AUSTIN, Texas -- The combination of COVID-19 job loss and employer-provided health insurance is hitting Texas families hard, but many are eligible for health coverage under Medicaid if they sign up and meet income eligibility guidelines.

Texas has the highest rate of uninsured residents and children in the nation, but state lawmakers nonetheless have declined to expand Medicaid under the Affordable Care Act.

Melissa McChesney, policy analyst for the Health and Wellness Team at the Texas Center for Public Policy Priorities, said that when uninsured people get sick, they often wait too long to see a doctor.

"That has cost implications for that particular person, as that's a much more expensive way to treat that illness as opposed to going to a doctor when they first got sick," she said. "But also, it's more expensive overall for everyone."

It's estimated the cost of COVID treatment for someone uninsured can top $30,000, which could lead some people to skip testing or delay getting medical care.

Texans can learn more about benefits that might be available during the current health crisis, including Medicaid, SNAP food assistance and the Children's Health Insurance Program, at YourTexasBenefits.com.

According to a Georgetown University report, the number of uninsured children in Texas increased 16% between 2016 and 2018. McChesney said it keeps rising because many families earn too much for Medicaid eligibility, but not enough to purchase coverage through the Affordable Care Act. She said the pandemic has illustrated how many families are vulnerable.

"If we expanded Medicaid and provided insurance to those parents -- we've seen it in other states - it would create a 'welcome mat' effect, where you would also see the children of those parents becoming insured through the Medicaid program as well," she said.

More than 10% of Texas children were uninsured prior to the pandemic, a number likely to increase due to more than 2 million unemployment claims filed across the state since March.

The Georgetown report is online at kidshealthcarereport.ccf.georgetown.edu and the
and Center for Public Policy Priorities frequently asked questions are at forabettertexas.org.

Advocates for working families in New York say they want less talk and more action to improve child care in the state.

Gov. Kathy Hochul has proposed a child-care construction fund and a task force to address the issue - which advocates say will make a dent in the child-care shortage, but doesn't do enough.

Estimates show New Yorkers spend a grand total of $14 billion a year on child care, or about $22,000 per year, per child. High child-care costs also are cited as a major reason young families leave the state.

Rebecca Bailin, executive director of New Yorkers United for Childcare, said universal child care is possible if the state will fund plans to implement it.

"That child care would be free, easy to apply, nearby and accessible to all families," she said. "There's no reason, with a budget of $237 billion, she cannot start to implement universal public child care now."

Bailin said a lack of political will has been the biggest hurdle for universal public child care, since 74% of New Yorkers say they want it. Feedback from some state lawmakers is positive, although enacting a universal plan could cost $12 billion a year - 6% of the state's current budget.

A Cornell University poll found high child-care costs are one reason some people can't join the workforce, while other reasons are lack of accessible child care that keeps people from working.

Bailin said a universal public system could counteract these economic harms.

"It's a $10 to $13 return on investment for every dollar spent," she said. "Making New York an affordable place for families will help to stop the exodus of families, make it possible for us to grow our workforce and our tax base."

Although New York offers child-care programs, some families earn too much to qualify for them, or have issues with immigration status that keep parents from reaching out. Bailin said expanding New York's Child Tax Credit and Working Families Tax Credit could help the system, as well as investing in the child-care workforce.


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January is National Mentoring Month and in Minnesota, program leaders report waiting lists for kids to be matched up with an adult willing to spend some valuable time with them.

Calls are being renewed for volunteers. Community-based mentoring programs connect youths who do not have many role models in their lives with adults for a range of activities. It could include attending sporting events, museums, or doing arts and crafts together.

Jill Hinners, executive director of Mentor North in Duluth, said it is all about helping children develop new skills and confidence.

"We definitely see kids that are introverts, shy, anxious," Hinners explained. "Where maybe they just have a little bit of difficulty putting themselves out there to form a large network of friends."

She suggested a mentor might put them more at ease in making connections as they grow. Her group pointed to research showing mentored kids are 22% more likely to have felt a strong sense of belonging. Hinners noted even though Minnesota has a good track record for volunteer work, her office reports a waitlist of between 50 and 60 kids.

Other data show kids who have a mentor are 55% more likely to enroll in college and are 78% more likely to volunteer regularly. Hinners stressed the outcomes can be traced back to a sense of belonging.

"We want youths to feel that they are developing their voice," Hinners emphasized. "To be able to make themselves heard in their community and courageous enough to take leadership positions in their community."

Hinners pointed out even though they have a backlog, volunteer levels have rebounded from a pandemic dip. She added they are trying to be more accommodating in certain ways, including making sure kids with disabilities have a good experience.

Adults who want to become mentors are put through a screening process before they are matched with a youth who has similar interests.


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Nearly 9,000 families are on the wait list for the Oregon Employment Related Day Care program, and family advocates are calling on lawmakers to ramp up funding to meet the growing need. Child-care prices in Oregon can exceed college tuition and have outpaced growth in household incomes, according to research by Oregon State University.

Dana Hepper, director of policy and advocacy with the Children's Institute, said most families, even if they don't qualify for the ERDC, cannot afford child care.

"And most child-care providers do not make living wages. So we can't rely on just parents paying tuition to solve this child-care crisis," she insisted.

Hepper added that the state needs to spend at least $500-million more on the ERDC program this year. This would serve the families that are on the wait list, as well as those who have vouchers for the program but cannot find a child-care provider.

All but one county in Oregon is considered a child-care desert for infants and toddlers, according to Hepper. A child-care desert is defined as having only one licensed child-care slot for every three or more children. She added that there has been more funding for preschools, such as Head Start and Multnomah County's "Preschool For All" which has expanded access. But even if they are not deserts, Hepper added, every county in the state has a shortage of preschool care.

"I think there's a dearth of child-care because there's a lack of public investment in child-care. And the data bears that out," she continued.

Hepper highlights Gilliam County as the only Oregon county that is not a desert for infant child care because it has invested public funds. She added that the ERDC program alone will not solve the child-care crisis; the state also suffers from a shortage of child-care workers.

"We need strategies that support the workforce and invest in pathways to enter this workforce with the skills that you need," she concluded.