Rural Arizonans, especially children, are more likely to rely on Medicaid for health coverage compared to people in metro areas, according to a new report.
They would have the most to lose if federal funding is cut. The Georgetown University Center for Children and Families reported more than half of children living in rural areas are covered by Medicaid, along with more than one-third of adults.
January Contreras, executive director of the Children's Action Alliance, said the conversations in Washington, D.C., about possible cuts to Medicaid seem "disconnected" from what is happening on the ground in Arizona.
"What will happen if coverage for hundreds of thousands of people is taken away is, there will be more uncompensated care," Contreras pointed out. "People will continue to need emergency rooms, they'll continue to need health care services - and those costs will shift to others in the health care system."
Contreras noted when federal funds are allocated for transportation, it is seen as an investment in critical infrastructure. She contended Medicaid dollars should be viewed the same way. But in Congress, House Republicans are considering hefty cuts to the program as part of deficit reductions of over $5 trillion.
Major cuts would force states to raise new revenue, trim the Medicaid rolls or cover fewer health services, according to KFF. Contreras called Medicaid dollars "a lifeline" for Arizona's health care sector. She noted it is a growing industry in the state, with some of the best-paying jobs, so cuts would jeopardize local economies.
"We will see the impacts across the board," Contreras predicted. "We will see hospitals experiencing painful times; we will see not only less jobs being available, but possibly jobs being lost. And that's all on top of the pain that people will experience."
Joan Alker, executive director of the Georgetown University Center for Children and Families, said some proposals call for Medicaid reductions of nearly $2.5 trillion. She described it as "horrifying," especially since the program was not a big issue on the campaign trail last fall.
"There was complete silence about it, despite the fact that it is the largest source of public coverage by far in the United States," Alker observed. "It's also a very popular program with the voters of all political stripes."
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Kentucky's Appalachian counties are expanding efforts to help ensure kids are off to the right start educationally.
Research shows attending a high-quality preschool before kindergarten can boost well-being and economic outcomes later in life but most rural children lack access to centers or programs such as Head Start
Alissa Taylor, Kentucky state director for Save the Children, said eastern Kentucky communities are thinking outside the box, pointing to efforts in Whitley County to establish a reading room at a local shelter, where kids whose families do not have permanent housing still have access to a quiet space for learning.
"A nice place for the individuals and children staying there to relax, read a book, work on their homework, their education, in an environment that is similar to a home setting, where they may be missing that in other aspects of their life," Taylor outlined.
According to the National Rural Education Association, nearly one in seven rural students experiences poverty, one in 15 lacks health insurance, and one in 10 has changed their residence in the previous 12 months.
In Perry County, Taylor noted a community steering committee began a rapid response after flooding in the summer of 2022, which helped kids get back into classrooms sooner than in neighboring counties.
"They attributed the community impact approach and that steering committee being formed already before the flood, enabling them to act faster," Taylor explained.
Nick Carrington, managing director of community impact for Save the Children, pointed out rural children across the nation face systemic barriers to receiving a good education, especially very young children.
"Rural areas themselves have been under-resourced historically," Carrington stressed. "With just 7% of philanthropic dollars going to rural places that represent more than 20% of the national population."
Federal data show more than half of rural families with kids under 5 years old live in a child care desert.
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As Black History Month continues, advocacy groups in Ohio are pushing for policies that benefit children from all backgrounds. They emphasize the importance of leadership in shaping public health and social programs that impact millions of young people.
The Rev. Dr. Starsky Wilson, president and CEO of the Children's Defense Fund, said recent executive orders on diversity, equity and inclusion won't deter children's education and health-care access advocates.
"There is an arc of history that is longer than a four-year presidential cycle," he said, "and there is a vision for our children that is bigger than the White House."
After-school and summer programs known as "Freedom Schools" around the country use CDF's uniquely designed inclusive curriculum and storytelling to ensure scholars of diverse backgrounds are affirmed that their impact on the world is profound.
The Rev. Dr. Eva Marie Wolfe, executive director of CDF Freedom Schools of Licking County, said that even as they begin gearing up for their summer program, some families have already shown interest in enrollment. She explained the program's impact.
"We welcome, of course, all scholars, all children, into the program, no matter what their background is, their academic competency is, no matter their ethnicity," she said. "They see their differences as an asset, not as a detriment. Each one of them is valuable."
Wolfe said fostering inclusion and diversity education is just as important in suburban and rural areas of Ohio as it is in the cities.
In preparation for the summer program, they are hiring for various roles. People can go to RCFreedomSchool.org to apply or check out the Children's Defense Fund Freedom Schools site to find programs around the country.
Disclosure: Children's Defense Fund-OH Chapter/KIDS COUNT contributes to our fund for reporting on Children's Issues, Education, Health Issues, Hunger/Food/Nutrition. If you would like to help support news in the public interest,
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Legislation in Olympia would make school meals free for every student.
Senate Bill 5352 would ensure every student has access to free breakfast and lunch starting in the 2026 school year. Washington state has already made strides in this effort, with 70% of students having access to free meals.
Sen. Marcus Riccelli, D-Spokane, said 70% is a "C-minus" grade and he wants schools to be an "A-plus" on the issue.
"We know they'll learn and they can grow and play, and they'll do it in a healthy way," Riccelli explained. "And, by the way, there will be less disruptions in the classroom. We don't have lunch shaming that goes on, and also there's a significant reduction in administrative burden when every kid has access to universal meals."
Riccelli pointed out school meals for all is essentially a tax cut for working families, noting the student of a single mother making $19 an hour currently does not qualify for free school meals. Organizations such as the American Heart Association are supporting the measure. Critics said the program is too costly, especially while the state faces a budget crunch.
Hannah LaMont, a fifth grade teacher in the Edmonds School District, said students cannot focus when they're hungry. LaMont noted this is the first year all students in her class have received free meals.
"This is also the first year that I haven't heard a student say, 'No, I'm not going to eat lunch today because I don't have money in my account and my parents can't afford to,'" LaMont recounted. "This is the first year that I haven't given a student my own lunch to make sure that they have eaten, or had to keep snacks in my classroom to make sure that my students are fed."
Riccelli argued while the state is dealing with a tight budget, it still needs to make investments in schools. He stressed he is tired of hearing about test scores and graduation rates while kids are hungry at school.
"It's just not attainable for a lot of kids," Riccelli contended. "They're going to be sicker, they're going to be distracted if they don't have appropriate nutrition, and that seems like a basic need and we need to be about first meeting the basic needs of our kids in school."
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