

Families with uninsured children should consider the federal government's Children's Health Insurance Program (CHIP), which provides coverage through Medicaid and other CHIP programs, said Matt Pelo, founder and CEO of Fore Genomics, to ConsumerAffairs.

The CHIP program can help families whose incomes disqualify them from from Medicaid and there is the benefit of being able to apply during any month of the year, unlike adults, he said.

"Some families are unaware that these programs could provide comprehensive coverage for their children at a low cost," Pelo said.

Are more children uninsured?

The number of uninsured children has recently grown.

Despite the uninsured rate falling overall for Americans, the number of uninsured children, defined as under 19 years old due to Census data collection, grew to 5.4% in 2023 from 5.1% in 2022, according to Georgetown University's Center for Children and Families.

That is equal to around 223,000 more children who are uninsured, Georgetown said.

Georgetown said just three states saw an improvement in their child uninsured rate — Colorado, Kentucky and North Dakota — but most states had their uninsured rate go up, particularly in New Mexico, South Carolina, Alabama, Louisiana, Washington and Texas.

More children left uninsured if cuts go through

Proposals to cut Medicaid by as much as $880 billion over 10 years or more would leave even more children uninsured.

Fourty-one states, including Washington D.C., have been expanding Medicaid under the Affordable Care Act, but federal funding for that expansion would be taken away, leaving around 20 million people without coverage, said Adam Searing, an associate professor at Georgtown University, in a blog post.

"This level of cuts to Medicaid is unprecedented and if enacted would mean tens of millions of children, parents, seniors, people with disabilities and working families would lose access to affordable health care," he said.