RALEIGH, N.C. – More than one million North Carolina children benefit from Medicaid coverage, and as the nation's largest public health-insurance program turns 50 this week, a new report from the Georgetown University Center for Children and Families finds Medicaid has long-term benefits for children, their parents and North Carolina's economy.
Michelle Hughes, executive director of NC Child, says the help Medicaid offers is valuable across the board.
"Medicaid is an incredibly important program for North Carolina," she says. "We know it has a huge benefit for children's health, and it impacts our adult population's health. It is a wise public investment."
Children make up 52 percent of North Carolina's Medicaid population. Nationally, the uninsured rate for children fell from 14 to seven percent in recent years, partly as a result of Medicaid expansion efforts in some states. Parents who believe their children may qualify for Medicaid coverage can call 1-877-KIDS-NOW.
One of the studies included in the Georgetown report examines the tax payments of a group of people who received Medicaid as children in the 1980s and 90s. Joan Alker, executive director with the Georgetown Center for Children and Families, says by the time the group had reached age 28, the government had recouped 32 cents for every $1 spent on Medicaid.
"Some studies are now finding that children who received Medicaid actually pay more taxes as adults, and use fewer government subsidies," says Alker. "The government is getting a great return on investment by providing kids with Medicaid."
As Medicaid celebrates its half-century milestone this week, Hughes says there's valuable perspective to be gained with the passage of time.
"One of the really great things about Medicaid turning 50 is we now have decades of data that basically shows this is an incredibly important program," she says.
The Georgetown report also found that children with Medicaid coverage grow up to be healthier adults with decreased incidences of drinking, eating disorders and deaths by treatable causes.
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Child tax credits offer a financial lifeline to parents and can lift children out of poverty, according to a report from New Mexico's Voices for Children.
Jacob Vigil, deputy policy director for the nonprofit, noted in addition to federal child tax credits, New Mexico is one of 16 states with its own child tax credit. He said the credits, including refundable credits, are among the most effective ways to fight poverty because they return money directly to families who know best how to address their specific needs.
"These tax credits play a really important non-stigmatizing role in providing assistance to families in most need of support," Vigil explained.
In New Mexico, Vigil pointed out the state returned $132 million to almost 240,000 households this year through the state's child tax credit program. The credit varies by income level, with the largest credits available to low-income families. Because it is refundable, families can receive the full amount for which they are eligible regardless of their tax liability.
Studies show generous tax credits can lead to long-term improvements in health and higher earnings in adulthood, and also improve school performance, which increases college attendance rates. According to Vigil, extra federal child tax credits provided to families during the pandemic had a huge effect on the state's children.
"With the expansion of the federal CTC and it being refundable temporarily in 2021, that was 450,000 kids -- and that's 95% of the child population -- 32,000 children lifted out of poverty," Vigil reported.
Post pandemic, the federal child tax credit is no longer fully refundable, which means 36% of New Mexico families earning the lowest incomes are unable to access the full federal credit, while at the same time, a married couple making up to $400,000 receives the full amount of the tax credit.
Disclosure: New Mexico Voices for Children/Kids Count contributes to our fund for reporting on Children's Issues, Education, Human Rights/Racial Justice, and Immigrant Issues. If you would like to help support news in the public interest,
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By Dawn Attride for Sentient.
Broadcast version by Trimmel Gomes for Florida News Connection reporting for the Sentient-Public News Service Collaboration
Since she was five years old, Luz Vazquez Hernandez has spent her days on farms. Before she was school age, Vazquez Hernandez and other young children would watch under the shade, while their parents picked fruits under the scorching Florida sun; parents couldn’t find or afford childcare. Then, on her 14th birthday, she started working the fields herself, travelling for picking seasons in Michigan and Florida.
“I suffered pains and aches that my parents felt every day. Complaining to my parents was not an option, and my body adapted,” she wrote in a blog for National Consumers League. While her peers focused on school, she and her brother endured extreme heat and the toil of farmwork. “There was a lot of kids. It felt very normal to be there… my guess would be more than 50 percent [of workers were children],” Vazquez Hernandez tells Sentient.
