Hungrier kids, missed check-ups: Trump's cuts to childcare make it a lot harder to be a parent
'People don't think about those parents,' Angelique Marshall, a Washington, D.C.-based at-home childcare provider, told Salon. Most of the parents the 56-year-old serves have children with disabilities and don't have much flexibility in their schedules. 'They have to go to work to be able to take off when the children need surgery or they have a serious illness or impact on their life.'
Under the Trump administration, the nation's pandemic-stressed child welfare system has taken a hit through temporary funding freezes, staffing cuts and Project 2025-aligned moves to weaken critical programs. The changes — some part of President Donald Trump's effort to slash social spending — place a strain on the government's distribution of funds and support for programs like Head Start and the Child Care and Development Fund, argued a group of U.S. senators in an April letter to Health and Human Services Secretary Robert F. Kennedy Jr. By the time those changes trickle down to providers like Marshall and the families she serves, the impacts feel much more like crashing waves.
That's why Marshall counted herself — and her students — among the attendees of last month's "Day Without Child Care" action in Washington, D.C. Organizers had asked that parents call off work and providers close their doors to demonstrate how critical childcare is to the nation's daily grind. But Marshall chose to keep the doors of her daycare, Ms. P's Child and Family Services, open; her parents, she said in a video call, can't afford to go without work for a day, even if it's in protest.
At Washington's Freedom Plaza, a makeshift field day took place, where children enjoyed free swag, food and activities. Meanwhile, parents and providers shared stories during a rally at the plaza while organizers with SPACEs in Action, a nonprofit advocacy organization, led visits with city council members to advocate for early childhood education funds.
'Children and families with low-income wages, they won't get a quality start in education at all, and it's not because a child can't learn, it's because the underinvestment effect that they have [on] the overall potential,' Marshall said. 'We're going to see a downslide if they don't get the help and support they need because you're talking about defunding them, but you're not talking about what you're going to do with them.'
The administration's effort to cut some 10,000 jobs at the Department of Health and Family Services has resulted in a roughly 37.5% reduction in staff at the Administration for Children and Families, which oversees childcare and child welfare programs. Those layoffs included staff of the Office of Child Care and Office of Head Start, a federal program that provides early childhood education, social and health services to more than 750,000 children of low-income families up to age 5 — and that was flagged for elimination in Project 2025. The reduction in force also shuttered five of the 10 ACF offices, which helped ensure that grants reached individual facilities in 22 states and five territories, and acted as liaisons between program administrators and the government.
The Trump-backed reconciliation bill passed by the House on May 22 also stands to make matters worse for children and families. The bill threatens to cut more than $700 billion from Medicaid and nearly $300 billion from SNAP through 2034, according to Congressional Budget Office estimates of an earlier version of the bill. Medicaid serves more children than any other age group, while SNAP provides food assistance for more than 40 million people, including some 16 million children.
Marshall said she became a childcare provider in 1995 out of need, having searched for nearly five years for someone who could care for her daughter, who she said has intellectual disabilities, while she worked for the federal government. After exhausting all of her options, she opened Ms. P's Child and Family Services in the downtown Washington area to provide services to middle- and low-income families with disabled children. Not long after she opened her doors, she realized that other parents of children with disabilities faced similar hurdles while not fully understanding how best to support their kids with the limited knowledge of disabilities available at the time.
The issues she faced have become more complicated for her and the families she works with, as childcare has become less affordable. Living in Washington under Trump also means that a good portion of her clients are federal workers — or at least they used to be. Marshall said that several of the parents she serves have lost their jobs as a result of DOGE's recommended federal layoffs, which a judge blocked on May 22. Combined with threats to federal funding for public assistance, it has been too much for many of them to bear, she said.
'We're supporting the most vulnerable children in the District of Columbia and their parents who are working, and the ones who work in the federal government, who lost their job, who're now having mental health issues and breakdowns and anxiety — I mean, they're unpacking a lot of new things, and people are not realizing it,' she said.
