Latest news with #TheCenturyFoundation
Washington Post
4 days ago
- Business
- Washington Post
Future of health policy in the United States
Jeanne Lambrew Director of Health Care Reform and Senior Fellow, The Century Foundation Drew Altman President and CEO, KFF Additional speakers to be announced. The following content is produced and paid for by a Washington Post Live event sponsor. The Washington Post newsroom is not involved in the production of this content. Mark Bertolini CEO, Oscar Health
Yahoo
27-05-2025
- Business
- Yahoo
How Medicaid Cuts Could Impact Early Intervention for Young Children
The first warning sign Rebecca Amidon spotted was when her 1-year-old daughter wasn't walking on her feet. 'She would only walk on her knees, and her coordination seemed really off,' Amidon recounted. Then physical therapists noticed tremors, a sign of a neurological condition that affects balance and coordination. Medicaid covered a brain MRI, which led to a proper diagnosis as well as orthotic ankle braces and weekly physical therapy appointments at the local hospital to support her development. 'Medicaid is there to catch us all when we fall,' said Amidon, who lives in Manistee, Michigan. 'It's not just for people who've always needed it; it's for people like my family as well, who never thought that we would be in a position to rely on it. Without Medicaid and these early intervention services, our family would be facing a much different reality.' Get stories like this delivered straight to your inbox. Sign up for The 74 Newsletter As plans for cutting hundreds of billions of dollars in Medicaid take shape in Congress and President Donald Trump's proposed budget, parents and child health advocates are warning about collateral damage. Namely, the healthy development of young American children. Nationwide, 31 million children rely on Medicaid, and experts such as Julie Kashen, senior fellow and director for women's economic justice at The Century Foundation, have sounded the alarm, saying, 'Reductions in coverage could worsen the health of those children and their communities.' While Congressional debate is largely focused on cutting coverage for low-income adults and limiting states' ability to raise taxes for healthcare spending, the impact could well cause children to lose services and access to health care. 'There's not a lot of fat to cut in Medicaid,' Elisabeth Wright Burak, senior fellow at the Georgetown University Center for Children and Families said on a recent webinar. 'Cuts would put states in a very difficult position of making hard decisions between spending more or rolling back existing coverage or services.' Medicaid, a state-federal partnership, supports American families in many different ways. The health coverage it provides to low-income children has been shown to improve health and boost educational attainment. Nearly three in 10 child care workers are covered by Medicaid, and it is a major funder of community health workers. Medicaid also helps fund part C of the Individuals with Disabilities Education Act (IDEA), which provides early intervention screening and services. Established by Congress in 2004, the program is designed 'to enhance the development of infants and toddlers with disabilities, to minimize their potential for developmental delay and to recognize the significant brain development that occurs during a child's first three years of life.' The program provides early intervention screening and services with resources that vary by state. Nationwide, about 540,000 children under age 3 receive Part C services, and about half of them are enrolled in Medicaid, according to a report from the Infant and Toddler Coordinators Association. Part C saves taxpayers money by minimizing long-term costs for children with disabilities, promoting school readiness and reducing the prevalence of severe disabilities in adulthood. These benefits have been extensively documented: These services are proven to support outcomes for infants and toddlers with developmental delays. As a result of early intervention services, 42% of young children served did not need special education by the time they reached kindergarten. Infants and toddlers with disabilities who receive services under Part C demonstrate improved social-emotional skills, knowledge and behaviors — with two-thirds substantially improving and about one half catching up to a level appropriate for their age. Every state has different Medicaid policies and protocols, which can limit the support that children receive. In Texas, 75% of the state's Medicaid enrollees are children, said Adriana D. Kohler, policy director of Texans Care for Children, a children's advocacy nonprofit. About 2.8% of the state's children under age 3 receive Part C services compared to 7% nationwide, the latest data show 'It's pretty complicated for the early intervention providers,' Kohler said. 'We leverage over a dozen different funding sources, and Medicaid is a critical source of funding.' Related Owing to drastic cuts in Medicaid that Texas lawmakers enacted in 2011, the number of early intervention providers dropped from 58 to 40, while enrollment in the Part C program dropped by 20% to 30% in some areas, according to Kohler. 'You had to be a more severe case or have higher needs in order to qualify,' she said. 'These programs are having to do more with less.' Texas is also one of 10 states that has not agreed to the Medicaid expansion approved in the Affordable Care Act, meaning that uninsured adults living under the poverty line cannot access Medicaid unless they are pregnant, gave birth in the past year, have a disability or live in a nursing home. Burak underscored the particular risks for children's health care in states that did not expand Medicaid and rely on taxing managed care organizations to pay for services. A proposal now before Congress would prohibit such provider taxes, meaning states like Texas would likely be forced to cut back on coverage or services for kids.
