WAKE FOREST, N.C. -- Early-childhood educators are finding themselves choosing between basic needs and health care. The median salary for child-care workers in North Carolina is not quite $21,000 - too high to qualify for Medicaid, but leaving many early-childhood educators in the gap.

A new report from one group that advocates for Medicaid expansion in North Carolina interviewed early-childhood educators from across the state, and 1-in-5 said they don’t have health insurance. One educator who asked to be referred to as "Eryka," said she plans her budget very carefully each week for rent, food, electricity, and gas to get to work. But buying private health insurance is far out of reach for her.

She said that means she goes to work even when she’s sick.

"Most of the time, I kind of just have to ride it out and hope I get better. Otherwise, I am going to the ER, wasting their time, or the urgent care, wasting their time, for something small,” Eryka said. “If I had strep throat, I have to go pay $75, $100, to go to urgent care just to get antibiotics. Nothing is easily accessible when you don't have good health insurance."

Two measures in the state Legislature, House Bill 5 and Senate Bill 3, would raise the income level for those eligible for Medicaid. Senate Leader Phil Berger, R-Eden, took aim at provisions in both bills, saying it represents a tax that ultimately will be passed on to patients and taxpayers.

Bills in the House and Senate propose to use federal funding to expand access to Medicaid, as 37 other states already have done. Leaders from both parties and the governor have different approaches to increasing access to health care, but would need to reach a compromise in order to actually pass legislation this session.

Statewide, it's estimated that 500,000 people are in the "coverage gap," earning too much for Medicaid. Among them are thousands of early-childhood educators such as Meranda who said that while she enjoys working with toddlers, the fact that she's been uninsured for more than a year is frustrating.

"If they expanded Medicare, it would be such a huge burden lifted off,” Meranda said. “Then I wouldn't have to worry about getting sick and how long I am going to stay sick for. Am I going to get OK, or is this something serious because I have cancer that runs in my family. All four of my grandparents had it, my great-grandparents had it, my mother had it."

Members of the Early Childhood Advisory Council appointed by Gov. Roy Cooper wrote to legislators last week to share how expanding Medicaid to close the health-insurance coverage gap can help the state's more than 1 million young children.

Reporting by North Carolina News Connection in association with Media in the Public Interest and funded in part by the Park Foundation.


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The high cost of child care in Washington can strain family budgets. It can be even harder when families are experiencing homelessness.

A statewide call center is helping people find care and a way to afford it. BrightSpark Early Learning Services operates the Child Care Aware of Washington Family Center, which fields calls from families.

The center also has homeless navigation services. Erika Washington, department manager of family access with BrightSpark, said staff ensure they understand each families' needs.

"Does your little one have any special needs? And we're really able to pinpoint programs that meet each families unique needs," said Washington. "This offers families some stability and just knowing that we're on their side, we have their back and we're also understanding of some of the challenges that they may face."

Washington said the call center is able to connect families with state child care subsidies like Working Connections, or through the homelessness grace period.

The center also provides follow-up services after 30, 60, and 120 days.

Washington talked about one family BrightSpark was able to help that moved to Washington and ended up needing housing. The family had one school-age child and two kids under the age of five.

Washington said they connected the family with a child care program that understood how to support families experiencing homelessness.

"So when transportation became an issue, or when hours of operation became an issue," said Washington, "this child care provider was able to really support this family's needs and really become more of like a family or support system for that parent."

Washington said the center wants to uplift families' voices and let them know how they can take action. She said they support enough families experiencing homelessness to understand their needs.

"A lot of times those families who are experiencing homelessness are working the evening hours or weekend hours," said Washington, "and that's a big challenge across our state, of being able to find child care programs that is available during those hours. And so, it's something that we hear time and time again, and we often are providing support but that need continues to be there."

Utah parents can expect to pay between $800 and $1,200 dollars a month for child care but a new program is expanding its reach into Summit County to help with affordability.

The nationwide child care network Upwards will offer need-based child care scholarships of up to $1,700 for preschoolers. The group is partnering with Summit County and Park City Municipal.

Starr Mastrodonato, program manager for Upwards, said to qualify, at least one parent must reside or work in Summit County, and the total family income cannot exceed 100% of the county's area median income. She pointed out removing barriers to child care also means parents can stay in the workforce.

"It really allowed them to make life decisions on, 'We both can continue to work and to contribute to our family,'" Mastrodonato explained. "And that obviously is just monumental in just overall well-being, not only for their household, their children. And it continues to help the economic workforce."

While cost is one factor, availability is another. Research shows no one county in Utah has the sufficient number of licensed care providers to meet demand. Summit County has the highest percentage of child care needs being met at 54%, according to Voices for Utah Children. Statewide, the number drops to 36%.

Mastrodonato explained expanding assistance to Summit County comes after their Park City pilot program was able to assist 34 working families and helped support 17 child care providers. For every child enrolled at a provider location, the provider receives an additional $300 per month. She added Upwards is excited to build on the program's success.

"We're hoping they take this model, to see how successful it has been," Mastrodonato noted. "And within six months, be able to identify that we can expand to reach more families."

Summit County scholarships and child care provider incentives became available earlier this month. They will be available on a first-come, first-served basis each month.


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More employers are offering benefits to adoptive parents, according to a new survey by the Dave Thomas Foundation for Adoption. The amount of paid leave offered to foster parents is now nearly 10 weeks, up 3% from last year.

Jeremy Madden, a resident of Liberty Township, Ohio, and his wife relied on workplace adoption benefits through his employer, Fifth Third Bank, to adopt their baby daughter. He said the process was easy and the financial reimbursement was a game changer, as adoption can cost thousands of dollars. Now, they've settled into life as a family.

"She's fantastic, we wouldn't change anything," he said. "She's brought so much joy and happiness into our life. She's developing her own personality. She is super smart."

Companies that offer new adoption benefits include Harley-Davidson Motor Co. Inc. and Ziff Davis Inc. Highly ranked companies include Ferring Pharmaceuticals and Liberty Media Corp., American Express and MongoDB Inc. Ferring Pharmaceuticals topped the list for providing unlimited financial reimbursement for adoption costs and 26 weeks of paid leave to adoptive parents.

Rita Soronen, the foundation's CEO, cited a 10% increase on average in financial reimbursement for adoption.

"It tells the employees that we're a family-friendly organization, that there's equity if we're offering benefits for families that are formed through birth, we also want to give benefits to families that are formed through adoption," she said, "and it creates a sense of loyalty and retention and goodwill."

She said it's important for employers to consider foster and adoption benefits, not only for its employees, but the good of the community.

"It says to the community that we understand that there are lots of ways that our families are formed," she said, "and we can provide the kind of supports that a family might need to move to that next phase of being a unified and thriving family."

According to the National Council for Adoption, 2022 saw the fewest number of adoptions from foster care since 2015, around 53,000 children nationwide.


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