Potential funding cuts to needed federal services, alongside the stress of job loss and parenting a child with a disability, create layers of hardship that many of these parents are struggling to navigate, Marshall added. 'That's like an onion.'
As her families adjust to the upheaval in their lives, Marshall said she's had to make some changes herself. She has had to lay off two members of her four-person daycare staff since January on account of Congress' 2025 budget change for D.C. Even with the pay equity fund's support, the increased costs and 80-to-100-hour work weeks associated with providing care for children with a range of disabilities also mean she's unable to pay her remaining staff more than the mandated minimum, let alone what she believes they're worth.
While Marshall said she's left the door open to her former employees to return should they choose if the funding increases again, she's also had to work with parents to find temporary solutions to the problems introduced by their new normal. In some cases, she's helped some parents with resumes as they start job hunts, facilitated exchanges of leftover baby formula and clothing, and connected them with others to create a sort of weekend childcare network.
'It's all about strategizing and thinking through some things,' Marshall said. 'I mean, if we got two parents who lost their jobs and on the weekends you want to work, let's see if this parent will be able to take care of your child, since they have the same disability. It's all about community and building it.'
In Washington, SPACEs in Action organizers pressed council members to vote for Democratic Mayor Muriel Bowser's then-upcoming budget proposal, which promised to fully fund child care programs, including the Early Childhood Educator Pay Equity Fund, a fund that supports childcare facilities in offering competitive minimum wages and healthcare for staff.
Destynee Bolton, a childcare organizer for SPACEs in Action, told Salon that they also wanted to make sure that the funding included increases and adjustments to account for inflation and program educators' growth in credentials.
Meanwhile, the city is facing a $1.1 billion shortfall for the 2025 fiscal year after Congress decided to revert its budget to the 2024 fiscal year allotment, following the House of Representatives' refusal to vote on a new proposal. While Bowser has invoked a law allowing the city to autonomously increase its budget, she also planned to reduce city spending by $410 million in response to the federal budget cuts.Taken together with the threats to public assistance, these potential cuts to local dollars will only worsen the inequities in education, food security and health care access already affecting the district, Bolton said.
'That means a child loses their education, and then they lose that access to food security, in addition to Medicaid services being cut as well,' she said in a video call. 'Not being able to have that security — that means that children and families, low-, middle-income, working families, won't be able to go to doctor's appointments and get health advice that they would need.'
Bowser, however, unveiled her response to the district's budget deficit on May 27, which included full funding for core childcare programs like the Child Care Subsidy Program and the pay equity fund. While her proposed budget still needs approval from the D.C. Council, the mayor also asserted that the city was still calling on Congress to restore its spending to its initial budget.
Both Bolton and Marshall say that a substantial federal and local investment in early childhood education through a comprehensive approach to the workforce and revenue raisers, as well as an equitable tax system, would alleviate the difficulties that low- and middle–income families face.
'If high earners in D.C. are to contribute at the same level that low- to middle-income individuals have to contribute, that would help a lot with the programs that we have in the district,' Bolton said. 'They're able to have more viability because it's always the same thing every year — something always ends up on the chopping block.'
The impact of New Mexico making childcare free for about half of the state's children is a prime example of the value of adequate investment in childcare, Bolton added.
Five years after implementation, the state began to see the percentage of New Mexicans falling below the federal 'supplemental' poverty drop from 17.1% between 2013 and 2015 to just 10.9% today, according to The Guardian. Simultaneous wage increases for childcare workers in the state had a similar effect, with just 16% of childcare providers living in poverty compared to 27.4% in 2020.
Marshall questioned where the funds the Trump administration has recouped from layoffs and federal funding freezes will be going — and why it couldn't go to childcare.
'I believe that the United States of America is one of the most industrialized countries, but we do not budget childcare as an essential part of the infrastructure. Why not?' she said. 'But let me tell you, you can tell a lot about the heart of the nation when you have to care for the most vulnerable children and the seniors, and when you don't care and you're just throwing things away, what are you doing?'
