The Impact of State-Level Political Ideology on Children’s Health Insurance Coverage in the United States, 2008–2024

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 22. Health Insurance

Abstract

Healthcare access remains a central indicator of children’s health and well-being in the United States. Despite major coverage expansions through CHIP, Medicaid, and the Affordable Care Act, insurance gaps persist for millions of children. Pervious research suggests that state political environments shape access to public insurance programs, yet few studies examine how long-term ideological differences influence children’s coverage across multiple policy periods. This study analyzes the relationship between state-level political ideology and children’s health insurance status using IPUMS ACS, IPUMS CPS, and NSCH datasets from 2008-2024. We assess children ages 0-18 across key policy periods including the pre-ACA, ACA rollout, Medicaid expansion, and the COVID-19 non-stop coverage period. Our preliminary results indicate that uninsurance rates are consistently higher in republican-led states than in democrat-led states, even as most children nationwide remain insured overall. By linking shifts in state political ideology with changes in children’s health coverage across different policy periods, this study will fill a critical gap in the literature on political determinants of health focused on children and provide new insights into how on-going policy periods shape children’s health needs and coverage.

Authors

• Samuel Jr Ocasio, University at Albany, SUNY

• Ngozichukwuka Jacob Agwu, University at Albany, SUNY