A nationwide purge of Medicaid rolls is underway after a three-year pause during the pandemic. And in Texas, most of those dropped are children.

Federal policies barred states from removing people from Medicaid during the pandemic. Renewal notices started going out in April, and according to the Kaiser Family Foundation, a health policy research organization, Texas had disenrolled 82% of its Medicaid recipients by the end of May.

Stacey Pogue, senior policy analyst for the group Every Texan, said the paperwork to re-enroll can be cumbersome.

"Families with kids who have Medicaid -- that's more than half of all kids in Texas -- you need to watch your mail," Pogue advised. "There's going to be a yellow envelope that arrives when it's your turn to renew with the paperwork you need and the instructions you need."

Families have 30 days to collect necessary paperwork and get the renewal turned in. Pogue pointed out those who need someone to walk them through the process can go to TexasCommunityPartner.com, a service for Texans to access food, cash and health care.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said if families have moved and have not received the renewal letters it could be alarming to learn their coverage has lapsed, but there is no need to panic.

"If your child has lost coverage, and you find that out, say, at the pharmacy, then your child is probably still eligible, so try to get help," Alker urged.

Pogue added although the number of those being disenrolled is huge, an estimated 89% still qualify financially.

"There's no open-enrollment period for Medicaid," Pogue explained. "You can apply for yourself or for your kid year-round. So, if you didn't get any notices about this renewal process until you got the denial, it's not too late. Send in what you need to, because kids can apply year-round for Medicaid."

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.