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Scientific American
an hour ago
- Scientific American
Inside the Collapse of the America's Overdose Prevention Program
At an addiction conference in Nashville, Tenn., in late April, U.S. Secretary of Health and Human Services Robert F. Kennedy, Jr., spoke about his own experience with drug use. 'Addiction is a source of misery. It's also a symptom of misery,' he said. Kennedy's very personal speech, however, ignored recent federal budget cuts and staffing reductions that could undo national drug programs' recent progress in reversing overdoses and treating substance use. Several experts in the crowd, including Caleb Banta-Green, a research professor at the University of Washington, who studies addiction, furiously spoke up during Kennedy's speech. Banta-Green interrupted, shouting 'Believe science!' before being removed from the venue. (The Department of Health and Human Services did not respond to a request for comment for this article.) 'I had to stand up and say something,' says Banta-Green, who has spent his career working with people who use drugs and was a senior science adviser at the Office of National Drug Control Policy during the Obama administration. 'The general public needs to understand what is being dismantled and the very real impact it's going to have on them and their loved ones.' On supporting science journalism If you're enjoying this article, consider supporting our award-winning journalism by subscribing. By purchasing a subscription you are helping to ensure the future of impactful stories about the discoveries and ideas shaping our world today. The Trump administration has defunded public health programs and made plans to consolidate or eliminate the systems that track their outcomes, making it difficult to monitor the deadly consequences of substance use, Banta-Green says. For instance, staff cuts to the Overdose Data to Action program and the Opioid Overdose Prevention and Surveillance program will hamper former tracking efforts at the Centers for Disease Control and Prevention and at local and state health departments' prevention programs. A recently fired policy analyst at the overdose prevention division at the CDC's National Center for Injury Prevention and Control— who wishes to remain anonymous, citing fear of retaliation—tells Scientific American that she used to provide policy support to teams at health departments in 49 states and shared public overdose data and information to Congress. She is a veteran who should have had protected employment status, but she lost her job during federal cuts in February. 'No one else is doing surveillance and data collection and prevention like the CDC was,' she says. 'There's so much that's been cut.' (When approached for an interview by Scientific American, a CDC spokesperson said, 'Honestly, the new administration has changed how things normally work' and did not make anyone available for questions.) What Gets Measured Gets Managed Provisional data suggest that deaths from drug use declined by almost 25 percent in 2024, though overdoses remain the leading cause of death for Americans aged 18 to 44. Cuts to the National Survey on Drug Use and Health will make it difficult to measure similar statistics in the future. Because substance use is highly stigmatized, Banta-Green says it's important to have diverse, localized and timely data from multiple agencies to accurately capture the need for services—and the ways they're actually used. 'You can't design public health or policy responses if you don't know the scale of the need,' he says. Overdose trends vary by region—for example, usage of the synthetic opioid fentanyl appeared earlier on the East Coast than the West—so national averages can obscure critical local patterns. These regional differences can offer important insights into which interventions might be working, Banta-Green says. For instance, important medications such as naloxone rapidly reverse opioid overdoses in emergency situations. But getting people onto long-term medications, including methadone and buprenorphine, which reduce cravings and withdrawal symptoms, can more effectively prevent mortality in both the short and long term. Declining deaths may also mask tragic underlying dynamics. Successful interventions may not be the only cause of a drop in overdoses; it could also be that the people who are most vulnerable to overdose have recently perished and that there are simply fewer remaining at risk. 'It's like a forest fire burning itself out,' Banta-Green says. This underscores the need for the large-scale data collection threatened by the proposed budget and staff cuts at the CDC and National Institutes of Health, says Regina LaBelle, an addiction policy expert at Georgetown University. 'What [the administration is] doing is shortsighted' and doesn't appear to be based 'on the effectiveness or the outcomes of the programs that [it's] cutting,' she says. For example, despite promising to expand naloxone access, the Trump administration's latest budget proposal cuts funding for a critical program that distributes the lifesaving medication to first aid responders. 