Texas Coverage Gap Project

Families & children

Covering parents tends to bring more children into the coverage they already qualify for, and it eases financial stress at home.

Low-income parents: more coverage, less distress Association

ACA expansions increased coverage among low-income parents, reduced problems paying medical bills, and reduced severe psychological distress. Uninsured rates for parents in non-expansion states would have fallen by an additional 28% with expansion.1

Limits: No significant change in general health status was found.

More eligible children enrolled ("welcome mat") Association

When parents became eligible, about 710,000 additional children who were already eligible enrolled in Medicaid or CHIP nationally.2

Fewer reported cases of child neglect Association

Expansion states saw 422 fewer reported neglect cases per 100,000 children under 6 per year, relative to non-expansion states (95% confidence interval: 91 to 753 fewer).3

Limits: This is a state-level association. It measures reports, not actual incidence, and the study did not identify how coverage would cause the change. Physical abuse reports did not change.

Texas parents currently qualify only at very low incomes, so these findings apply directly to Texas families.4

We did not find strong expansion-specific research on unpaid family caregivers, so this page makes no claims about them.

Sources for this page

  1. McMorrow, Gates, Long, Kenney, Health Affairs 36(5):808-18 (2017), doi:10.1377/hlthaff.2016.1650 (2017-05). https://www.urban.org/research/publication/medicaid-expansion-increased-coverage-improved-affordability-and-reduced-psychological-distress-low-income-parents [evidence C1]
  2. Hudson & Moriya, Health Affairs 2017;36(9):1643-51, doi:10.1377/hlthaff.2017.0347 (2017-09). https://doi.org/10.1377/hlthaff.2017.0347 [evidence F5]
  3. Brown, Ravallion et al., JAMA Netw Open 2019;2(6):e195529, doi:10.1001/jamanetworkopen.2019.5529 (2019-06). https://pmc.ncbi.nlm.nih.gov/articles/PMC6575148/ [evidence C2]
  4. Texas HHSC Medicaid for Parents and Caretakers page; KFF coverage gap report (accessed 2026-10-24). https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-programs-services/programs-children-families/medicaid-parents-caretakers [evidence L3]

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