Rates of private health insurance coverage for children increased between 2013 and 2014 for the first time since 2008, the first year in which the American Community Survey collected data on health insurance (see Figure 1). The rise corresponds with the implementation of the individual mandate under the Affordable Care Act (ACA), the opening of state and federal insurance exchanges, and an improving employment market.
Between 2008 and 2014 (the most recent data), rates of children's coverage grew nearly 4 percentage points; to 94 percent. Growth in public insurance, such as Medicaid and the Children's Health Insurance Program (CHIP), was largely responsible for these gains (up 10.8 percentage points since 2008), while rates of private insurance coverage fell concurrently (down 5.6 percentage points). But between 2013 and 2014, the combined rise in public coverage (0.8 percentage points) and private coverage (0.4 percentage points) produced the second-largest overall gain—1.1 percentage points—in children's insurance rates in the seven-year span. The largest increase—1.4 percentage points—occurred between 2008 and 2009 when Congress and the Obama Administration reauthorized CHIP.
Private insurance rates rose most in the rural Midwest and South as well as in Western cities in 2014, while public insurance grew most significantly in suburban places in the Northeast, South, and West.