Every state has been screening newborns for several decades, usually performing a heel-prick blood test, a hearing test and a heart check.
Several disorders diagnosed through newborn screenings can be treated and their effects significantly reduced when caught early.
Sen. Ben Hansen, R-Blair, said Nebraska is one of only three states without a provision for parents to "opt out" of newborn screening for religious or other reasons. His bill, Legislative Bill 1060, would change that.
Hansen noted constituents brought this issue to his attention, pointing out refusing the screenings can result in a lawsuit, lack of a birth certificate and even the possibility of the state taking a child away.
"That kind of philosophically goes against my idea of a parent's liberty to either object or accept doing a test such as this," Hansen explained.
In 2008, Nebraska's Department of Health and Human Services temporarily removed a child from parents who refused the newborn screening based on their religious beliefs. The case reached the Nebraska Supreme Court, which determined the state's mandated screenings do not violate the free exercise of religion provisions in the Nebraska Constitution. The court noted the screenings test for conditions which, untreated, "can lead to mental disabilities, loss of hearing, loss of vision, irreversible brain damage, or death."
Hansen stressed his bill only leads to a change in the state's newborn screening protocol if the parents or guardians specifically request it.
"Only if the parent actually engages with the hospital or the doctor and says, 'Hey, look, I do not want this test on my child,'" Hansen emphasized. "It's not like when you go to the hospital to have a baby, the doctor says, 'OK, so do you want to have this test done?' They don't even ask that question; it's just done."
Julie Luedtke managed Nebraska's Newborn Screening Program for 24 years before retiring. She is concerned about treatable disorders being missed if parents opt out of newborn screenings.
"Every year, just in Nebraska, somewhere between 50 and 60 babies with one of these clinically significant diseases gets identified, and gets into treatment, and has these terrible things prevented," Luedtke stressed.
When she managed the screening program, Luedtke surveyed her peers in states with an "opt out" provision, asking whether any babies whose parents opted out of the screenings were later found to have disorders. She noted there were a number of them, including a baby who died at eight days of age from galactosemia, the inability to process the sugar galactose present in breast milk, cow's milk and other dairy products.
"She's feeding her baby, not knowing that's basically killing the baby," Luedtke recounted. "If they'd done the screen and gotten the results back, they'd know to get that baby changed right away and onto a soy formula, and the baby would have been fine. Sadly, that baby died."
The measure had its first hearing on Jan. 31 in the Health and Human Services Committee. As yet, no further action has been taken.
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More than 300,000 children have been dropped from Medicaid and Peach Care for kids since the pandemic ended.
A report from the Georgetown University Center for Children and Families pinpoints a nationwide trend: More than 4 million kids were left uninsured, soon after the COVID public-health emergency ended.
Georgia ranks third-highest for the number of children who have lost coverage.
Judy Fitzgerald, executive director of Voices for Georgia's Children, said many lost coverage because of procedural reasons rather than eligibility.
"They're not ineligible, but there was missing or incomplete paperwork, or what we know from families is, they felt like they didn't receive the notification, they didn't know," she said. "And so, there are a large number of children who are still eligible."
Fitzgerald said the repercussions of disenrollment can be dire, as when children can't get timely access to health-care services, they're more vulnerable to illnesses and developmental delays. The report also found parents with access to employer-sponsored health plans can't always afford the cost of adding their dependents.
While parents face higher income requirements for Medicaid, many children who lost coverage during the pandemic are still eligible. Fitzgerald said Voices for Georgia's Children is advocating for ways to increase enrollment for children, including a more simplified enrollment process and assistance from state agencies to expedite screening.
"So, we're asking the state to expand the kinds of organizations that could screen kids for eligibility, and enroll them in coverage temporarily while the state processes an official enrollment," she added, "and this is something called presumptive eligibility."
She said programs such as SNAP, and information through the Department of Labor, could be used to facilitate renewals. For families who don't qualify, she said, alternative coverage options are available through the insurance marketplace. Navigators through Georgians for a Healthy Future can help find them.
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The Medicaid and Nevada Check Up programs had more than 13,000 fewer children enrolled last year than during the pandemic, according to new research from the Georgetown University Center for Children and Families.
States have been reexamining Medicaid benefits since the pandemic ended, and disenrolling families based on their head-of-household's eligibility. Carissa Pearce, health policy manager for the Children's Advocacy Alliance, said this means some children were also dropped from coverage who are still eligible.
As a result, she said, the Centers for Medicare and Medicaid Services told states to stop disenrolling and ensure they were looking at individual eligibility.
"Meaning that children would be screened separately from their parents, and that was a really important change," Pearce explained. "Specifically in Nevada, every person who had been disenrolled up to that point in August and September of 2023 were reinstated for their coverage, so that they could fix their system and then proceed with disenrollments."
Pearce said Nevada didn't start disenrolling children again until January of this year, giving families more time to check the requirements and submit the documentation to keep their coverage. But from January to February, about 1,500 Nevada children were dropped. She said it's important for families to see if their child is eligible for Nevada Check Up or consider a state marketplace insurance program at nevadahealthlink.com.
Tara Raines, deputy director of the Children's Advocacy Alliance, said her message to families is to not avoid medical appointments if they suspect their child may not be covered. She said there are other programs that families can be directed to, and thinks the state could do more to reach and inform families.
"I think a campaign that lets people know, 'Hey, you were disenrolled from Medicaid, here are your options,' would be incredibly helpful," she said, "and I don't know if that looks like partnering with school districts."
Raines said families' living conditions and circumstances vary in the Silver State. This could mean some may not have a permanent address, but should not mean they go without health coverage.
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More than one million children in Texas no longer have health insurance through Medicaid, despite being eligible for coverage, according to a new report from the Georgetown University Center for Children and Families.
During the COVID-19 pandemic, states were not allowed to cancel coverage - then last year, state health departments were tasked with rechecking the eligibility of Medicaid recipients.
Brittney Taylor-Ross, senior policy analyst with the advocacy group Every Texan, said despite the option to slowly complete the task, Texas chose to do it in one year's time.
"We didn't take up a lot of the flexibilities that were offered, so that was a state choice at the leadership level. We also chose to go through this unwinding process pretty quickly. Other states have paused their process when they've seen that things don't look right," Taylor-Ross said.
The report shows Texas has disenrolled more children than any other state. Anyone who lost coverage must reapply. Taylor-Ross said as of April, the median amount of time to process a new Medicaid application is 95 days. Federal law requires this number to be 45 days or less.
Most families don't realize they no longer have coverage until they go to the doctor's office.
Joan Alker, research professor, McCourt School of Public Policy, and executive director, Georgetown University Center for Children and Families, said the problem affects not only families, but the pediatricians and clinics that treat them.
"Kids are going to miss out on those well-child visits, they're going to miss out on getting the medications they need - be it an inhaler for their asthma or an ADHD medication. And that really sets them back, both in their health and their success in school," she said.
Because of the unwinding, more than 4 million fewer children are enrolled in Medicaid. One out of four of those children lives in Texas.
Disclosure: Georgetown University Center for Children & Families contributes to our fund for reporting on Children's Issues, Health Issues. If you would like to help support news in the public interest,
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