Yahoo
20-05-2025
- Business
- Yahoo
House GOP proposes nearly $300 billion cut to SNAP over the next decade
INDIANAPOLIS — As the GOP spending bill makes its way to the House Rules Committee, food insecurity experts have expressed concerns that a proposed $290 billion cut to SNAP over the next decade is still up for debate, potentially affecting the more than 600,000 Hoosiers who rely on the program. 'All 610,000 could be impacted by the proposed cuts,' Mark Lynch with the Indy Hunger Network said. According to Lynch, the federal government provides more than 80% of food assistance dollars: the largest percentage within the nation's food insecurity safety net. 'Every community center like we're in today, every church, synagogue, and mosque; everyone who has tried to help: that's less than 20% of the total money and goods that are in the food insecurity system,' Lynch said. 'It's a nearly 30% cut to the program over the next decade,' Rachel West with The Century Foundation said. If that cut comes to fruition, West said the average Hoosier on SNAP could lose between $110-$120 in monthly benefits, assuming they're not kicked off the program altogether. 'It's nearly a full week of benefits,' West said. 'Indiana families are in a worse position than many American families if these benefits go cuts go into effect.' According to West, the GOP spending bill would pass SNAP costs onto states — something never before seen in the program's 50-year history. 'If the House cuts that they're proposing come to fruition, it would be a $356 million additional cost to the state of Indiana,' Lynch said. This comes as the state decided not to opt into the popular Sun Bucks program — a summer EBT program that would have cost the state $2.8 million to administer this year. 'The state didn't feel comfortable with $2.8 million? I don't know how they would feel anywhere close to comfortable with $356 million,' Lynch said. 'A state that just passed a budget that exceeded $46 billion is not a poor state,' State Sen. Fady Qaddoura (D-Indianapolis) said. Sen. Qaddoura submitted a request to legislative leaders for a review of Indiana's food insecurity safety net, and what options the state has should these cuts take place. 'Especially as we are hearing discussions within the community of economists across the United States that we are on the verge of a recession, and if that is the case, then we need to act quickly to be sure that no one is left behind,' Sen. Qaddoura said. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
16-05-2025
- Business
- Yahoo
Officials Sound Alarm Over Delayed Federal Child Care Payments to States
The Trump administration has failed to send out an estimated hundreds of millions in discretionary funding to state child care agencies that should have gone out weeks ago, five sources in the federal government and advocacy organizations confirmed. The Child Care Development Block Grants (CCDBG), which states mostly use to provide subsidies to low-income families, were anticipated to arrive around April 1, the start of the federal fiscal year's third quarter. Get stories like this delivered straight to your inbox. Sign up for The 74 Newsletter 'The money hasn't gone out, and that is extremely unusual,' said Ruth Friedman, a senior fellow at The Century Foundation who served as director of the Office of Child Care at the Administration for Children and Families (ACF) under the Biden administration. Emily Adams, policy associate for child care & early childhood programs at the American Public Human Services Association, concurs. Adams works directly with state child care agency directors across the country, and one told her they were notified by their regional child care office that ACF's Office of Grants Management said the funding has not yet been approved for awards and there was no timeframe for when the grants might be approved. In response to a request for comment, a spokesperson at the Department of Health & Human Services, said, 'ACF is working to award third quarter discretionary CCDF funding as soon as possible.' The CCDBG is part of a complex system of federal child care funding. The largest source comes from the Child Care and Development Fund (CCDF), which has two components: mandatory payments made through the Child Care Entitlement to States, which states have already received, and the much larger pot of discretionary CCDBG money, which they haven't. Congress determines the level of CCDBG spending annually and has allotted $8.75 billion to states for the 2025 fiscal year that ends in September. It usually takes two weeks for these block grants to flow to states after Congress passes a continuing resolution funding the government, which it did on March 14. Officials in the Biden administration sent out the first and second quarter funding to state child care agencies on a normal schedule. But the third quarter installment hasn't gone out under the Trump administration, Friedman, Adams and other sources confirmed. Unlike Head Start programs, which face immediate consequences if their funding is delayed, states typically have more cushion for child care, so they may not yet have to make hard choices. That's in part due to the fact that they have a longer time to spend the money, so some may have past funding to keep using. Also, some states put more of their own money into the mix than is required by federal rules, creating even more runway in those places. Related 'Most states have about a month of funds that they can use before they're in big trouble,' Adams notes. But if the money doesn't arrive soon, 'It is eventually going to cause a problem for states,' Friedman explains. The vast majority of the funding covers subsidies that help low-income families pay for child care; if that money dries up, states will have to stop paying for those subsidies. If that happens across all states, the parents of the 1.4 million children who receive them could be left to either cover the full cost themselves or pull their children out of child care. Providers, in turn, could face a wave of unpaid bills and disenrollments. 