Many toddlers lose Medicaid coverage on their first birthday

July 11, 2016

Many babies born to mothers who are covered by Medicaid or CHIP are automatically eligible for that coverage during the first year of their lives. A federal policy that requires eligibility be reevaluated on their first birthday means many toddlers, likely still eligible for coverage, fall through the cracks. An analysis of data from the 2014 American Community Survey found children between the ages of 1 and 2 were less likely to be covered by Medicaid or CHIP than infants. Some reasons for the dropped coverage include:

  • A toddlers' first-year review is pegged to their date of birth, which is generally different than the annual renewal date for other family members' coverage;
  • States that don't seek babies' Social Security numbers until they turn 1 may have a tougher time getting the income and other data they need to process the renewal;
  • Some systems ask for documentation proving the baby's citizenship, which is not required if Medicaid or CHIP paid for their birth; and
  • Antiquated computer systems sometimes drop babies after their first birthday unless a renewal has been processed, a problem in states that are behind in renewals.