Her experience is part of a growing, and often illegal, issue of child labor, particularly in dangerous industries like agriculture, which is the largest employer of children. Like Vazquez Hernandez, many immigrant children are exposed to extreme heat and physical duress while working in fields, or with hazardous chemicals. They are also employed to work on dangerous equipment in slaughterhouses; the Department of Labor’s (DOL) various investigations have uncovered illegal child employment in the supply chain of large meat companies like Tyson and Perdue.
Despite the scrutiny, at Tyson’s shareholder meeting earlier this year, investors voted against deeper auditing of their supply chain. Perdue claims they have strengthened their efforts to end child labor over the past two years. But the problem is systemic: child labor protections for hazardous agricultural jobs have not been updated in over 50 years, creating loopholes that are difficult to regulate.
While you can start working a regular job at 14, the Fair Labor Standards Act (FLSA) prohibits youth under 18 from working hazardous jobs.
That is, except in one industry: agriculture, where you can work at 16.
Why the Youngest Child Laborers Often Work in Agriculture
“It doesn’t make sense to us. If a job is hazardous, if it’s dangerous, the kid should wait till they’re 18…why would [they] make this exemption in agriculture? And we know that agriculture has very high injury and fatality rates compared to other sectors,” Reid Maki, coordinator of the Child Labor Coalition, tells Sentient.
But even this lower limit for agriculture doesn’t stop large companies from illegally employing kids well below this age limit; Vazquez Hernandez says as long as you look older, you can pass by scrutiny to find work.
Accidents are bound to happen when young kids work with dangerous equipment, and they have, sometimes resulting in death. There was Marcos Cux, a 14-year-old migrant worker who shredded his arm at Perdue’s Virginia facility. Or Duvan Robert Thomas Pérez, a 16-year old child from Guatemala, who died after being pulled into a machine at a Mar-Jac poultry plant in Mississippi.
These equitable loopholes in child labor laws are a “legacy of racism,” Maki says. “A lot of the early kids that were picking crops were Black kids and then [that] morphed into a lot of Latino children…these loopholes are allowed to exist because Congress just doesn’t care enough about Brown kids.” Kids who end up in dangerous jobs like meatpacking are largely unaccompanied migrants, he says.
A New York Times investigation reported that since 2021, nearly 400,000 children have crossed the southern border alone, mainly from Guatemala and Honduras. Magaly Licolli, director of Venceremos, a human rights advocacy for poultry workers group, has experienced these unaccompanied kids working in poultry in Arkansas.“They cross the border to help their family back home,” Licolli tells Sentient.
In the early 2000s, the DOL was mostly seeing kids work typical jobs, like in movie theaters or shopping malls. “But what we have found in the last five years is this uptick of serious child labor exploitation in industries such as manufacturing, meatpacking plants [and] poultry processing plants where we have very young kids that are cleaning very dangerous equipment on the kill floor at 2:00 in the morning,” a DOL spokesperson tells Sentient.
Keeping Corporations Accountable
In 2024, there were 736 child labor law violations, according to the DOL’s most recent data. The details of their investigations are harrowing: “Federal investigators witnessed children concealing their faces and carrying glittered school backpacks before starting their overnight shift,” the DOL investigation into a cleaning company used by Perdue earlier this year stated.
Tyson Foods, which previously hired sanitation contractors that employed children, is now under investigation for employing minors at two of its Arkansas poultry plants. A local teacher tipped off authorities after one of her 14-year-old students told her he would spend the summer working at Tyson, inspection warrants reveal.
Keeping large meat corporations like Tyson accountable is extremely difficult, Licolli tells Sentient.
“Very few people know the dynamics of these corporate towns and why these corporations gain so much [power]. It is because they began in small rural places like Arkansas, where they can build their political power.” Licolli founded Venceremos in Tyson’s headquarters state, Arkansas, to address the onslaught of numerous worker violations and deaths at the poultry plants there.
One of the most effective strategies Venceremos has developed is interacting with investors and faith leaders to try to enact change at Tyson, which is marketed as a company with Christian values.
“Investors have been fighting these companies for many years…it was important that we connected the fight,” she says. Most recently, they put forth a proposal for Tyson to audit the number and extent of kids working within their supply chain, which Tyson rejected, saying that they are confident of their protocols and core values on child labor. Venceremos is working on their next proposal, which Licolli hopes will gain more traction, considering the ongoing Tyson investigation.
A Surge in States Weakening Child Labor Laws
Work to create corporate accountability may be undermined by a push from various states trying to loosen their child labor laws.