'It would be extraordinarily destabilizing,' Friedman said. It's unclear if the funding is delayed due to personnel challenges or is being held back for more substantive reasons. By April, the Trump administration had fired nearly half the workforce at ACF. Trump has threatened to eliminate Head Start (although officials recently walked that back) and the so-called 'skinny' budget he released on May 2 would eliminate preschool development grants that help states improve early childhood education and the Child Care Access Means Parents in School program, which helps low-income parents afford child care while going to college. The Trump administration has withheld other federal funding that Congress appropriated and he legally has to disburse. In April, Congressional Democrats released a tracker that found at least $430 billion had yet to go out the door to a wide variety of programs, from Head Start to USAID. But the CCDBG funding wasn't included in that sum. On top of the delayed block grants, state child care agencies have also been subjected to Elon Musk's DOGE effort dubbed 'Defend the Spend' without any warning and little explanation. Now, when an agency wants to draw down federal funds from the payment system — normally a 'routine and regular process,' Friedman said, and one in which they're typically reimbursed for dollars they already spent — they receive an email directing them to take a new step in which they have to justify why they need the money. In an email received by a state agency director on April 17 and shared with Adams, the sender wrote, 'We are requesting additional clarification regarding this payment. An ideal payment justification includes a description of the award and what you plan to do with the funds.' It then directs the recipient to click on a long URL to do so. The email ends with simply, 'God Bless America.' Adams noted that agency directors told her the emails 'looked spammy and they don't come from a known email address.' Some states have had to justify their spending as many as three times before getting it. The process has now led to delays. 'What they typically would get in two to four business days is taking five to 10 business days,' Adams said. An ACF spokesperson said in a response to a request for comment, 'While some states have been asked for additional clarification prior to their CCDF drawdowns being approved, no states have been denied the ability to draw down CCDF funds as the result of the Defend the Spend review. In addition, the CCDF program is being phased out of the Defend the Spend review, so CCDF grant recipients will no longer be asked for a justification to draw down CCDF funds.' In Ohio, the delay caused a scary hiccup in April, said Tamara Lunan, director of care economy organizing at the Ohio Organizing Collaborative. The week of April 14, providers who typically receive subsidy payments from the state on Tuesdays didn't receive anything. Then those with Saturday payments didn't get them either. Although the state technically has a 10-day window to send payments out, 'usually the only thing that throws it off is if there was some type of error in the billing or a holiday,' Lunan explained. When Lunan, who was hearing directly from providers about the missing payments, asked the Ohio Department of Children and Youth (DCY) what happened, she said she was told 'that they got DOGE'd,' and were made to give an extra explanation for the money. But in a later meeting, the state changed its tune slightly: According to meeting notes, the department said it was due to a 'system glitch at the federal level.' The payments went out on April 22, which falls within the 10-day window, but some providers had to wait a week longer than usual to get paid. It took a quick toll: Some had to lay off staff because they couldn't make payroll, while others paid staff late, Lunan said. Jodi Norton, DCY's chief communications officer, noted that the department hasn't strayed outside the allotted time frame, including the week of April 14. 'DCY continues to work with federal partners when additional justification is needed and thus far has been successful in maintaining the 10-day window for payments,' she said. Lunan said the payments have now resumed as normal, but if more delays crop up in the future it could leave some providers to not just lose staff but go out of business entirely. 'Providers are really scared about this,' she added. States already go through a rigorous process to justify their spending long before they draw down money. Every three years they have to submit a lengthy state plan to the federal government, as required by law, that describes their child care programs and how they will follow relevant rules. Those plans, which are publicly available, are then carefully reviewed by the U.S. Department of Health and Human Services; it's only after they're approved that states can get any money. After that, states are monitored to make sure they are following federal rules, and they must track their spending and report it back to the agency to make sure they follow all the requirements. They also undergo annual financial audits. 'There are many pieces put in place by Congress to ensure that federal funds are being spent as intended and as required,' Friedman said. It is 'already quite extensive.' The new 'Defend the Spend' approach 'is not an efficient process for ensuring good stewardship of federal funds,' she added. 'This new process does not create new information, but it does create burden and uncertainty for state agencies.'
