During the COVID-19 public health emergency (PHE), states implemented numerous Medicaid and Children’s Health Insurance Program (CHIP) policies and operational processes that helped to maintain coverage and support access to needed physical and behavioral health services for children and adolescents. When the PHE ends, which may occur as early as January 2023, many of these temporary policies will also conclude, jeopardizing the significant progress made over the last two and a half years.

The PHE’s conclusion and subsequent loss of flexible access and coverage policies is particularly important when considering the scale of Medicaid—covering 42 percent of all births and over 40 million children nationwide—and the disproportionate coverage of children of color, with more than one in two Hispanic or Latino/a children, American Indian or Alaska Native, Black, other, or multi-racial children enrolled in Medicaid. In addition, the racial and ethnic disparities that exist among children enrolled in Medicaid and CHIP have been further exacerbated by decades of systemic discrimination and the COVID-19 pandemic, with Black and Brown children more likely—compared to white children—to experience higher rates of infant mortality, mental health emergency department visits, substance use, asthma and obesity.

As state Medicaid and CHIP agencies prepare for the end of the PHE, there is an opportunity to make permanent and build upon the temporary policies that were adopted during the PHE in order to improve continuity of coverage and access to health care services.