The Children's Health Insurance Program, covering low-income kids across the country, turns 25 in August, but Pennsylvania has had its own "CHIP" even longer - and it was used as a model for the federal program.
CHIP was launched in Pennsylvania five years earlier than the national program. CHIP allows states to cover children when parents can't afford private health insurance.
Today, said Antoinette Kraus, executive director of the nonprofit Pennsylvania Health Access Network, about 136,000 children in the Commonwealth are enrolled in CHIP, which is a slight decrease from previous years.
"We think that's because right now, we're still under a Public Health Emergency," she said, "so a lot of kids are enrolled in Medicaid with their families and they can't be cut off from coverage during this period. So, we expect when the public health emergency ends, a lot of kids will transition from Medicaid to CHIP."
That's because in Pennsylvania, CHIP can cover any uninsured child who is not eligible for the state Medical Assistance or Medicaid program. The current end date for the Public Health Emergency is Oct. 13, although there's a chance it could be extended.
The Pennsylvania Health Access Network helps families find health services that fit their budget. Kraus said one persistent barrier they see is that parents don't always know the income eligibility requirements for CHIP and assume they can't afford it.
"But really," she said, "for parents with very low incomes - if you're making between $21,000 and $28,000, and you have a kid under five, or you're making between $18,000 or $28,000 and your kid is between six and 18 - CHIP is free for them."
Kraus added that Pennsylvania is seeing one of the lowest rates of uninsured residents in its history, both for adults and children. She credited a combination of the Affordable Care Act, Medicaid and CHIP. However, a report from 2019 showed that 4.6% of children in the state still were uninsured.
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A refundable child tax credit aimed at helping families with young children was proposed in Gov. DeWine's budget but was stripped out by the Ohio House.
Advocates said it is not too late for lawmakers to restore it and offer families some financial relief.
Lynanne Gutierrez, president and CEO of the advocacy group Groundwork Ohio, said the funding is critical.
"This is a really strong policy that acknowledges the needs of families," Gutierrez explained. "It won't solve everything but it is an almost billion dollar investment. So his largest, single largest investment in young children and families that has been proposed in his tenure."
If passed, the child tax credit would be Ohio's largest direct state investment in young children to date, providing up to $1,000 per child under age seven, at a time when more than eight in 10 Ohio parents said inflation is forcing them to cut back on groceries.
Opponents argued the state cannot afford it but polling by Public Opinion Strategies showed nearly five of six Ohio voters support a state child tax credit, including majorities across party lines, with more than four of five Republicans, nearly eight in 10 independents, and almost 95% of Democrats. Support grew even higher when respondents learned it had been supported by both Presidents Biden and Trump.
Guillermo Bervejillo, research manager for the Children's Defense Fund of Ohio, called it a bipartisan policy.
"Nearly 20% of children in Ohio are living in poverty currently," Bervejillo pointed out. "That's 470,000 kids. A refundable child tax credit would have directly put money into the hands of those most in need and who are taking care of children."
Supporters said the Senate now has a chance to restore it in the final budget version, due by July 1. They are encouraging families to contact legislators, write letters or attend a rally June 17 at the Statehouse in support of the credit.
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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 software 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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