Last May, Iowa governor Kim Reynolds signed a bill that would allow meat plants to legally employ kids as young as 14 — and work night shifts, too. Since 2021, 28 states have introduced bills to weaken child labor protections, with about half actually enacting them. However, federal law still trumps state law, which can mean serious charges for businesses that follow state law, such as several restaurants in Iowa who were fined up to $180,000.
Reynolds called the DOL’s fines “misguided,” and issued a statement in July saying “a couple extra hours of work for kids who choose to have a job are much more likely to help than hurt them.” The DOL maintains their stance and encourages safe employment for teens of age.
“We all had our first jobs, right? I was a really bad busboy…you learn valuable skills, you get some extra money that’s needed and we want to encourage those opportunities…that is a lot different than a 12-year-old working on the kill floor of a meat packing plant,” the spokesperson tells Sentient.
Reynolds’ idealistic vision of child employment is far from the reality, for many kids. No one wants to work these intensive jobs in these poor conditions, Licolli says, which means companies focus on hiring immigrant children, often for low pay.
Subcontracting the Liability
A strategy used by corporations like Tyson and Perdue is using subcontractors who employ children, as evidenced by the DOL’s investigations.
“Employers say, ‘oh well, we don’t know about what this other company [does]’ and, ultimately, there’s a legal responsibility or moral responsibility to take responsibility within their supply chain,” the DOL spokesperson said.
Tyson did not respond to our multiple requests for comment, but in their code of conduct they state that they don’t “tolerate” child labor.
“Over the past two years we have strengthened our efforts to hold suppliers accountable for child labor compliance by implementing age verification audits, tightening facility access procedures, and launching an internal reporting campaign,” Perdue said, in part. Perdue’s full statement can be viewed here.
While the Child Labor Coalition still has a lot of progress to make, Maki says they’re proud of their smaller achievements, like publishing reports recommending updated protections to governance, and successfully pushing for a ban on pesticide exposure that neurologically affects children. The ban was almost complete during the Obama administration, then Trump stalled it, and finally Biden enacted it. If bills try to raise the age of child labor in agriculture, Maki says farm lobbyists will likely try to kill them to preserve the family farm.
“I just don’t see it having a huge impact on the family farm and we’re only asking that kids [have] the same rules that apply to all other children and teenagers in the country. Ag does not deserve this exemption, especially since a lot of the companies are owned by corporations,” Maki says.
How Farm Lobbying Has Created Loopholes
An example of farm lobbying working against child labor protections was the backlash against updated protections by the Department of Labor for hazardous labor in 2011. Updated protections for youth working in non-agricultural jobs went through without any opposition. Agricultural jobs, however, were met with a misinformation campaign from lobbyists, Maki says.
For example, one of the rules put forth to protect child workers was that kids under 16 should not be allowed to operate power-driven equipment. “But the way that the farm lobby characterized the rule was, oh, ‘the rules prohibit power driven machinery. So that means if a teenager on a farm wants to use a flashlight, they won’t be allowed to,’” Maki tells Sentient. They exaggerated the impact and said the regulations would kill the family farm, he says.
Pressure from farming groups worked. The Obama administration released these proposed rules very close to the election, which ended up making them quite politicized. As a result, the administration pulled the rules.
“So the rules officially died in 2011 or 2012. And ever since then, we have been trying to crack that door open again, because we really feel that the Department of Labor has an obligation to protect kids from known dangers,” Maki says.
The DOL currently has 733 investigators, who have to cover 165,000,000 workers, meaning they have to be strategic in how they use their resources. Recently, they have started charging more aggressive child labor fines.
For example, Packer Sanitation, used by Tyson and others, was fined $1.5 million for illegally employing more than 100 children. In 2024, the DOL’s child labor fines were double that of 2023, despite the overall number of violations being slightly lower. Democrats have also introduced the “Let’s Protect Workers Act,” which would see child labor violation fines significantly increase, if passed.
“After years of seeing my parents toil in the fields and working beside them, I feel the need to be an advocate for my community,” Vazquez Hernandez says. She is now at Michigan State University studying Public Policy, and worked with CLC to advocate for farmworker protections — a mission she intends to continue advocating for.
Dawn Attride wrote this article for Sentient.
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