Chapin Hall

The Issue

The central role of economic hardship as a driver of child welfare system involvement underscores the importance of addressing the concrete needs of families and promoting economic stability. In addition to income poverty, material hardship is a consistent predictor of child protective services (CPS) contact, above and beyond family characteristics. Access to Medicaid and healthcare for children and their families, specifically, is associated with reduced risk for child welfare system involvement.

The Evidence

• McCray (2018) found that state-level increases in the percentage of children covered by Medicaid and private health insurance are associated with a reduction in substantiated reports of physical abuse.
• Brown et al. (2019) found that Medicaid expansion for adults with dependent children between 2010 and 2016 was associated with a reduction in the screened-in neglect report rate for children under age 6. They estimated that 125,000 fewer neglect cases involving children under age 6 would have been reported between 2014 and 2016 if all states had expanded Medicaid eligibility.
• McGinty et al. (2022) found that Medicaid expansion in 2014 was associated with a 13% reduction in child neglect reports for children ages 0-5, a 15% reduction for children ages 6-12, and a 16% reduction for children ages 13-17 between 2008 and 2018.

The Way Forward

Medicaid plays a critical role in safeguarding child well-being by reducing economic hardship and ensuring access to essential healthcare services. Research shows that Medicaid expansion and continuity in coverage are associated with lower risk for child welfare system involvement. These findings underscore the importance of Medicaid to promote child safety and family stability, and hence, the need for policymakers to prioritize and protect this vital program.

For questions related to this brief, please contact Alana Barr.