Yahoo
04-05-2025
- Business
- Yahoo
Trump wants us to have more kids — but it's more expensive than ever
There are few policies that attract bipartisan support, and the child tax credit is one of them. Since the late 1990s, both Democratic and Republican administrations saw the measure as a way to support middle-income and lower-income families. This year, the discussion is a little different. Along with a potential increase of the credit, the Trump administration is considering a one-time, $5,000 baby bonus and other incentives, according to The New York Times. A 'National Medal of Motherhood' medal would honor those with six kids or more, and quotas for married couples or applicants with children for programs like the Fulbright fellowship are being considered, according to The Times report last month. The issue of boosting fertility rates, rather than just supporting American families, has entered the chat. 'The fact that the [Trump] administration jumped straight to motherhood medals and not something like paid leave or child care solutions shows just how out of touch they are with what parents in America are experiencing right now,' said Julie Kashen, a director for women's economic justice at The Century Foundation. After embarking on an ambitious tariff policy that faces economic headwinds, the Trump administration now will be tested on its commitment to American families. The administration will set the scope and size of the child tax credit, consider additional incentives and suggest how these are structured when it comes to defining the income of eligible families. The administration will have to balance its embrace of pro-family values with widespread concerns about the economy and the growing deficit. "The expectations of a recession have gone up, so I think it winds up being pretty important for the administration to deliver some tangible family policy wins,' said Leah Sargeant, author of a recent report published by Niskanen Center that highlights the potential benefits of a baby bonus. The Trump administration has issued no executive orders on a child tax credit, and Congress is still deliberating the future of the American Rescue Plan Act that includes the credit provision. The child tax credit that temporarily increased benefits and broadened eligibility during the Biden administration expired in 2023. The current credit provides $2,000 per child for eligible individuals making up to $200,000 and up to $400,000 for married couples filing jointly. Without a congressional extension, the credit would revert to $1,000 per child in 2026 if the Tax Cuts and Jobs Act provisions expire at the end of this year. Even though the child tax credit has been popular with both parties for decades, some experts suggest it excludes poor families because they don't make enough money to qualify for it. 'It's for American families who are not among the poorest,' said Kathryn Edin, director of Bendheim-Thoman Center for Research on Child and Family Wellbeing at Princeton University. 'In fact, 25% of American children are left out of any or part of the credit because the credit has been so skewed away from the poor — it's remarkable the degree to which it is ignored by the poor." The baby bonus discussion has struck a different tone. "It's a very different logic, this is really about boosting fertility — this is pronatalist,' Edin said. 'It's not about helping families with kids, it's literally paying people to have kids." Trump appears to be open to the pronatalist ideas. 'We will support baby booms and we will support baby bonuses for a new baby boom,' he said at the Conservative Political Action Conference in 2023, as quoted by The New York Times. Even supporters of the baby bonus say that it's a temporary measure that could help, but will not automatically incentivize more Americans to have kids. 'A $2,000 baby bonus would cost a modest $5.3-$7.7 billion per year, depending on whether it was a universal program or phased in at a 20 percent rate to be fully claimable at $10,000 of earnings,' Niskanen Center's Leah Sargeant argues in the report. "It's clear that families are struggling, that families can't and shouldn't be left out of this reconciliation package, and that there's a pretty broad menu of ways to help from catching up the child tax credit to inflation and instituting a baby bonus that'll work for a lot of American families," Sergeant said in an interview, noting there is an appetite for pro-family legislation. "And I also think just communicating that supporting families is a priority of this administration." Even before the start of Trump's second term, American families had been struggling. And it's not clear his administration would be able to convince Americans to have more kids while the economy is headed for a recession. The proposed baby bonus wouldn't even cover the average cost of delivery for most parents. The average total cost for vaginal births is $14,768 and for cesarean sections is about $26,280, according to UW Health data. An average middle-income family with two children spends about $310,605 to raise a child, according to recent data compiled by the Brookings Institution. Child care costs have also risen. Daycare and preschool costs are up 22% between January 2020 and September 2024, according to the Bureau of Labor Statistics. In the U.S., the burden of early childhood care falls on parents, which makes it an outlier compared to other developed economies. This takes a toll on parents' ability to keep working as well as care for their children. 'The labor force participation of parents with young children is weaker in the United States than in many of our peer nations, likely because of our lack of paid parental leave policies as well as the high cost of child care,' according to analysts at the Economic Policy Institute. With the addition of tariffs, there are now early indications that it will become even costlier and more challenging to afford baby products and raise children. While it's still early to determine whether things will get a lot worse for parents, it's clear that Trump will have to balance the shaky economy, fears about the deficit, tangible economic relief for families who are struggling and commitment to pronatalist beliefs. "A lot of American data have indicated that one of the reasons they don't want to grow their family is because they are not sure that economically they will be able to in the coming years,' said Courtney Joslin, who leads R Street's project for women and families. 'When you start from there, that's a different policy conversation than if you're starting with, 'Well, if we give an increased child tax credit, a baby bonus, that will suddenly boost Americans' willingness to have more children.' ' Joslin is doubtful these policies will dramatically boost the fertility rate. None of the broader issues are currently addressed in a systemic way by the Trump administration, according to experts. Ultimately, no amount of incentives will convince people to have kids if they feel financially insecure. 'It's time to move away from the DIY system we have — where it's every family for themselves,' said Julie Kashen. 'Instead, we need robust investments in child care, paid leave, maternal and reproductive care, sick leave and health care for all to strengthen the financial health and well-being of parents in America and make it easier for women to have families on their own terms.'
