Medicaid and the Children's Health Insurance Program have been a lifeline for struggling families during the pandemic - and a new report suggests more than six million children in the U.S. could needlessly lose that coverage.

A "continuous-enrollment" requirement will be lifted at the end of the public-health emergency, which could be as early as April.

The federal government then gives states 12 months to re-determine people's eligibility. But Ohio's new state budget calls for that work to be completed in 90 days.

Kelly Vyzral, senior health policy associate with the Children's Defense Fund-Ohio, said the shorter timeframe could lead to families being erroneously dropped from coverage.

"There are workforce shortages that are affecting Ohio Medicaid just like they're affecting every other business in Ohio, and they've got an enormous caseload to go through," Vyzral. "And we want to make sure that every family and every child that is eligible for Medicaid is able to maintain that coverage."

The findings from the Georgetown University Center for Children and Families indicate a nearly 12% increase in Ohio children enrolled in Medicaid and CHIP between February of 2020 and June 2021. That's roughly 134,000 kids at risk of losing coverage.

More than half of all children in the U.S. are enrolled in Medicaid and CHIP. Executive Director of the Georgetown University Center for Children and Families Joan Alker says 37.3 million kids are currently protected by continuous coverage.

"This mass and unprecedented eligibility redetermination process holds great risk for children and their families," said Alker. "And that risk will vary depending on where they live."

Positive measures Ohio has made to cover families are noted in the report, including expanding Medicaid under the Affordable Care Act and merging the Medicaid and CHIP programs.

Vyzral said they've also eliminated other red tape.

"They offer 12-month continuous coverage for families and children," Vyzral. "They have been improving their level of passive renewal, so that families don't have to continue to submit information if Medicaid can verify that through existing data and records they have."

She said she's hopeful Ohio will take advantage of the 12-month allowable time frame for redeterminations.

The lack of quality child care for infants and toddlers costs Colorado nearly $3 billion each year in lost earnings, productivity and revenue but an initiative in Mesa County shows what is possible when local governments, businesses and civic groups team up.

Keller Anne Ruble, client success manager for the data firm BridgeCare, said officials saw huge demand for child care in the town of Clifton, but no providers. So they built a new facility that provides child care and also trains new caregivers.

"So that they can meet the needs of working families and invest in their early care workforce pipeline," Ruble explained. "And because of that investment, they now have 270 seats at this child care center, and they've completely eliminated their child care desert."

Budgetary constraints imposed by Colorado's Taxpayer Bill of Rights make it much harder for the state to invest tax revenues in initiatives such as the one in Clifton. The state also recently froze enrollment in the Colorado Child Care Assistance Program. Over the past 15 years, Colorado's economic growth has dropped from fifth in the nation to 41st, according to the 2025 Colorado University Leeds School of Business report.

Half of Colorado parents said they have quit jobs, worked fewer hours and taken unpaid time off. In 2023, more than 10,000 moms left the workforce, all because of a lack of child care.

Ruble emphasized when the cost of child care is too high, many parents just cannot afford to go to work.

"Families across the country are spending up to 60% of their income on child care," Ruble pointed out. "That's equivalent to a second mortgage or a second rent payment."

Children younger than age 3 are experiencing one of the most crucial periods of brain development and Ruble stressed investing in quality care is important for their long-term health.

"When young children have high-quality, enriching early experiences with trusted caregivers, it sets them on a strong foundation for growing, flourishing into thriving adults that contribute to our workforce and our society," Ruble asserted.


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The number of Kentucky children enrolled in preschool increased in 2024, along with state spending per child, according to new data from the National Institute for Early Education Research.

The commonwealth spent around $6,500 per child during the last academic year, an increase of more than $800 from the prior year.

Steve Barnett, founder and senior director of the institute and the study's co-author, said it is unrealistic to think states could replace cuts to Head Start funding amid the Trump administration's proposed freezes of federal grant funding.

"And particularly replace it overnight if the program is suddenly defunded," Barnett emphasized. "States are going to have to step up and figure out what to do if that happens."

He added if Head Start funding is eliminated, access to public preschool will decline in several states by more than 10 percentage points, and in some, by 20.

Kentucky lawmakers have taken recent steps to expand preschool access, including passing House Bill 695, which established the Adaptive Kindergarten Readiness Pilot Project. The measure aims to provide no-cost, online education for 3- and 4-year-olds who may not be attending state-funded preschool programs.

Allison Friedman-Krauss, associate research professor at the institute, said states spent more than $13 billion on preschool last year, including $257 million in federal pandemic relief funding, in part to attract more qualified teachers.

"We also see in our data that many states are reporting teacher shortages in early childhood, that they've had to increase their waivers in order to get teachers in classrooms," Friedman-Krauss reported.

Research shows toddlers who attend preschool are more prepared for elementary school and less likely to be identified as having special needs, or be held back, than children who do not.


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Medicaid is in the crosshairs, as Republicans in Congress are expected to lay out proposals in May to cut $1.5 trillion from the federal budget, prompting strong opposition from educators.

Around 15 million Californians rely on Medicaid, known here as Medi-Cal, for their health care. However, as Mayra Alvarez, president of the Children's Partnership, noted, the cuts would also deal a devastating blow to schools.

"Medicaid is the third-largest source of funding for K-through-12 public schools to help children have access to routine health screenings, preventive services and physical speech and occupational therapies," she said.

The Trump administration is looking for savings to fund the president's other priorities, including extending his 2017 tax cuts, which primarily benefit the wealthy and corporations. School districts are uneasy because they are legally required to provide accommodations for students with disabilities, regardless of how much the federal government is willing to reimburse.

Sacramento County schools superintendent David Gordon said districts would have to make big cuts across all programs.

"Without those funds, there would be a huge bill," he said, "and school districts would be forced to basically play financial roulette to figure out what do we cut?"

Gordon said his district uses Medi-Cal funds to place mental-health clinicians at each school site, so students with psychological needs get early diagnosis and treatment.

Shana Hazan, a trustee for the San Diego Unified School District, said people don't realize the critical role districts play in providing health-care services.

"Students rely on Medi Cal for things like audiology, mental-health support, nursing and wellness, occupational and physical therapy, home hospital care," she said. "These are really essential for many students with the highest needs."