2023 State of Children's Health in PA

More Pennsylvania children lost health insurance last year, signaling a turn in the wrong direction after a brief reprieve during an earlier period of the pandemic. Between 2021 and 2022, the rate of children in Pennsylvania without health insurance increased significantly from 4.4% to 5.2%. i Pennsylvania now has the 5th highest number of uninsured children in the nation. Lack of coverage or even short gaps in coverage can result in missed appointments and delayed care for chronic conditions such as asthma, resulting in emergency department visits and missed school days. Uninsured Rate Trends The Census data showing a larger number of children going without health insurance than the prior year is surprising for several reasons. First, the Medicaid disenrollment freeze, in place during the COVID-19 public health emergency, continued throughout 2022. Therefore, the 2022 Census data does not reflect the unwinding of the Medicaid continuous coverage process (and the first time that renewals have been required in three years), which didn’t begin until April 2023. It was expected that the last full year of the COVID-19 public health emergency would reflect at least stable coverage or even gains in connecting kids to health insurance. In fact, Pennsylvania is one of only three states, alongside Connecticut and Wisconsin, that saw The more than 145,000 Pennsylvania children without health insurance could fill every seat in Penn State’s Beaver Stadium plus an additional 39,000 kids out in the parking lot.

declines in 2022 regarding its insured child population. All other states had improvements in their uninsured data or relatively stable coverage with no significant changes. ii Notably, private coverage rates significantly decreased for children in Pennsylvania and only five other states, which may provide a partial explanation for the overall worse uninsured rate. It’s also noteworthy that the opposite trend occurred for Pennsylvania adults whose uninsured rate significantly dropped, following the national trend. Another difference not seen in the child population is that the public coverage rate for adults significantly improved in 2022. Regional Comparison Pennsylvania’s uninsured rate for children has risen above the national average for the first time since 2017, with the state at 5.2% and the country at 5.1%. Pennsylvania also has the highest uninsured rate for children when compared to all neighboring states. New York, with a much higher child population, has half the uninsured rate as the commonwealth. Meanwhile, Ohio’s uninsured rate improved since the prior year, resulting in a switch of the rankings with Pennsylvania.

Percent Under Age 19 Without Health Insurance New York

2.6% 2.8% 3.4% 3.9% 4.2% 4.5%

West Virginia


New Jersey



Pennsylvania 5.2% Source: PPC analysis, U.S. Census Bureau, American Community Survey (1-year estimates), 2022


November 2023

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