More American children had health insurance during the pandemic than ever before. But now, as states are required to re-enroll those eligible for Medicaid, the number of uninsured is skyrocketing.

Nowhere is it more true than in Texas, where since what has called the "unwinding" started in April, already a half million children have lost coverage.

Stacey Pogue, senior policy analyst for the nonprofit policy institute Every Texan, said during COVID, federal government regulations prohibited states from removing individuals from Medicaid involuntarily, which benefited kids.

"Now that they've expired, we're back to business as usual in Texas, and Texas has become ground zero for children losing health coverage during unwinding," Pogue explained. "It's likely that most still qualify even though they've lost Medicaid."

A report from Georgetown University uses state-by-state data from the 2020 census. The number of uninsured American children dropped below 4 million in 2022, the first time it has happened in 15 years.

Overall, 21 states saw statistically significant declines in the rate or number of uninsured children, with Wyoming, North Dakota, Utah, New Mexico and Texas seeing the greatest improvements. Nonetheless, Pogue noted more than one in five uninsured children lives in Texas, more than any other state.

"It's just really clear from this report and these data that when federal law required Texas to remove barriers that parents face when they're trying to get their kids covered and keep their kids covered, that our child uninsured rate dropped notably," Pogue emphasized.

Valerie Borum Smith, a pediatrician in Tyler, said gaps in insurance coverage greatly affect whether parents seek help for their children, who she stressed have experienced crisis after crisis over the past several years.

"A yearslong pandemic, a national emergency on youth mental health, and last fall's 'triple-demic' of COVID-19, flu and RSV," Borum Smith outlined. "It's more important than ever that patients like mine have reliable access to care."

Nonprofits working with foster care children want them to know services are available to help them navigate life once they are out of the system.

The latest statistics from the Arkansas Department of Human Services show more than 3,400 children are in foster care. Some young people are never adopted or reunited with family members and age out of the system.

Jordan Otero Foster, LEAD ambassador for the nonprofit Foster Success, now 25, entered foster care when he was 17 and said three things contributed to his successful transition into adulthood.

"Relationships with supportive adults who will last far beyond our time in foster care, financial resources that meet the various needs of young people while we pursue our higher education, the workforce and as we find our footing as young adults, and the third way to accomplish this is to ensure that all young people have access of a network to peers and supportive adults," Foster outlined.

He pointed out many young adults struggle once they leave the foster care system because they do not know about available programs or support systems.

In Arkansas, more than 1,000 children in foster care have been there for more than a year. The department of Human Services tries to reunite children with family members when possible.

Hope Cooper, campaign manager for the advocacy group Journey to Success, said her organization works with lawmakers to create legislation to address adversities foster care kids face.

"Young people in foster care face additional challenges in completing school on time," Cooper explained. "They're often coping with some mental health issues. There are other unmet needs, and as young people get older, into their young adult years, many face housing instability or challenges with getting connected to work."


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Missouri has stepped up to fight childhood hunger by providing food aid over the summer for kids who rely on school meals for nutrition.

The U.S. Department of Agriculture's SuN Bucks program, launched this year, provides eligible families with a one-time, $120 EBT card per child to help cover grocery costs during the summer months.

Christine Woody, food security policy manager for the nonprofit Empower Missouri, said she is happy the program is available for families. However, she noted Missouri state departments involved in distributing the benefits had delays, meaning kids needing summer food aid did not receive it until fall this year.

"I'm just grateful that Missouri did it and I think the department had a lot of lessons learned, so 2025 is going to be a whole different experience," Woody asserted. "I'm hopeful that the kids will actually get the benefits in the summer when their families actually need it."

Families have 122 days to use the one-time SuN Bucks benefit after receiving their card. Research shows almost half of the children in Missouri rely on school meals for nutrition.

The USDA recently announced an additional $1.3 billion investment to strengthen local food systems. Woody explained Missouri's SuN Bucks program is based on the federal P-EBT initiative, which aimed to support children who lost access to meals during COVID-19 school closures.

She added her organization and others led a grassroots effort to get Missouri on board.

"Praise the Lord, they agreed to fund and run the program and there's funding to run it again in 2025," Woody emphasized.

The Show-Me State could receive more than $92 million in an economic boost generated from the SuN Bucks initiative.


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Five years ago, Minnesota established a program to bolster well-being metrics for children of color and young Native American kids. Today, fund recipients are sharing their progress.

The Community Solutions for Healthy Child Development Grants are in their second round of funding following what advocates called a successful pilot beginning in 2019. Given Minnesota's long-standing racial disparities, community sites making use of the aid hope the kids they serve find stability as they grow.

Brook LaFloe, associate director of the Montessori American Indian Childcare Center in Roseville, said they have been able to do things like hire a social worker, which helps build trust.

"Especially with our people's history with the boarding school era, it still lingers in some of our older generations, right?" LaFloe noted. "That mistrust in school, that mistrust in giving their children up to other people."

LaFloe added her team has maintained full enrollment for key services, including a program catering to children prenatal to 3 years old. Organizations such as Children's Defense Fund-Minnesota pushed for permanent funding after the pilot phase. The state health department said current grants are funded through 2027, but it is unclear what might happen down the road with future deficits forecast.

In northwestern Minnesota, the nonprofit All Nations Rise, which serves tribal members of White Earth Nation, carries out early childhood programming through a cultural lens.

Beth Ann Dodds, program manager for the group, said they have used the grant money to offer an Indigenous parent leadership class.

"They're learning more about themselves, which you need to have -- that self-awareness -- in order to make some positive changes," Dodds observed. "Whether that's with yourself, with that's with your family, or whether that's in your community. "

She added the curriculum has reached nearly two dozen parents, helping more than 70 children.

The grants have also helped fund efforts at Grandmother's House, a language and culture immersion program through Fond du Lac Tribal College in Cloquet.

Persia Erdrich, lead teacher for the program, said she has seen firsthand how outreach connects younger Native people with their tribal identity, aiding them in the development process. She sees the positive effects through her son.

"I started as a parent in this program, and his first words were in Ojibwe, his first sentences," Erdrich recounted. "He's bilingual now."