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About MaryLou Beaver

New Hampshire Campaign Director Every Child Matters Education Fund

Granite State Rumblings: The End Of An Era, Every Child Matters NH Is Closing After 10 Years

It is with a heavy heart that this will be the last official Granite State Rumblings as the NH Chapter of Every Child Matters is closing their doors.  

Over the last few years MaryLou has informed us in great detail about upcoming legislation in Concord and Washington with the goal of ending poverty, building a strong educational system, and fighting for low income families every day.  

Let me be the first to say Thank You for all of the hard work you have put in at Every Child Matters over the years.  I would also like to thank Marylou on behalf of the NH Labor News for her tireless work keeping us well informed and allowing us to share her weekly updates.  

While this may be the last official Granite State Rumblings, hopefully it will not be the last word from MaryLou.  

Matt, 
Editor of the NH Labor News


GRANITE STATE RUMBLINGS

Next week marks the end of a decade of advocacy, organizing, educating, researching, bird dogging, reporting, and having an important impact on the future of Granite State children and the programs and policies that affect them. Every Child Matters in New Hampshire is closing its doors.

Soon the lights will be turned off, the doors locked and the telephone disconnected. But the work we did over the course of the last 10 years lives on. It lives on in the legislation we helped move forward that impacts New Hampshire’s children and families, and the legislation that our collective voices helped stop that would have been detrimental to children’s well-being. It lives on in the knowledge that we helped to educate others about the needs of children and knowing that we gave all of our best efforts to ensuring that every child has equal opportunities to grow up healthy, well-educated and safe in their homes and communities.

For the past ten years, the mission of Every Child Matters in New Hampshire was so resonant because its values were already deeply embedded within the State. And while we are saddened that our doors are closing, nothing about the closure of the organization changes that. The mission lives on in all of you and your commitment to do right by New Hampshire’s children – ALL of them. Please continue to carry it on through your own work and practice.

On a personal note, I want to thank all of you for allowing me to share my passion with you. I have enjoyed meeting you, talking with you, working with you, and learning from you. I intend to continue to be a big voice for kids in New Hampshire and in Washington. My role may change, but my heart is always in this.

I also plan to continue to write about the programs, policies, and legislation that impacts children and their families. If you want to continue to be in touch and informed by having my thoughts and musings appear in your inbox, please send me an e-mail at kids1stconsulting(at)gmail.com.

Thank you for being a part of my life these past ten years!
MaryLou Beaver

New Hampshire Director
Every Child Matters

Granite State Rumblings: The Dire Consequences Of ACA Repeal In NH

Last week we took a broad look at what repeal of the Affordable Care Act could mean for Medicaid and CHIP. This week let’s dig a little further into what the repeal would mean to children.

Repeal of the ACA would have particularly dire consequences for the 4.4 million children who would become uninsured. Health insurance for children has long-term positive outcomes, such as reductions in infant mortality and childhood deaths, improved health, and reduced disability. But there are subtler effects, too: expanding health coverage for low-income children improves high school and postsecondary success, and also employment over the long haul. Plus, children’s life chances are improved when parents are able to get the care they need, like treatment for depression (which is widespread among low-income mothers of young children). In states that have expanded Medicaid under the ACA, many more parents have health insurance, making access to treatment for behavioral health or substance use disorders more available, which helps parents’ own health and improves outcomes for their children.  ~ Source: CLASP ~

