A new analysis of 2022 census data has uncovered a troubling trend: The uninsured rate for Pennsylvania children worsened during the final full year of the COVID-19 pandemic.

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 Pennsylvania Partnerships for Children, emphasized despite the Medicaid continuous coverage and other flexibilities in place during the public health emergency, Pennsylvania is among a few states observing a decline in the rate of children having access to health insurance.

"We did see the uninsured rate get worse for children; it went up to 5.2%," Ludwick reported. "And that's a pretty significant increase from the previous year, which was 4.4%. And we were surprised because we expected at least stable or improvements to the coverage, like many other states have seen during this latest census round."

Ludwick pointed out children are facing greater barriers to accessing health insurance compared with adults. The exact reasons for the disparity are unclear, but data suggests some children may not be properly enrolled in Medicaid, despite being eligible.

Ludwick anticipated next year's data may show an even more concerning decline in coverage, so they are urging the Department of Human Services to take a couple of actions they think could help better connect kids to coverage.

"First is to immediately restore coverage for children who lost coverage during the unwinding of the Medicaid continuous coverage provision, due to an error in how the state was determining eligibility," Ludwick recommended.

Ludwick added they also recommend the Department of Human Services provide children from birth through kindergarten with continuous health insurance coverage for multiple years. She further urged policy changes to ensure seamless access to health insurance between Medicaid and the Children's Health Insurance Program.

Maryland ranks second in the nation for charging children who have committed crimes as adults. But one expert says a more trauma-informed response in the justice system would better serve those young people. In fiscal year 2023, more than 3-thousand Maryland youth were charged with committing a violent crime - or a nonviolent felony. Another 8-thousand were charged with misdemeanors.

Joseph Ribsam, director of child welfare and juvenile justice policy with the Annie E. Casey Foundation, said it's common for juveniles in the justice system to have traumatic experiences. He adds trauma screenings of juveniles before they even head to court would allow the justice system to know the best way to help them.

"Oftentimes, the type of offenses that we think of that would be required to separate a young person from community are also the same types of offenses that are displayed when somebody's engaged in dysregulated behavior, which is the type of behavior that somebody who's been exposed to trauma significantly would engage in," he explained.

A report by Human Rights for Children finds Maryland ranks behind only three other states in the number of people who were imprisoned for crimes they committed as children.

According to a 2021 study, 23% of detained girls and nine percent of detained boys meet the diagnostic criteria for post-traumatic stress disorder. Ribsam said some actions taken by the justice system do not help address trauma - and at times even exacerbates the problem.

"If you really start to understand what are the drivers of the behaviors, you can find the right solution, and might find that the right solution doesn't even need to involve a justice system at all. It does start with actually understanding the needs, and not always presuming that behaviors are best solved with punitive responses," he continued.

Ribsam added that increased access to treatment and therapy would best serve juveniles in the justice system, too.

Concerned parents are pushing the authorities to help parks and day cares remove sand from sandboxes contaminated with ash after the Los Angeles fires.

The City of Pasadena sent crews to remove the top two inches of sand from sandboxes in local parks. Los Angeles County recommended the same thing but so far is not funding the remediation.

Juana Sanchez, a mother of two toddlers in Eagle Rock, said she has been calling authorities, to little avail.

"I called my local park to hear what steps were taken to remediate ash," Sanchez explained. "I was told, well, our park has been raking the sand daily and power washing all durable surfaces. That just effectively disturbs ash so that it's no longer visible."

When asked about sand removal, the Los Angeles County Department of Health said no one was available for an interview. Sen. Sasha Perez, D-Los Angeles, who represents areas affected by the Eaton fire, has called for more soil testing.

Sanchez pointed out small day cares that survived the fire may not be able to afford to clean up their sandboxes and play yards.

"Can someone quarterback this? Can someone show leadership on this issue?" Sanchez asked. "My concern is that right now, it's like a political hot potato that nobody wants to touch and that we'd rather pretend doesn't exist."

Cristina Alvarado, executive director of the Child Care Alliance of Los Angeles, said many small day cares serving low-income communities of color are facing big bills in their quest to reopen safely.

"In terms of cleaning, there are some grants available," Alvarado noted. "We are also going to be giving some stipends, you know, to child care providers, as much as we were able to obtain from donors. I think that there, there are efforts to help them clean. I know that we've been talking to some of the big toy manufacturers to see if they can donate sand for the sandboxes."

The Child Care Alliance has also distributed buckets of cleaning supplies and air purifiers to day cares downwind of the fire zone.


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Many Tennessee families cannot afford child care and providers cannot afford to pay their staff fair wages, according to a new report.

The nonpartisan ThinkTennessee found families spend 41% of their income on child care, forcing tough choices for many.

Erin Hafkenschiel, president of the group, said child care is a major affordability issue, alongside housing and health care. With 165,000 job openings each month and 50,000 unfilled, she pointed out the child care shortage makes it harder for companies to find and keep workers.

"We are hearing from parents that they are not able to stay in the workforce, return to the workforce after having kids," Hafkenschiel reported. "Or even if there's some other sort of life change that happens, they're not able to stay in the workforce because it's simply unaffordable."

She added a lack of affordable child care costs the state more than $2 billion annually in lost earnings, productivity and tax revenue. The report also found 32% of parents had to turn down a promotion, raise or job opportunity because of child care issues.

Hafkenschiel noted child care providers face licensing and zoning hurdles, making it tough to open new facilities.

"One of the examples that we explore in our brief are zoning regulations," Hafkenschiel explained. "There might be a zoning regulation in a city that is keeping a child care center from being open in more of a residential neighborhood."

ThinkTennessee is looking at other states for ways to cut child care costs. Hafkenschiel emphasized one idea is to put child care centers in workplaces or schools, where rents could be more reasonable and savings could be passed along to families.

"Another example that we've seen that's worked really well in other states, not yet here in Tennessee, but is what's called a Tri Share Program, where you essentially are sharing the cost," Hafkenschiel outlined. "An employer could potentially contribute. The family, of course, contributes. And then either the state and/or local government contributes."

The report laid out four recommendations to expand child care and support workers. It suggested easing regulations to allow more centers to open, encouraging businesses to offer child care, find ways to improve job quality for child care workers and invest in affordable care for low-income families.


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