A new report shows the number of children covered by Medicaid varied widely between states as pandemic-era protections were lifted, with Alaska seeing a decline.

The Georgetown University report says nationwide, more than 4 million fewer children were enrolled in Medicaid and the Children's Health Insurance Program at the end of last year versus spring 2023, before the expiration of continuous coverage. Alaska saw a 9% drop in enrollment.

The report estimates that in 70% of cases, children's coverage was canceled for procedural or 'red tape' reasons, such as difficulty navigating the state's website, reaching a person via a help line, or not receiving renewal notices.

Trevor Storrs, president and CEO, Alaska Children's Trust, said since there haven't been changes in eligibility criteria, procedural cancellations are likely.

"More than likely, we have a significant number of Alaska children who are eligible for Medicaid, but were potentially dropped from the program during the unwinding process. Alaska already had one of the highest rates of uninsured children, and this just adds to it," Storrs explained.

Alaska was one of eight states that disenrolled so many children, it had fewer enrolled than prior to the pandemic.

The Alaska Children's Health Insurance Program, Denali KidCare, offers coverage for kids up to 18, and income eligibility for kids is higher than for adults.

The report notes that 12 states and the District of Columbia have developed multi-year coverage programs, with some states keeping kids enrolled up to age 6. Storrs said in meetings with the state Department of Health, advocates are making the case for keeping kids enrolled.

"One of the things that we're in conversations with them is not making children have to re-enroll every year. So, from zero to six, once qualifying for Medicaid, they stay on; and then from seven to 18, it's every two years versus every year," he continued.

Currently in the state, Medicaid recipients must reapply each year. Medicaid coverage includes checkups, sick visits, immunizations as well as dental and vision care.

Study co-author Joan Alker, with the Georgetown University Center for Children and Families, said gaps in coverage can lead to long-term negative health impacts.

"Kids are going to miss out on those well-child visits, they're going to miss out on getting the medications they need - be it an inhaler for their asthma, or an ADHD medication," Alker pointed out. "And that really sets them back, both in their health and their success in school."

A Florida bill that would roll back child labor restrictions cleared a Senate panel this week, sparking debate over whether it empowers families or risks pushing vulnerable teens out of school. The proposal, which would allow 16 and 17 year-olds to work longer hours on school nights and in some hazardous jobs, drew sharp criticism from advocates who warn it could worsen chronic absenteeism and dropout rates.

Tsi Smyth, vice president for public relations with the nonprofit advocacy group Voices of Florida, says the changes will affect some students more than others.

"This is going to disproportionately affect students that are growing up in poverty, and you are going to relegate them to a lifetime of poverty," he explained.

Sen. Jay Collins, R-Tampa, sponsored Bill 918 and says it would match state rules with federal standards. It would allow 16 and 17-year-olds work 40 hours a week during school, up from the current 30-hour limit, and allow some currently banned jobs such as roofing. The measure passed along party lines, with Republicans in support. It now moves to the full Senate.

Collins said that most teen jobs are in safe places such as grocery stores, and his measure provides valuable work experience.

"Ultimately, we're not talking about 'The Jungle' by Upton Sinclair. We're talking about them working at Publix, at Piggly Wiggly, or jobs within the industry," he continued. "This is a far cry, I think often we demonize the employer cause it's going to take advantage of the children. This is a parental rights thing. Parents know their kids best."

Opponents including Sen. Carlos Guillermo, D-Orlando, warned it could lead to abuse.

"This bill is going to lead to exploitation of minors, exploitation of children, and I get the parental-rights conversation but there's no reference to parental rights in the bill," he explained.

The House bill faces one final committee vote. With Republican supermajorities controlling both chambers, passage appears likely, making Florida the latest GOP-led state to relax child labor laws. Business groups back the measure, but opponents warn it risks teen safety.

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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