Health Affairs January 20, 2026
Cuts to federal Medicaid funding pose a substantial risk to all children, regardless of their insurance coverage. H.R.1, the One Big Beautiful Bill Act, focuses on reducing federal spending, partly achieved through substantial changes to Medicaid and the Children’s Health Insurance Program (CHIP). According to the Congressional Budget Office, these provisions would increase the number of uninsured individuals by 9.1 million by 2034, a shift that would dramatically alter the pediatric health care landscape.
Medicaid and CHIP, which provide coverage for 38 million US children, are critical drivers of children’s access to health care services and promotion of improved, more equitable health outcomes. Although the Medicaid provisions in HR1 primarily target adults, several mechanisms in the legislation would directly and...
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