Health Insurance Coverage of the Center-Based Child Care and Early Education Workforce: Findings from the 2019 National Survey of Early Care and Education

Research BriefEarly ChildhoodDec 5 2023

Health insurance coverage provides individuals with a safety net in the event of illness or injury, enabling access to health care while protecting individuals from high medical costs. Health insurance is also a critical resource to ensure that a worker can remain healthy and work consistently.1 Having health insurance coverage is associated with improved outcomes such as better selfreported health, reduced mortality, increased diagnosis and treatment of chronic diseases, greater financial security, and improved depression outcomes.2 Health insurance can be purchased privately, either by an individual or sponsored by an employer (or spouse/domestic partner’s employer), or it can come from a public source (e.g., Medicaid). Alternatively, an individual may be uninsured.

Child care and early education (CCEE) teachers may obtain health insurance from any of the sources mentioned above, including as part of their compensation package over and above wages paid. However, recent studies suggest that relatively few child care programs offer health insurance to teachers, and many CCEE teachers are uninsured.3

National rates of health insurance coverage vary by race and ethnicity. For example, Hispanic and Black adults report higher rates of uninsurance and lower rates of private health insurance compared with White and Asian adults.4 It is unclear whether, and to what extent, similar disparities exist among CCEE teachers.

Given the importance of health insurance coverage for health, social, and economic outcomes, it is vital to understand health insurance coverage among CCEE teachers. In this snapshot, we used data from the 2019 National Survey of Early Care and Education (NSECE) to compare the health insurance coverage of CCEE teachers with that of the U.S. population. We also examined variation in health insurance coverage, source of coverage, and uninsurance among center-based CCEE teachers. Finally, we examined health insurance coverage by race and ethnicity.

This brief is part of the Child Care and Early Education Policy and Research Analysis (CCEEPRA) project. CCEEPRA supports policy and program planning and decision-making with rigorous, research-based information.


1 Gehr, J. & Wilke, S. (2017). The evidence builds: Access to Medicaid helps people work. The Center for Law and Social Policy.

2 Sommers, B. D., Gawande, A. A., & Baicker, K. (2017). Health insurance coverage and health—what the recent evidence tells us. New England Journal of Medicine, 377(6), 586-593.

3 Child Care Services Association. (2020). 2019 NC Early Care & Education Workforce Study: ECE Workforce Compensation. Ndugga, N & Artiga, S. (2023). Disparities in health and health care: 5 key questions and answers.

4 Amadon, S., Maxfield, E., & McDoniel, M. (2023). Wages of center-based child care and early education teachers: Findings from the 2019 National Survey of Early Care and Education. OPRE Report #2023-062. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.