Two million children and adults in California could lose health-insurance coverage over the next year - as the state winds down the continuous-coverage requirements in place during COVID, according to a new report from Georgetown University.

The pandemic health emergency officially ends May 1, but on April 1, California will start re-determining eligibility for 50-million people on Medi-Cal.

Mike Odeh, senior director of health with the nonprofit Children Now, said recipients must make sure the program has their current address.

"The state has been proactive in asking families to make sure that their contact information is up to date. And we know that they have launched a campaign," Odeh said. "So families can visit keepmedicalcoverage.org to sign up for email and text message alerts with updates about medical renewals."

Children who are still eligible could lose coverage if the renewal notice goes to the wrong address or if there is an administrative error. During the pandemic emergency, the state was required to keep all Medi-Cal recipients on the program. But now the income requirements will kick in once again. More than 56% of kids in California and 52% nationwide are covered under Medicaid or CHIP.

Federal research indicates 72% of the kids who lose their Medicaid coverage will still be eligible, and that Black and Latino families are at greater risk of losing coverage.

Report co-author Joan Alker, executive director of the Center for Children and Families at Georgetown University's McCourt School of Public Policy, said many factors come into play.

"Language issues may be a barrier when you have families who are perhaps mixed-status immigrant families, who have some fear about engaging with the government; families who live in rural areas, who don't have good internet connectivity," Alker said. "There are lots of reasons families are going to be at greater risk."

Starting in 2025, California will begin keeping kids on Medi-Cal enrolled until their fifth birthday, with renewals annually after that. Undocumented children have been eligible for Medi-Cal since 2016.

Iowa has released an interactive website to help parents find real-time child care options for their kids.

Iowa Child Care Connect, which the state has nicknamed "C3," uses crowdsourcing technology, helping people use up-to-the-minute data to find child care where and when they need it.

Sheila Hansen, senior policy advocate for the nonprofit Common Good Iowa, said C3 is a vast improvement over what the state had before.

"It was kind of clunky and it wasn't really very fast," Hansen recounted. "Hopefully this will be a vast improvement upon that and families will be able to just go in there and immediately find openings in their area."

The site also offers information on subsidies the providers accept along with current real-time openings and quality ratings. Hansen argued the state should focus on improving pay and working conditions for child care workers.

She acknowledged while the technology is a step forward, Common Good Iowa and other advocates said the state does not need more brick-and-mortar child care centers. It needs more staff, which has been the real challenge.

"That's because they're just unable to find the people who want to work in child care because the pay is so low or the benefits aren't there," Hansen explained.

The Iowa Department of Health and Human Services requires child care providers to complete various training requirements and update their certification every two years.


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The deadline is approaching for families to apply for food benefits in Washington state.

The national program known as SUN Bucks is the U-S Department of Agriculture's summer EBT program, which was created during the pandemic and made permanent this year. Most families were automatically eligible for the program, which provides a one-time payment of $120 per child in a household. Families who did not receive the benefit and believe they are eligible can apply through Saturday.

Norah West, assistant director of the Office of Communications and Government Affairs for the Washington State Department of Social and Health Services, said many students get meals through school.

"Having kids be out of school during the summer months makes it a little harder to get access to that nutritious food, and the price of groceries are not going down," West pointed out. "We're pleased to be able to offer even a small amount of assistance to folks."

Kids were automatically enrolled in the program if they are at a school in the National School Lunch Program and qualified with a meal application or Family Income Survey, or they're between age eight and 18 and in a house qualifying for benefits like the Supplemental Nutrition Assistance Program or Temporary Assistance for Needy Families.

Families meeting the National School Lunch Program's income eligibility guidelines for free or reduced-price meals can apply for SUN Bucks. In Washington state, more than 580,000 kids have received benefits this summer, totaling nearly $69 million. West noted the USDA has other summer meal programs as well.

"The federal government also offers two other programs called Sun Meals and Sun Meals to Go through school districts, and those are on site meal programs or in some rural areas," West outlined. "People may have the option to go to a site and pick up food and take it with them."

This summer, 37 states chose to participate in the SUN Bucks program.


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As Pennsylvania children return to school, health advocates stress the importance of keeping them insured.

The 2023 State of Children's Health in Pennsylvania report found more than 145,000 children are without health insurance.

Becky Ludwick, vice president of public policy at the Pennsylvania Partnerships for Children, said the back-to-school season is an ideal time to raise awareness among parents in Pennsylvania about free and low-cost public health insurance options. She added many children lost Medicaid coverage during unwinding but some have transitioned to the Children's Health Insurance Program.

"There's an increasing number of kids going without health insurance or have lost health insurance over the past year," Ludwick reported. "We just really want to take this time as kids are gearing up to get back into school again, to remind parents on what they can do to get their kids insured. So we're looking really at Medicaid and the Children's Health Insurance Program."

According to Children's Health Insurance Program guidelines, a family of three earning $60,000 annually can enroll in the program for an average monthly premium of $58 per child, with additional copays as needed. No family earns too much to apply.

Ludwick pointed out the American Academy of Pediatrics emphasizes the importance of back-to-school checkups, including routine vaccinations. She stressed enrollment in Medicaid and CHIP is open year-round and recommended parents contact the programs to ensure their children have comprehensive coverage for their health needs.

"We would encourage the families to reach out as quickly as possible on getting their child enrolled through Medicaid or CHIP," Ludwick stated. "In order to get that coverage, to make sure that they are then covered for their yearly physicals, immunization. That also covers mental health services and dental."

Ludwick pointed out recent measles outbreaks have highlighted declining vaccination rates, particularly for the MMR vaccine, which is putting communities at risk. Vaccination coverage among kindergartners in Pennsylvania has declined gradually, with the latest data showing a drop below 95% for the first time in six years.