'A Chance at Redemption' When LaBelle was acting director of the White House Office of National Drug Control Policy during the Biden administration, she led efforts to expand evidence-based programs that provided clean syringes and tested users' drugs for harmful substances. These strategies are often referred to as 'harm reduction,' which LaBelle describes as 'a way you can meet people where they are and give them the services they need to keep them from dying.' José Martínez, a substance use counselor based in Buffalo, N.Y., says harm-reduction practices helped save his life. When Martínez got his first job as a peer advocate for people using drugs, he was still in a chaotic part of his own addiction and had been sleeping on the street and the subway—and regularly getting into fights—for a decade. The day after he was hired to help provide counseling on hepatitis C, he got into a New York City shelter. As his bruises healed, he learned life skills he was never taught at home. 'For a lot of people, drug use is a coping tool,' he says. 'The drug is rarely the problem. Drug use is really a symptom.' Working with others who understood that many people need help minimizing risks gave Martínez a chance to make progress toward recovery in a way that he says abstinence-only treatment programs couldn't. 'I don't agree that somebody should be sober in order for them to do things different,' he says. Over the past six years working for the National Harm Reduction Coalition, Martínez started a national support network for other peer program workers and community members—people who share their experiences and are a trusted source of education and support for others using drugs. 'There's never no time limit,' he says. 'Everybody works on their own pace.' Though Martínez's program doesn't take federal funding, the Trump administration is cutting similar kinds of peer programs. Martínez says doing this peer work gives many users a sense of purpose and stability—and helps them avoid previous behaviors. The proposed 2026 federal budget will slash the CDC's opioid surveillance programs by $30 million. It also creates a new subdivision called the Administration for a Healthy America that will consolidate the agency's prevention work, along with existing programs at the Substance Abuse and Mental Health Services Agency (SAMHSA), which often coordinates grants for treatment programs. The programs formerly conducted through SAMHSA are also facing cuts of more than $1 billion. Advocates fear this will include a shift toward funding abstinence-only priorities, which, Martínez says, 'will definitely mean that we're going to have more overdoses.' (Some research suggests abstinence-based treatment actually puts people at a higher risk of fatal overdose than those who receive no treatment at all.) 'The general public needs to understand what is being dismantled and the very real impact it's going to have on them and their loved ones.' —Caleb Banta-Green, addiction research professor These cuts could disproportionately affect communities already facing higher overdose rates: Martínez, who is Puerto Rican, notes that U.S. Black, Latino and Indigenous communities have experienced drug overdose death increases in recent years. In many states, overdose deaths in Black and brown communities remain high while white overdose death rates are declining. Looming cuts to Medicaid programs, LaBelle warns, are likely to worsen inequalities in health care access, which tends to make communities of color more vulnerable. In Kentucky, where Governor Andy Beshear recently celebrated a 30 percent decline in overdose deaths, Shreeta Waldon, executive director of the Kentucky Harm Reduction Coalition, says the reality is more nuanced. While national overdose deaths declined in white populations from 2021 to 2023, for example, they continued to rise among people of color. Black and Latino communities often face barriers when accessing health services, many of which have been shaped by predominantly white institutions. Waldon says it's essential for people from diverse backgrounds to participate in policy decisions and necessary to ensure that opioid abatement funds —legal funds used toward treatment and prevention—are distributed fairly. Without adequate federal funding, Waldon predicts treatment programs in Kentucky will become backlogged—potentially pushing more people into crisis situations that lead to emergency services or incarceration rather than to recovery. These financial and political pressures are not only making it harder to find support for people in crisis; they also reduce opportunities to discuss community needs. Waldon says she knows some social workers who now avoid terms such as 'Black woman' or 'marginalized' in grants and public talks out of fear of losing funding. But people currently needing treatment for substance-use disorder are not necessarily aware of the federal funding news—or 'what's about to hit them when they try to go get treatment and they're hit with barriers,' Waldon says. 'That's way more important to me than trying to tailor the way I talk.' Funding and staffing cuts don't just limit resources for the people most in need. They limit the ability to understand where someone is coming from, which undermines efforts to provide meaningful care, Martínez says. Harm reduction is more than the services and physical tools given to community members, he says. It's about the approach. 'When you look at a whole person, you plant the seed of health and dignity,' he says. 'If everybody deserves a chance at redemption, then we've got to rethink how we're approaching things.'


