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Access for special populations enrolled in Medicaid and CHIP

Medicaid and the State Children’s Health Insurance Plan (CHIP) provide health insurance coverage to people who have historically experienced disparities in accessing and using health care services, such as racial and ethnic minorities and lesbian, gay, bi-sexual, and transgender (LGBT) populations. Additionally, these programs play an important role in covering special populations, including children and youth in foster care and individuals involved in the justice system.

The majority of Medicaid beneficiaries are racial and ethnic minorities, with over 57 percent of adults enrolled in Medicaid and over 67 percent of children enrolled in Medicaid and CHIP identifying as Black, Hispanic, Asian American, American Indian or Alaska Native (AIAN), or multi-racial. Although the majority of Medicaid and CHIP beneficiaries across all races and ethnicities reported having health insurance coverage for the past 12 months and having high rates of having a usual source of care, there were disparities in many key measures of access.

Medicaid and CHIP also play an important role in covering children and youth involved in the child welfare and juvenile justice systems. The majority of youth who stayed overnight in foster care (63.5 percent) and children or youth who had stayed overnight in jail or juvenile detention (60.4 percent) are covered by Medicaid or CHIP. For both populations, at least one in five of these youth reported experiencing a major depressive episode at some point in their lifetime and nearly one in five reported having a substance use disorder in the past year.

While Medicaid’s role is limited with respect to those who are incarcerated, it plays an important role in the treatment of mental illness and substance use disorders for adults under community supervision. Over one quarter of adults under community supervision were enrolled in Medicaid. Relative to their privately insured peers, Medicaid beneficiaries under community supervision were more likely to be Black or Hispanic. With few exceptions, Medicaid beneficiaries under community supervision reported higher rates of behavioral health conditions than their privately insured or uninsured peers.

Learn more by reading these report chapters and briefs: