New Jersey Report Warns Medicaid Cuts and Low Test Scores Threaten Nearly 860,000 Children
Why It Matters
A new report on child well-being in New Jersey is raising alarms about the potential consequences of federal Medicaid reductions on hundreds of thousands of children enrolled in the state’s public health insurance program. The findings come as state and federal officials face mounting pressure to address both healthcare access and persistent academic underperformance among the state’s youngest residents.
What Happened
Advocates for Children of New Jersey released its annual Kids Count report, measuring 63 areas of child well-being across all 21 counties in the state. The report covers demographics, family economic security, health, protection, and education, and warns that looming federal cuts to Medicaid could devastate programs that support healthy child development.
Nearly 860,000 youth in New Jersey rely on NJ FamilyCare, the state’s public health insurance program tied to Medicaid. Mary Coogan, president and chief executive officer of Advocates for Children of New Jersey, said the group is watching for signs of deterioration in coverage rates. “We’re more concerned about a drop-off,” Coogan said. “In some counties, the uninsured rate is starting to creep up.”
Coogan also noted anecdotal evidence that some families — including those with illegal immigrants — may be withdrawing from programs like NJ FamilyCare out of fear, even when their children remain eligible. “A child, even if they’re undocumented, can still enroll in FamilyCare,” Coogan said. “It’s covered by state dollars — as long as the family household meets the income eligibility requirement.”
By the Numbers
The Kids Count report includes several data points that underscore ongoing challenges for New Jersey children:
- 860,000 children in New Jersey depend on NJ FamilyCare for health coverage
- 63 measures of child well-being were tracked across all 21 New Jersey counties
- Among third-graders taking the New Jersey Student Learning Assessments in the 2023–24 school year, only 44% met or exceeded expectations in English language arts
- 48% of third-graders met or exceeded expectations in mathematics
- Racial disparities in maternal and infant health outcomes persist despite state initiatives such as Nurture NJ
Zoom Out
The concerns raised in New Jersey mirror national debates over the size and scope of Medicaid, a jointly funded federal-state program that has grown significantly in cost and enrollment over the past decade. As Washington considers restructuring Medicaid funding, states with large enrollment populations face difficult decisions about how to sustain coverage levels without increasing the state’s long-term financial obligations.
Academic underperformance in reading and math is also a nationwide challenge. Post-pandemic learning loss has left many students — particularly in lower-income communities — below grade level, and recovery has been uneven. Coogan pointed to anxiety and school avoidance as compounding factors: “Kids are hesitant, they’re overly anxious and they’re not wanting to go to school. If they’re not in school, they’re not going to learn.”
On the healthcare side, New Jersey’s experience with maternal health disparities is also reflective of broader national trends. The report notes that despite the Nurture NJ initiative aimed at improving outcomes for Black women and pregnant people, inequities in maternal and infant health remain. Maternity unit closures across the country have further strained access to prenatal and postnatal care, particularly in underserved communities.
What’s Next
The Kids Count report is expected to inform state-level policy discussions as New Jersey lawmakers weigh budget priorities amid potential reductions in federal Medicaid funding. Advocates for Children of New Jersey is calling on state officials to protect NJ FamilyCare enrollment and expand access to early education and preventive health services.
Coogan emphasized the long-term cost of inaction, noting that healthier mothers and children require fewer interventions down the road. “Having a baby takes a toll on your health,” she said. “And maybe if women were healthier when they became pregnant, you wouldn’t see so many problems at birth.”
State officials have not yet outlined a specific legislative response to the report’s findings, but the release is likely to factor into ongoing budget negotiations in Trenton as the state weighs government spending priorities against a backdrop of rising long-term costs.