A recent analysis showed the rate of uninsured children in the U.S. grew from 2022 to 2024. Experts say this could lead to more pediatric cancer deaths
More than four million U.S. children under age 19 lacked health insurance in 2024. The uninsured rate peaked at 6.1 percent—the highest level in the past decade, according to a recent analysis by the Georgetown University Center for Children and Families, a health policy research organization. That marks a nearly 20 percent increase in the number of uninsured children nationwide since 2022.
Being uninsured creates gaps in medical care. And these gaps don’t just interfere with routine pediatric care; they also disrupt treatments for serious illnesses such as pediatric cancers, for which early detection is often a matter of life and death.
On supporting science journalism
If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today.
“When you don’t have insurance, you’re likely to delay care,” says Kimberly Johnson, a pediatric cancer epidemiologist and a professor at Washington University in St. Louis. “In the case of cancer, that can delay diagnosis, and the cancer can become more advanced, which then is associated with a worse prognosis.”
The spike in the number of uninsured children is a direct upshot of Americans’ fragmented health care system. This patchwork of public insurance, private insurance and other employer plans creates a shaky environment for families whose income or job status changes, says Derek Brown, a health economist and a professor at Washington University in St. Louis. These life shifts may force parents to repeatedly lose and re-enroll in insurance, threatening the health of their children.
Many uninsured children are eligible for Medicaid (the government insurance program for people with limited income) or the Children’s Health Insurance Program (a joint federal-state program that provides matching federal funds for states to help insure children) but aren’t enrolled, says Joan Alker, a research professor at the Georgetown McCourt School of Public Policy. People may not know they are eligible, and individuals who are undocumented may fear deportation. “Especially in today’s climate, there are families where the child is a citizen and the parent is an immigrant, and they’re fearful of interacting with government,” Alker says. But such fears can only explain a small proportion of those who are uninsured, she notes.
More children are losing insurance because of bureaucratic red tape. In a process informally referred to as “Medicaid unwinding,” states have resumed Medicaid eligibility checks after a period of continuous coverage during the COVID pandemic. Some people who were eligible previously have been disenrolled not as a result of disqualification but simply because of bureaucratic mistakes.
These gaps in insurance coverage will result in more children getting sicker and dying. A 2020 national study in the International Journal of Epidemiology of more than 58,000 children and adolescents under age 20 with cancer found that those who were uninsured faced a sharply higher risk of dying within five years than those with private insurance across most cancer types. Eleven percent of the uninsured study participants received no cancer-directed treatment compared with 6.7 percent of those who were privately insured. Children and adolescents without insurance also had 31 percent higher odds of being diagnosed at a later stage of cancer and were 32 percent more likely to die in the five years after diagnosis than those with private insurance—living about two months less on average.
... continue reading