RALEIGH, N.C. -- An estimated 142,000 North Carolina children were uninsured last year, according to a new report released by the Georgetown University Center for Children and Families.
The report found the state's rate of uninsured kids jumped by 24% between 2016 and 2019, the seventh largest increase in the nation. Most uninsured children are eligible for Medicaid or the federal Children's Health Insurance Program, or "CHIP." But the government slashed budgets for outreach and enrollment assistance, leaving many families either unaware or confused about how to sign up.
Michelle Hughes, executive director with the group NC Child, said the Trump administration's hostile rhetoric toward immigrants is likely also deterring parents from signing up their kids.
"Latino children in North Carolina are more than twice as likely as other children to have no health care coverage," Hughes said. "And we really need to repeal the public charge rule that is impacting these kids."
The Trump administration is now resuming its scrutiny of green card applicants receiving public benefits. A federal judge temporarily halted the public charge rule over the summer citing concerns over the pandemic.
Additionally, the data reveals a surge of un-insurance among the state's preschool-aged children, with nearly 9,000 more kids under age 6 becoming uninsured during the three-year period - a nearly 36% increase for young children.
Joan Alker, executive director of the Georgetown University Center for Children and Families, said the number of uninsured children has increased every year of the Trump administration. The largest jump was between 2018 and 2019.
"What's so troubling is that, you know, we've had years and years of progress as a country, in a bipartisan way, to reduce the number of uninsured children. And what we see now is that trend has clearly turned around since President Trump took office," Alker said. "And we're going backwards at an accelerating rate."
About 726,000 children have lost health coverage nationwide since 2016, during a relatively strong economic period before the onset of the coronavirus. Hughes predicts that number is likely to increase.
She added state lawmakers could expand Medicaid or adopt a state plan where parents and caregivers can get health coverage. Research has shown that when parents are covered, their kids are more likely to be covered as well.
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As Alabama's legislative session kicks off, one advocacy group is calling for urgent action to protect children's health and safety.
VOICES for Alabama's Children has outlined 10 key policy priorities for 2025, with a focus on reducing preventable deaths and expanding access to health care. The group's data show more children are losing their lives to car accidents and firearms.
Apreill Hartsfield, policy and data analyst and director of Alabama Kids Count for Voices for Alabama Children, said lawmakers could strengthen child passenger safety laws and implement firearm safety measures to help save lives.
"Hopefully, a child does not come across a firearm but if they do, that there are devices on those firearms that will keep them from being accidentally discharged," Hartsfield urged. "Because this is a reason why children in our state are dying."
Lawmakers have already prefiled about a dozen firearm-related bills. Among them is House Bill 26, which would ban pistols modified to function as machine guns, and House Bill 103, which would require secure firearm storage, making it a crime if a minor gains access due to negligence, with some exceptions.
Hartsfield thinks expanding health care access should also be at the top of lawmakers' agenda. While most Alabama children are covered by Medicaid or ALL Kids, nearly 200,000 working adults remain uninsured, creating challenges for families trying to stay healthy. She stressed when parents have health coverage, their children also reap the benefits.
"The children are more likely to be covered by insurance and are more likely to get regular medical care, to do those 'well baby checks' and just to try to stay ahead of any kind of illness, or any kind of developmental delay," Hartsfield explained.
She added other priorities include expanding mental health services, strengthening tobacco and vaping laws to reduce underage use, and increasing funding for nutrition programs like Summer EBT. The group also wants to see stronger data-driven juvenile justice reforms and updates to the state's public school funding formula to better meet students' needs.
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Tennessee's "State of the Child" 2024 report shows some progress, but also highlights ongoing concerns.
The report from the Tennessee Commission on Children and Youth examines kids' health and mental health, education, family economics, and childcare.
It also looks at the state's child welfare and youth justice data.
Kylie Graves is the director of policy and legislative affairs at the Tennessee Commission on Children and Youth.
She said a key indicator they look at most frequently is the percentage of children living in poverty. She noted that the percentage of children living in poverty in Tennessee did go up slightly between 2022 and 2023.
"So in 2023 we had 19.7% of our children under 18 living below the federal poverty line," said Graves. "For our kids under five, it was 20% - just a little bit above that. That did stay consistent between '22 and '23, so we saw no change in the under five poverty rate."
Graves noted that the annual report provides a comprehensive overview of child well-being in the state.
She said it tracks progress, comparing it with previous years and other states, and highlights areas for growth.
Graves said the report consistently reveals the high cost of infant center-based child care for families in Tennessee.
"The average market rate is $13,126, and so it's very expensive for a lot of families," said Graves. "That does make it more expensive than in state tuition for all but one of our state universities."
Graves pointed out that Tennessee's education system is showing progress, with T-CAP scores rebounding post-pandemic - though most students are still only "approaching" expectations.
She said teen mental health is still a serious concern, with nearly one in four high school students reporting thoughts of suicide.
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New child labor laws went into effect in Virginia at the start of the year, but some advocates say more can be done.
House Bill 100 took effect in January, raising the maximum financial penalty to $25,000 -- up from $10,000 -- if a child dies or is seriously injured while working in violation of labor law. Cases that do not involve injury or death will have stiffer penalties, too, with maximum fines set at $2,500.
Nina Mast, a policy and economic analyst for the Economic Policy Institute, said it is just the start of combatting illegal child labor in the Commonwealth.
"This was a really important first step in the overall goal of strengthening child labor standards in Virginia," she said, "but the penalty amounts are really only as effective as the enforcement can be in the state."
Mast added that the legislation also created a group made up of youth-serving organizations and young people to explore the creation of workers' rights education for high school students.
Going forward, Mast said new laws must keep young people from working in dangerous or hazardous work environments, including staffing agencies that are often used to fill meatpacking and construction jobs. That keeps the main company from being held liable.
Mast said state labor agencies need more employees to hold companies accountable.
"Employers know this. They know that they will largely get away with violating the law and no one will ever enforce those violations," she said. "Adding capacity is really important to signaling to employers that the law will actually be enforced when violations are found."
Before the law went into effect, there was no minimum financial penalty for business owners who broke child labor laws.
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