Chicago Tribune
3 hours ago
- Chicago Tribune
Doctors: The US must concentrate on the unvaccinated to fight measles outbreak
The father of modern vaccines was a microbiologist named Maurice Hilleman, who developed a number of effective vaccines including that for measles. His work probably saved as many lives as that of any scientist in history. When measles resurfaced in the U.S. in the early 2000s, he was asked whether public education about vaccines could avoid the suffering of children with measles again. He answered with brutal honesty, 'No, I think children are once again going to have to suffer this disease in order for us to be aware of how bad it can be.' So far he has been proven correct. Last month, measles cases in the U.S. for 2025 passed 1,000, the highest figure since 2019. Measles is the most communicable disease known to man and although many consider it a trivial disease, three people have died in the ongoing U.S. outbreak — two children and one adult. More than 10% of U.S. cases have required hospitalization, a quarter of whom were children under 5. In our lifetime, few medical interventions have been as effective as measles vaccination. Before a measles vaccine was introduced in the mid-1960s, hundreds of thousands, and in some years millions of cases occurred annually, often resulting in hundreds and sometimes thousands of deaths. As long as U.S. vaccination rates remained above 95%, measles cases remained below 1 per million population: the country had established relative herd immunity (although even a high overall vaccination rate does not guarantee against a limited outbreak in an unvaccinated community.) In the past decade, vaccination rates have dropped to between 92% and 93%, a small decrease, but enough to create pockets of infection. Cases spiked above 2 per million in 2014, 2019, and this year. The direct and immediate challenge for Secretary of Health and Human Services Robert F. Kennedy Jr. is to concentrate on the unvaccinated fraction of the population — where measles spreads. To do this, he must shelve the idea that the measles vaccine plays a role in autism (that study has been debunked many times over) and further, he cannot leave the decision to vaccinate to individual whim, as he has suggested. He must address the reasons parents withhold measles vaccine from their children. The vaccine-hesitant are not limited to one ethnic or social class, or income group. Some are quite affluent, as evidenced by a 2014-2015 Disneyland outbreak among wealthier parkgoers. This year's final episode of the popular television medical drama 'The Pitt' concerns the interplay between the emergency room doctors and an upper middle class anti-vax mother of a teenager with life-threatening measles. Some vaccine-hesitant individuals will eventually accept vaccination for themselves and their children. First and foremost, this demands sensitive face-to-face discussions with parents, along with a nonjudgmental and empathic attitude. Parents of all social strata want the best for their children and many will listen to public health workers with communications expertise or trusted pediatricians and family physicians. Here's what will turn people off: reciting the medical facts in a condescending manner and turning the discussion political. Another relatively unvaccinated group are religious communities. No major religion forbids vaccination, but some religious communities have seen measles outbreaks in the unvaccinated. The current North American outbreak took hold in Mennonite communities in the U.S., Mexico and Canada. Once again, this means sensitive discussions with religious leaders to encourage vaccination in their communities. The final group of concern are foreign entries into the country. Migrants from low- to middle-income countries tend to be under-vaccinated, but their numbers are actually small compared to numbers of international tourists, who may be unvaccinated or inadequately vaccinated (and are not counted in vaccination statistics.) Foreign travelers have been the source of past measles outbreaks in Australia, Europe and North America. Mexico's outbreak is believed to have originated with a traveler returning from Texas. Travel medicine specialists play an important — but underutilized — role in preventing the risk of measles when people travel abroad. Currently, measles is not simply a domestic problem. While the media concentrate on reporting U.S. measles cases, where the current incidence is 3 patients per million population, it is lower than in Europe or Mexico. The situation is most serious in Canada, where the 2025 incidence of measles stands at 50 per million, more than 15 times higher than in the U.S. The vaccination rate in Canada is under 85%, another illustration of the importance of vaccination. There are definite indications the outbreak is slowing nationally and in Texas, the hardest hit state. If we are lucky, the outbreak may soon burn itself out — the pool of most susceptible will be exhausted and the school year is ending. But school will reopen in the fall and we should never depend on luck if there is a better alternative. In this case, vaccination. Memo to Robert F. Kennedy Jr.: You are on record as wanting better health for our children. If you are sincere, you must pay attention to Dr. Hilleman's words and put away any personal reservations you have about the measles vaccine. Have the federal and local public health officials in your charge implement vaccine solutions for the unvaccinated — without delay. Dr. Cory Franklin is a retired intensive care physician. Dr. Robert Weinstein is an infectious disease specialist at Rush University Medical Center.
