Can Implementing Continuous Medicaid Eligibility for Children Reduce Inequities in Academic and Developmental Outcomes?

This proposal aims to assess whether implementing continuous Medicaid eligibility under the Families First Coronavirus Response Act (FFCRA) was associated with improvements in children’s academic and developmental outcomes and its role in addressing inequities by race, ethnicity, and income. Medicaid and CHIP cover over 37 million children in the U.S., including the majority of children in poverty and children of color. However, many children still face gaps in coverage. In response to COVID-19, all states temporarily implemented continuous Medicaid under the March 2020 FFCRA, allowing children to stay consistently enrolled without gaps. Previously, approximately half of states offered 12 months of continuous eligibility for children. This variation provides an opportunity to examine whether newly implementing continuous eligibility led to better educational and developmental outcomes—particularly for children more likely to be Medicaid-enrolled. Using nationally representative data from the National Survey of Children’s Health (2017–2022), this research will use a difference-in-difference design to compare academic and developmental outcomes before and during the FFCRA among states that did and did not newly implement continuous eligibility, with analyses by children’s race, ethnicity, and poverty level. These findings could inform how national 12-month continuous eligibility for children, starting in 2024, could help advance equity in developmental and academic outcomes.