HARRISBURG, Pa. – Some children's advocates are saying the bill introduced in Congress as a replacement for the Affordable Care Act would be bad for kids in Pennsylvania. The American Health Care Act would put a cap per person on Medicaid spending, and set a maximum amount available for individuals based on factors like age or disability.

Joan Benso, the president and CEO of Pennsylvania Partnerships for Children, says if a child is in the category for typically healthy children and has a serious injury or chronic disease like asthma, medical expenses could easily exceed that cap.

"The State of Pennsylvania or their parents would be solely responsible for the full cost of those services, rather than having the historic cost-sharing we've had with the federal government," she explained.

Benso emphasizes that the impact on children with disabilities is still unclear. Those supporting the reform legislation say it would give states more flexibility in health-care spending.

The Medicaid caps could add millions of dollars a year to state health-care costs. And as Benso points out, Pennsylvania is already dealing with a budget deficit of about $3 billion.

"And at the end of the day, what we assume will happen is, services to kids delivered under Medicaid would be cut," she said.

Medicaid currently covers about 2.8 million Pennsylvanians, including 1.2 million children.

Under the Affordable Care Act's Medicaid expansion, more than 600,000 Pennsylvanians got health insurance. But Benso notes the current bill would end that expansion in 2020, leaving the state to pay for any additional Medicaid enrollees, and reducing the federal share for coverage of current expansion enrollees.

"And we assume at that point in time, the state won't be able to pick up that additional cost and adults will lose coverage, including adults that are parents," she added.

Benso also noted that parents' access to health insurance can have a profound effect on their children's health and well-being.


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CLARIFICATION: We updated language to clarify the timing for when the study's authors began tracking certain outcome measures for children within the foster care system. (9:30 a.m. CST, Nov. 22, 2024)

This Saturday is National Adoption Day and the latest findings showed Minnesota has made progress in helping kids in the foster care system secure a better future.

Aaron Sojourner, labor economist at the W.E. Upjohn Institute for Employment Research, helped lead a study of reforms Minnesota approved in 2015. He said states often provide financial support to children in foster care but support ends when a child is adopted or placed in a kin guardianship.

Minnesota decided to continue payments to households who take a child in permanently. Sojourner pointed out three years after foster cases started, positive outcomes became clear.

"The kids were scoring much higher on standardized achievement tests," Sojourner reported. "They were experiencing less turnover in schools and school instability."

He noted the incentives also boosted the chances of kids age 6 and older exiting the foster care system and moving into permanent home settings by 29%. Sojourner added while the results are encouraging, it is just one aspect of the child welfare landscape. Other research has shown racial disparities in Minnesota's foster care system, especially when looking at reducing entry rates.

Sojourner stressed if state lawmakers revisit the extended monthly payments in budget talks, they will need to realize the long-term payoff from these investments.

"The state is paying more money now but they're going to reap the benefits down the road," Sojourner contended. "In terms of increased earnings and employment."

His team's study said prolonged exposure to foster care is tied to poor transitions into adulthood, including homelessness.


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Nearly one in four Kentucky kids has experienced at least two Adverse Childhood Experiences, or ACEs, including abuse, neglect or household dysfunction, according to the latest Kids Count County Data Book.

Experts said the findings should prompt policymakers to better measure risk and pave the way for prevention.

Terry Brooks, executive director of Kentucky Youth Advocates, said the impact of ACEs on children can leave a lifetime imprint.

"When we think about Kentucky in 20 years, data around ACEs today is going to be a leveraged factor that we're going to be seeing the results of," Brooks projected.

According to the Centers for Disease Control and Prevention, ACEs trigger a toxic stress response in the body, which can change brain development and can lead to chronic health problems, mental illness and substance use disorders in adulthood.

Mentorship, guidance and support from adults and community members can help foster positive childhood experiences and buffer the impact of ACEs.

Aleah Stigall, a student at Boyle County High School, said a network of mentors participating in pageantry has helped her cope with loneliness.

"I was able to gain a lot of mentors," Stigall explained. "Some I like to even call my sisters, because of how they've impacted me and really show me what a true titleholder looks like and how you can make a strong impact on your community."

The findings also show more families are transient and struggling to stay housed. Brooks explained the state has seen significant increases in rental cost burdens.

"That eight-year-old little girl going to school has inevitably heard her mom and dad worrying about, are they going to get evicted, and are the lights going to stay on?" Brooks observed. "I don't think any of us can fully measure the impact it has on that little kid."

According to the research, Kentucky is short around 200,000 housing units. And between 2018 and 2022, 44% of Kentucky households spent 30% or more of their income on rent and utilities. In 20 counties, residents' rental cost-burden rates have reached 50%.

A new annual report shows New York City has more than 146,000 homeless students.

The Advocates for Children of New York report finds this is an increase from last year when more than 119,000 students were homeless. It also finds more than half of students were temporarily sharing housing with others, while 41% lived in shelters.

Jennifer Pringle, director of Project LIT with Advocates for Children of New York, says the city can help these students by addressing transportation delays.

"Roughly 40% of students in shelters are placed in a different borough from where they go to school, which means that students in temporary housing often face long commutes and are disproportionately impacted by busing delays," she said.

Other recommendations include eliminating the 60-day shelter limits and addressing shortages in staff supporting students in temporary housing. But, Pringle notes there's work the state can do too. More than 115 groups want the state to add a weight for students in temporary housing as part of the school funding formula re-evaluation.

The biggest challenge to implement these recommendations is political will, although they have broad support. But, student homelessness has been a long-standing issue for the city. This is the ninth year in a row New York City's homeless student population has included more than 100,000 students. There are many reasons students become homeless.

"Certainly we know there's a growing housing-affordability crisis," she continued. "Families indicate that domestic violence is one leading driver of family homelessness. And then also we have immigrant families, newcomers to the city as well, who are in temporary housing."

Living in temporary housing significantly impacts students' education. The report finds most students in either temporary housing or a shelter were chronically absent. It also notes their English Language Arts proficiency was 20% lower than students in permanent housing.


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