Medi-Cal has dropped several hundred thousand low-income children from the health insurance rolls since April 2023, according to a new report from Georgetown University.
The data show a net drop in children's Medi-Cal enrollment of 200,000 kids between April and December of last year, as the state started redetermining participants' annual eligibility - which had been paused to ensure continuous coverage during the pandemic.
Mayra Alvarez, president of the Children's Partnership, said another 100,000 have been dropped this year.
"Some 80% of the people that lose coverage in California are losing it for procedural reasons," said Alvarez, "not because they're not eligible but because their paperwork didn't make it to the county, or they waited too long on the line and got frustrated and had to hang up, or they moved and the letter never even reached them."
The state of California has made a massive outreach effort to keep those who are eligible covered.
More than half a million children, half of California's kids, depend on Medi-Cal. And three quarters of them are children of color.
It is unclear how many kids who lost Medi-Cal were later enrolled in private coverage.
Joan Alker is a co-author of the report, and executive director of the Center for Children and Families at Georgetown University. She said gaps in coverage can lead to long-term negative impacts.
"Kids are going to miss out on those well-child visits, they're going to miss out on getting the medications they need," said Alker, "be it an inhaler for their asthma or an ADHD medication. And that really sets them back, both in their health and their success in school."
A few years ago, California lawmakers passed a requirement for continuous coverage in Medi-Cal for children ages zero to five.
Alvarez said she is urging them to follow through and allocate $10 million in the next state budget to fulfill this mission.
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Advocates for working families in New York say they want less talk and more action to improve child care in the state.
Gov. Kathy Hochul has proposed a child-care construction fund and a task force to address the issue - which advocates say will make a dent in the child-care shortage, but doesn't do enough.
Estimates show New Yorkers spend a grand total of $14 billion a year on child care, or about $22,000 per year, per child. High child-care costs also are cited as a major reason young families leave the state.
Rebecca Bailin, executive director of New Yorkers United for Childcare, said universal child care is possible if the state will fund plans to implement it.
"That child care would be free, easy to apply, nearby and accessible to all families," she said. "There's no reason, with a budget of $237 billion, she cannot start to implement universal public child care now."
Bailin said a lack of political will has been the biggest hurdle for universal public child care, since 74% of New Yorkers say they want it. Feedback from some state lawmakers is positive, although enacting a universal plan could cost $12 billion a year - 6% of the state's current budget.
A Cornell University poll found high child-care costs are one reason some people can't join the workforce, while other reasons are lack of accessible child care that keeps people from working.
Bailin said a universal public system could counteract these economic harms.
"It's a $10 to $13 return on investment for every dollar spent," she said. "Making New York an affordable place for families will help to stop the exodus of families, make it possible for us to grow our workforce and our tax base."
Although New York offers child-care programs, some families earn too much to qualify for them, or have issues with immigration status that keep parents from reaching out. Bailin said expanding New York's Child Tax Credit and Working Families Tax Credit could help the system, as well as investing in the child-care workforce.
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January is National Mentoring Month and in Minnesota, program leaders report waiting lists for kids to be matched up with an adult willing to spend some valuable time with them.
Calls are being renewed for volunteers. Community-based mentoring programs connect youths who do not have many role models in their lives with adults for a range of activities. It could include attending sporting events, museums, or doing arts and crafts together.
Jill Hinners, executive director of Mentor North in Duluth, said it is all about helping children develop new skills and confidence.
"We definitely see kids that are introverts, shy, anxious," Hinners explained. "Where maybe they just have a little bit of difficulty putting themselves out there to form a large network of friends."
She suggested a mentor might put them more at ease in making connections as they grow. Her group pointed to research showing mentored kids are 22% more likely to have felt a strong sense of belonging. Hinners noted even though Minnesota has a good track record for volunteer work, her office reports a waitlist of between 50 and 60 kids.
Other data show kids who have a mentor are 55% more likely to enroll in college and are 78% more likely to volunteer regularly. Hinners stressed the outcomes can be traced back to a sense of belonging.
"We want youths to feel that they are developing their voice," Hinners emphasized. "To be able to make themselves heard in their community and courageous enough to take leadership positions in their community."
Hinners pointed out even though they have a backlog, volunteer levels have rebounded from a pandemic dip. She added they are trying to be more accommodating in certain ways, including making sure kids with disabilities have a good experience.
Adults who want to become mentors are put through a screening process before they are matched with a youth who has similar interests.
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Nearly 9,000 families are on the wait list for the Oregon Employment Related Day Care program, and family advocates are calling on lawmakers to ramp up funding to meet the growing need. Child-care prices in Oregon can exceed college tuition and have outpaced growth in household incomes, according to research by Oregon State University.
Dana Hepper, director of policy and advocacy with the Children's Institute, said most families, even if they don't qualify for the ERDC, cannot afford child care.
"And most child-care providers do not make living wages. So we can't rely on just parents paying tuition to solve this child-care crisis," she insisted.
Hepper added that the state needs to spend at least $500-million more on the ERDC program this year. This would serve the families that are on the wait list, as well as those who have vouchers for the program but cannot find a child-care provider.
All but one county in Oregon is considered a child-care desert for infants and toddlers, according to Hepper. A child-care desert is defined as having only one licensed child-care slot for every three or more children. She added that there has been more funding for preschools, such as Head Start and Multnomah County's "Preschool For All" which has expanded access. But even if they are not deserts, Hepper added, every county in the state has a shortage of preschool care.
"I think there's a dearth of child-care because there's a lack of public investment in child-care. And the data bears that out," she continued.
Hepper highlights Gilliam County as the only Oregon county that is not a desert for infant child care because it has invested public funds. She added that the ERDC program alone will not solve the child-care crisis; the state also suffers from a shortage of child-care workers.
"We need strategies that support the workforce and invest in pathways to enter this workforce with the skills that you need," she concluded.
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