As federal pandemic health emergency protections are set to expire starting in April, child advocates are concerned the program that kept Florida's uninsured children stable will result in a sharp rise in children and families becoming uninsured.

A new report by the Georgetown University Center for Children and Families showed how Medicaid and the Children's Health Insurance Program brought down the child uninsured rate across the country and stabilized it in Florida, but it is now in jeopardy.

Alison Yager, executive director of the Florida Health Justice Project, said if protections are lifted, she is concerned children who may no longer be Medicaid eligible, but should be through the state CHIP program, KidCare, will not see a smooth transition and cause a gap in care.

"For kids who have ongoing medical conditions, even one month without coverage could be terribly detrimental to that child's health and to that family's finances," Yager pointed out.

The report showed Florida's program was a critical lifeline for more than 65.7% of the state's children during the COVID-19 pandemic. Children younger than five receive 12-month continuous eligibility while those ages five and older receive six months of continuous eligibility.

Yager urged health officials to prepare for the potential coverage gap and find solutions, including streamlining both health insurance programs.

Joan Alker, executive director of the Georgetown University Center for Children and Families and the report's author, said states such as Florida which have not expanded Medicaid for adults under the Affordable Care Act, are more vulnerable for putting children at risk, since the majority of their enrollment growth during the pandemic has been children.

"So, states like Florida, Georgia and Texas that don't cover a lot of adults in their program, this is really who we're talking about; children, very poor parents, and new moms," Alker outlined.

The report noted enrollment in Florida's Medicaid and CHIP program grew by 32.6% from February 2020 to August 2022. Florida's children made up 48.2% of the growth, much higher than the 32% growth nationally.

Millions of people are expected to lose Medicaid coverage during what some are calling the "unwinding" process. The report lists two reasons for it: Either an individual's income has risen and they are no longer eligible, or red tape and communication barriers in states prevent families from renewing coverage if eligible before April.

In eastern Kentucky, advocacy groups are expanding summer learning opportunities for families.

Isolation and learning loss plague many rural Kentucky kids once school lets out, and research shows children can lose up to 34% of what they learned during the prior school year during the summer.

Alissa Taylor, Kentucky state director of children's safety programs for Save the Children, said transportation is one of several barriers for rural kids.

"They don't have access to the resources, public services, and exposure to the arts, those type of things that other kids are getting during the summer," Taylor pointed out. "We know that sparks creativity, it encourages continued learning throughout the summer."

According to a 2019 Center for American Progress survey, 3 of 4 parents said they have had at least some difficulty finding child care during the summer.

Taylor noted Save the Children is offering around 60 summer opportunities in 19 eastern Kentucky counties, including full-day, four- to six-week camps for elementary-aged children.

"There's either bus transportation, or a gas-voucher program that's offered for families to get their kids to the camp," Taylor emphasized. "They're provided two meals a day. They're having fun, we know that they're learning while they're having fun, and they want to keep coming back."

She added the feedback from families has been positive, including one mother who said the summer programs allowed her to keep earning a paycheck during the summer.

"We know that jobs are really hard to come by," Taylor acknowledged. "The summer camp and her kid having something to do was an excellent way for those kids to continue learning and for her to stay employed."

More than half of survey respondents said costs for child care during the summer are a significant challenge.

Groups fighting for children's health are asking Gov. Gavin Newsom and lawmakers to require insurance companies to cover hearing aids and related services for kids.

Advocates want to see language in the budget trailer bill which would mandate the coverage.

Michelle Marciniak, co-chair and co-founder of the nonprofit Let California Kids Hear and the mother of a child with hearing loss, noted hearing aids can cost about $6,000 a pair and they need to be replaced every 3 or 4 years.

"Parents are making difficult financial decisions," Marciniak pointed out. "They're hosting fundraisers, GoFundMe pages, they're putting it on their credit cards. And some are forgoing them altogether. And it really doesn't need to be this way."

Opponents of a mandate argued it would raise costs for insurance companies, who will pass it on to consumers. In 2019, a bill to mandate hearing aid coverage for children - Assembly Bill 598 - passed both chambers in the state Legislature - but was shelved in favor of the current state-run program called Hearing Aid Coverage for Children. That program costs more than $16 million dollars a year but currently serves only 200 out of about 8-thousand eligible children. Experts say it's a flop because so few audiologists participate in the program - and that is blamed on low reimbursement rates for providers, administrative red tape, and overburdened clinics.

In 2019, a bill to mandate hearing aid coverage for children, Assembly Bill 598, passed both chambers in the state Legislature but was shelved in favor of the current state-run program called Hearing Aid Coverage for Children. The program costs more than $16 million dollars a year but currently serves only 200 out of about 8,000 eligible children. Experts said it has been a flop because so few audiologists participate in the program, which is blamed on low reimbursement rates for providers, administrative red tape, and overburdened clinics.

Marciniak acknowledged California does a great job at screening children for hearing loss, but does a terrible job at making intervention affordable.

"Now, over 30 states have recognized that this is a developmental emergency for children, and they have acted on it by requiring health plans to cover pediatric hearing aids," Marciniak emphasized. " And we believe this is the best, most efficient delivery system that's connected to a child's medical home."

Just one in 10 children has hearing aids covered by a private insurance plan in California. Experts estimate 1,000 deaf or hard-of-hearing kids are born in the state each year. Lawmakers and the governor have until June 15 to finalize the budget.

Utah Gov. Spencer Cox joined the Children's Collaborative for Healing and Support last week to announce a pilot program in the state designed to support grieving children and connect them to services.

According to the Children's Collaborative, there are more than 60,000 young people in Utah who have experienced the death of a parent or caregiver. The pilot's purpose is to help kids get the help they need.

Gov. Cox noted in Utah, one in 15 children will experience the death of a parent or sibling before they reach the age of 18. He said family's shouldn't suffer alone.

"We have the resources already available and we need to use them," Cox urged. "Not only do children suffer the emotional pain of losing a caregiver, they often experience trauma and when not provided support they have long-term consequences like low self-esteem, depression and poor performance in school."

Gov. Cox added it is important to remember losing a parent can also mean sudden financial and housing insecurities, which leave some youth homeless. According to the Children's Collaborative, the Utah pilot program will lay the groundwork for it to be implemented in other communities nationwide.

According to the group, the program will use both a "school based identifying strategy and a data matching system using public records on a state level," to offer assistance.

Rich Nye, superintendent of the Granite School District, said tragedies, like losing a loved one, have an immediate impact on how well children preform in school and the type of education they receive. Nye considers partnerships like the Children's Collaborative as a "key to unlocking the full potential," of communities.

"Because it is partnerships like these that reach down within the community, at the individual level," Nye emphasized. "Schools are uniquely positioned, given our role as hubs in the community, of connecting children and their families to these resources."

The Children's Collaborative for Healing and Support was created by the COVID collaborative. The pandemic took more than 1.1 million American lives and the group eventually discovered 340,000 children lost a parent or caregiver to COVID-19.


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