This week marks the 25th anniversary of the Children's Health Insurance Program, known as CHIP, which in California is part of Medi-Cal.

The program has been wildly successful. As of 2020, just 3.6% of kids in the Golden State were uninsured. Medi-Cal and CHIP serve almost 5.5 million children in the state.

Even though most children are healthy, said Joan Alker, executive director of the Georgetown University Center for Children and Families, it's too big a risk to go without health insurance.

"So any gap in coverage for children is a problem for families and a problem for our country as a whole," she said. "It pays enormous dividends to make sure that children have access to health insurance so that they can grow up healthy and thriving."

The state Legislature has steadily improved Medi-Cal by making undocumented children eligible in 2016, and by eliminating all premiums as of July 1.

Alexandra Parma, senior policy research associate with the First 5 Center for Children's Policy, said California is working to get federal approval to allow kids to stay on Medi-Cal from birth to age 5.

"The change would allow children to be continuously enrolled in Medi-Cal until their fifth birthday," she said, "so they wouldn't have to do those annual renewals as under the previous policy."

Sarah Crow, First 5's managing director, said the program's biggest flaw is that too few doctors accept Medi-Cal, resulting in long wait times to see existing providers.

"We have too few providers that accept Medi-Cal because of very low payment rates that are offered to the MediCal program," she said, "so that's where the program suffers."

Crow advised parents to ensure the county Medi-Cal office has a current address on file, so no one loses coverage. The state held off on sending out annual renewal notices during COVID, but that will change once the pandemic state of emergency is lifted.

With state lawmakers back in Boise, changes could be coming to Medicaid.

Voters approved Medicaid expansion in 2018, but Republican legislators have consistently said the program is too costly for Idaho. Some are considering repealing the expanded program. However, such radical changes could hurt families the most.

Randi LaSalle, a single mom with four kids on Medicaid, said at one point, she was working two jobs and paying $800 per month for private health insurance, which was more than her rent.

"I stopped working two jobs because it just wasn't feasible with trying to take care of a bunch of kids and bouncing between counties to kind of keep up two jobs," LaSalle explained. "Things are a little tighter, but at least now I don't have to pay for insurance anymore."

Expansion helped cover people who made too much to qualify for Medicaid and fell into a coverage gap. The program covers about one in six adults and three in eight children in Idaho. LaSalle hopes legislators make the program more accessible for families this session.

Randy Johnson, Idaho government relations director for the American Cancer Society Cancer Action Network, said health coverage is important for preventive care and cancer treatment, and repealing or placing barriers to Medicaid access won't stop people from getting sick.

"People still are going to go to the hospital, and taxpayers are still going to end up covering those costs," Johnson pointed out. "It's just not up-front, and instead of going to their doctor, they're going to have to go to the ER, which is way more expensive."

Johnson argued changes would mean fewer people are covered in Idaho, which would hurt families.

"It creates that coverage for people who are working, who are doing the right thing, who want to make sure that their families are protected," Johnson stressed. "This helps them do that."

Supporters of the health program are holding Idaho Supports Medicaid Day at the Capitol on Jan. 28 in Boise.


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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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