Consistency in Health Coverage and Care: Why It Matters for Young People and Families
January 12, 2026
Good health and wellbeing are essential to living fulfilling and productive lives. When parents are healthy, they are better able to meet their families’ daily needs and care for themselves and their children—supporting children to grow into healthy adults. When young people are healthy, they have a strong foundation from which to pursue education, work, and the goals they set for themselves.
To be healthy and well, young people and families need consistent access to health care—and the consistent health coverage that makes it possible. Lapses or changes in coverage and care can result in a four-year-old who needs speech therapy missing weeks or months of services, delaying progress at a critical time. A young person managing anxiety losing access to counseling, making it harder to stay engaged in school, maintain relationships, or show up consistently at work. Or a mother recovering from hip surgery facing high out-of-pocket costs and worrying about whether she can afford to take time off from work and also pay for rent, food, and other basic expenses—delaying follow-up care and slowing her recovery.
Disruptions in care make it hard for families to stay healthy—and they are all too common. They reflect policy choices that make access to health coverage and care precarious, especially for families with low incomes and immigrant families. Too often, families are forced to move between coverage options, including public programs such as Medicaid and CHIP, employer-sponsored insurance, and ACA Marketplace coverage, as their circumstances change, creating gaps that interrupt care. At the same time, Medicaid and CHIP, while they provide critical coverage promoting the health and wellbeing of 77 million children and adults, are burdened with eligibility restrictions, benefits cliffs, work requirements, frequent recertifications, age cutoffs, and exclusions tied to immigration status – making coverage hard to maintain and care difficult to access.
And right now, we are moving in the wrong direction. With critical health programs such as Medicaid cut in the Reconciliation Bill (H.R. 1) signed into law last year, and Congress’s failure to renew enhanced premium tax credits that helped millions of families afford Marketplace coverage*, many young people and families face higher costs or the risk of losing coverage altogether.
Over time, these policy failures mean health needs go unmet and can escalate into crises, drawing some families into systems—such as child welfare—which are intrusive and harmful and can separate children from their families and communities. Policies that make coverage fragile—by tying it to work, age, income or immigration status—create instability where families need consistency.
For many – in particular transgender young people and immigrant families who have been targeted by this administration – access to care is not only fragmented, but uncertain and unsafe. Recent policy actions have raised new concerns about data sharing and surveillance within public health programs, increasing fear that seeking care could expose families to harm. At the same time, proposed federal regulations—and related state actions—have sought to restrict access to health care, narrowing trusted pathways to care, deepening instability and fear and threatening families’ health and wellbeing.
Stable health coverage matters. When families can count on coverage, they are better able to seek care early, manage ongoing health needs, and address challenges before they escalate. Children can receive preventive care and early intervention. Young people can maintain relationships with providers through key transitions. Parents and caregivers can access care that reduces stress and supports their ability to care for their families.
Consistent coverage is essential to health and wellbeing and underpins the ability of children, young people, and families to build their lives and futures. And it should be guaranteed for everyone – not treated as a privilege for the few.
CSSP’s new policy brief series, Consistent Health Coverage and Care, examines how policy choices shape whether children, young people, and families can access health coverage and care they can rely on. Each brief explores the barriers children, youth, and families face — and what policymakers can do right now to protect consistency in coverage and care. The series looks at ending harmful work requirements, maintaining coverage for young people transitioning to adulthood, ensuring continuous care for children and youth in foster care, and removing barriers for immigrant families. It also points the way toward a different approach – one that guarantees consistent coverage and care as foundational to health.