Yahoo
3 hours ago
- Yahoo
Kentucky's bourbon business is vital to our economy. Don't let DC dry it up.
Kentuckians, like all Americans, should be deeply concerned about the troubling developments that have been unfolding behind closed doors in Washington, D.C. Anti-alcohol activists are attempting to seize control of the Dietary Guidelines for Americans on alcohol, potentially inflicting significant harm on our state's economy and our way of life. The Kentucky beverage retail industry is a vital part of our state's economy, with direct retail alcohol sales supporting more than 17,000 jobs and contributing $1.4 billion in economic activity. Many of these businesses are small, family-run operations with tight margins, whose livelihoods are directly threatened by this opaque and potentially damaging process. These activists are pushing for radical changes, advocating that no level of alcohol consumption is safe and pushing for a limit of a mere one drink per week or less. This extreme position flies in the face of established scientific consensus. Opinion: Mid City Mall development can help rebuild our shrinking Highlands community Disturbingly, the process has been tainted by questionable practices. During the Biden administration, anti-alcohol activists appear to have gained undue influence, creating a separate panel not authorized by Congress that disregarded the scientific consensus. They selectively interpreted studies to align with their predetermined ideological agenda. Thankfully, our own Rep. James Comer, chairman of the House Oversight Committee, has been a tireless advocate for transparency and sound science in this process. He has been dogged in his investigation into the development of these alcohol consumption guidelines, exposing this opaque approach where unelected bureaucrats, many with foreign affiliations, are crafting policy behind closed doors. Rep. Comer's recent letter to Robert F. Kennedy Jr., the secretary of Health and Human Services, and Brooke Rollins, the secretary of agriculture, highlights the critical flaws in this process. He rightly pointed out how 'these overlapping evaluations went outside of the congressionally mandated review processes and issued conflicting guidance to the American public.' Rep. Comer's commitment to ensuring the dietary guidelines for alcohol are based on 'rigorous, sound, and objective scientific evidence, efficiently steward taxpayer dollars, and adhere to congressional intent' is commendable. Gerth: Trump's big budget bill sparks debate with Massie. Can't they both lose? | Opinion Rep. Brett Guthrie is also to be commended for his leadership on this issue. Rep. Guthrie has been a strong voice for Kentuckians and has worked diligently to ensure that the dietary guidelines are based on sound science and not on ideological agendas. Secretaries Kennedy and Rollins have the power to halt this concerning process and restore integrity to the development of these crucial guidelines. We urge them to act swiftly and decisively. Until they do, it is imperative that our entire Kentucky delegation, including our senators and representatives, continue to shine a light on this issue and demand transparency. They must make it clear that bias, conflicts of interest and cherry-picked science have no place in the dietary guidelines that impact millions of Americans. Tell us what you think. Submit a letter to the editor. Brian Edwards is the co-owner of Cellar Door Wine & Spirits and Thoroughbred Spirits in Murray, Kentucky. This story was updated to add a gallery. This article originally appeared on Louisville Courier Journal: KY, demand alcohol guidelines based on science, not bias | Opinion