HARRISBURG, Pa. – Children's advocates say repeal of the Affordable Care Act would leave thousands of Pennsylvania kids without health insurance. President Trump and congressional Republicans already are taking steps to repeal the landmark health-care law.

According to Joan Benso, president and CEO of Pennsylvania Partnerships for Children, that would reverse the gains the state has made toward getting all children insured.

"Some kids could lose coverage because they had pre-existing conditions," she said. "Other children could lose coverage because they are over the age limit of when you could stay on your parents' health insurance prior to ACA."

Almost 90,000 young adults who have "aged-out" of their parents' health insurance or extended Medicaid for foster children would become uninsured.

Benso pointed out that when parents get health insurance, so do their children – and prior to the ACA, there were more than 130,000 uninsured parents in Pennsylvania.

"The expansion of Medicaid in our state helped more of those families come into coverage, and we watched the number of children who were uninsured decrease," she explained.

She said the Medicaid expansion helped reduce the uninsured rate for children in Pennsylvania to 4.1 percent, an all-time low.

While federal legislators have said the Affordable Care Act will be replaced by "something better," just what that replacement would be has not been made clear. Benso says the conversation needs to slow down until those details are on the table.
 
"We can examine them and say, 'What are the pros and cons of the alternative?'” she added.

Right now, she said, the federal government picks up about 90 percent of the cost of the Medicaid expansion and CHIP, the Children's Health Insurance Program, in Pennsylvania, money the state cannot afford to replace.


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According to some experts, a significant undercount in Florida's 2020 census may have lasting consequences for the state, jeopardizing vital funding and representation for communities in need.

The census affects funding allocations for key Medicaid and early education programs.

Dominic Calabro, president and CEO of Florida Tax Watch, said the 750,000 uncounted residents have left the state "shortchanged," costing Florida billions in federal resources and potentially reducing its influence in national elections.

"When it comes to caring for children, this is, conservatively, I mean absolute, the lowest number is 10 billion, but it's more like 20, 21 billion plus over 10 years," Calabro outlined. "That's a lot of dough. That's money that's going to other states and communities where people Americans no longer live."

According to the U.S. Census Bureau, undercounts are a common challenge for states with transient populations. The Bureau has acknowledged historical undercounts, their effects and how they are "diligently working to address this issue" to improve census accuracy. Florida's shortfall also affects political representation.

Calabro believes the undercount may have cost Florida one or two congressional seats, reducing the state's voice in federal policymaking.

Local governments and organizations relying on the funding may face service challenges. Looking ahead to the 2030 census, Florida officials and advocacy organizations, including Florida TaxWatch, are exploring ways to reach more people.

Calabro stressed the plan is to get everyone to work together.

"Then focus on the harder to reach folks like children and those, particularly those under the age of six, and those that are both minorities and those are transient and moving about and migrants," Calabro explained.

In 2022, the Census Bureau formed the Undercount of Young Children Working Group, which is focused on identifying underlying causes of the undercount of young children and improving data on this population. The working group is researching ways to enhance the count of young children in the 2030 census.


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Utah child care providers, parents and children's advocates say the state's child care crisis is getting worse and they hope voters will take the issue to the polls.

Brigette Weier, program director for the advocacy group Utah Care for Kids, said this year's electoral races up and down the ballot will determine how the state cultivates a stronger child care system, or not.

"We want it to be a primary driver, because we really believe that everyone is touched by child care in some part of their daily lives, some aspect," Weier explained. "Whether that is yourself as a parent, as a business owner who relies on parents for part of their workforce."

Weier hopes Utahns will understand child care is not a partisan issue. Last week and over the weekend, parents, child care providers and their advocates gathered in Salt Lake City and Logan to demand better wages for child care providers and more affordable licensed child care options for families. They also want candidates to back an "inclusive expanded Child Tax Credit."

A recent Bankrate study lists Utah among the states with higher concentrations of "child care deserts," meaning not enough affordable care for families who need it. It can cost between nine and 11% of a family's income for child care, according to the study.

So, while the big federal races are important in the election, Weier stressed local, "down ballot" races have the most effects in communities, including addressing child care discrepancies.

"Think about the people that you know and what they need," Weier suggested. "That would be my one nugget is, make it personal. It is about you, and it is about those people that you pass on the street on your morning walk every day. What do you want for them?"

Despite decreases in recent years, Utah still holds one of the top spots in the nation for its high fertility rate. Some attribute state lawmakers' reluctance to subsidize child care to the Legislature being made up mostly of older men who have not had to deal with the current economic hardships young parents are facing.


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Today is National Brush Day and experts across Kentucky are reminding residents to brush their teeth twice a day, floss, avoid smoking, and especially for pregnant women and children, make an appointment for a cleaning and checkup with a dentist.

Julie Smith, registered dental hygienist and director of dental services for Cumberland Family Medical Center, which provides preventive and restorative oral health for more than a dozen school districts in the region, said without the program, most children would go the entire school year without seeing a dentist.

"It is not uncommon for us to see students who tell us they've never had a toothbrush or they've never had a toothbrush of their own because their entire family shares a toothbrush," Smith explained. "It's not uncommon to meet a child who says, 'When I am at one parent's house I have a toothbrush, but I don't have a toothbrush at the other parent's house.'"

The Kentucky Oral Health Coalition has launched a new series of free oral health materials for communities, dental offices, schools, libraries and other locations.

Dr. Jill Keaton, professor and dean of the Tanner College of Dental Medicine at the University of Pikeville and a member of the Kentucky Oral Health Coalition, said the new resources include information on dental insurance, and oral health tips for pregnancy, children, older adults, and people with substance use disorders.

"I love the fact that these resources are free and something that dentists or dental hygienists, dental assistants can print on their own and then distribute to patients or even other stakeholders," Keaton emphasized.

Smith advised as children have bags full of Halloween candy, it's important not to let them keep it in their rooms or have constant access to sugar, which causes tooth decay.

"Instead, keep it somewhere that maybe they get a couple of treats at meal time after their meal when it's going to do a lot less damage," Smith recommended. "Make the candy last."

According to a 2023 report by the University of Kentucky's Center for Excellence in Rural Health, the Commonwealth ranks ninth among states for oral cancer rates, and fifth in the percentage of adults with tooth extractions.


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