10 Reasons Why Repealing the ACA Would Harm Kids

  1. If health reform were repealed, insurers would go back to denying coverage for children with pre-existing conditions. Parents of children with cancer, children born with a birth defect, children with asthma, special-needs kids, among others, would once again be unable to get coverage for their kids without the Affordable Care Act.
  2. Insurers would return to the practice of placing lifetime limits on coverage so that if a child is fortunate enough to beat leukemia when they are 8 they would be uninsurable if they face another serious illness later in life.
  3. Dependent children through age 26 would not be guaranteed access to coverage on their parents’ policy, leaving scores of young adults, including recent high school and college grads, back among the ranks of the uninsured.
  4. Insurers would not have to cover vision care services or eyeglasses for children even if it is impossible for a child to be successful in school if they can’t see
  5. Insurers also would not be required to cover dental care, a horrible return to the days when lack of coverage could cause a child to die from an infected tooth that could have been addressed for about 100.
  6. Repealing health reform would jeopardize the future of the successful Children’s Health Insurance Program (CHIP), a federal-state program that offers low or no-cost coverage for families who earn too much to qualify for Medicaid but not enough to buy their own coverage. CHIP and Medicaid were crucial for families during the recession, ensuring that coverage for kids remained stable despite the downturn in the economy.
  7. Children with terminal illnesses would be returned to the days when they would not be able to get compassionate end-of-life hospice care unless they agreed to forgo looking for a cure for their illness.
  8. Insurers would be allowed to resume the practice of charging co-payments for preventive health services, including essential well-baby and well-child visits, and vaccinations, creating financial disincentives for parents to get care for their children that keeps them healthy.
  9. Children in foster care would no longer qualify for Medicaid beyond age 18. This provision parallels the one enabling young adults to remain on their parents’ health plans until they turn 26.
  10. Efforts to eliminate bureaucratic red tape and streamline enrollment processes for children who are already eligible but not enrolled in public health coverage would suffer if health reform was repealed. Nearly two-thirds of children who are uninsured actually qualify for coverage but face significant barriers that make it difficult for them to sign-up or re-enroll for coverage.

As we explained last week, through the Affordable Care Act, Medicaid and the Children’s Health Insurance Program (CHIP) have worked in unison to dramatically cut the ranks of the uninsured across the country. CHIP has provided coverage to the almost eight million children whose families currently or once lived in the coverage gap. 

Because of the options available under the ACA the percentage of uninsured children has dropped from 14.9 percent in 1997 to just 4.8 percent in 2015 — a 68 percent reduction. That is impressive! 

Medicaid and CHIP have also been an option for many parents who can participate in a health insurance option through their employers, but because of costs associated with employer based coverage have turned instead to these programs.

Michelle Andrews with Kaiser Health News, a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation wrote about this in a recent article.

Many Parents With Job-Based Coverage Still Turn To Medicaid, CHIP To Insure Kids

By Michelle Andrews, December 9, 2016

Lower income parents who have health insurance through their employers are increasingly likely to forgo family coverage and enroll their kids in Medicaid or the Children’s Health Insurance Program (CHIP) instead, a new study found. Working families’ growing reliance on these programs is something lawmakers should keep in mind when they consider whether to renew financing for the CHIP program in 2017, the study’s lead author said.

“These aren’t just safety net programs for uninsured families,” said Douglas Strane, a clinical research associate at PolicyLab at the Children’s Hospital of Philadelphia and the lead author of the study, which appeared in the December issue of Health Affairs. “If CHIP isn’t renewed, we could place substantial pressure on working families.”

Medicaid is the state-federal program that provides health coverage for low-income adults and children. CHIP provides health insurance for children in families whose incomes are modest but too high to qualify for Medicaid. In 2016, only three states — Arizona, Idaho and North Dakota — limited Medicaid/CHIP coverage to children whose families have incomes less than 200 percent of the federal poverty level ($40,320 for a family of three). In contrast, 19 states offered coverage to children with family incomes greater than 300 percent of the federal poverty level ($60,480 for a three-person family), according to the Kaiser Family Foundation. (KHN is an editorially independent program of the foundation.)

Medicaid/CHIP out-of-pocket costs vary by state, but coverage is generally significantly less expensive than employer coverage.

Health Affairs study analyzed data from the Medical Expenditure Panel Survey between 2008 and 2013 for families with incomes between 100 and 400 percent of the federal poverty level in which at least one parent had employer-sponsored coverage. The study predated the opening of the health law’s marketplaces, but the researchers said that because these families had employer-based coverage options, they would likely not qualify for less expensive coverage on the exchanges.

Over the course of the study, nearly all the families in which a parent was offered coverage accepted it for the parent, and about three-quarters of children in the sample were covered by their parents’ employer-sponsored plan, on average.

But the proportion of kids who lacked employer-sponsored coverage even though at least one parent had it grew from 22.5 percent in 2008 to 25 percent in 2013, the study found. Likewise, the percentage of children who were on Medicaid or CHIP even though at least one parent had coverage through an employer increased 3.1 percentage points, to 15.2 percent, over the course of the study.

Premium increases for employer-sponsored coverage may put a family plan out of reach for low- and moderate-income families, said Strane. Between 2006 and 2016 premiums rose 58 percent for family coverage, according to the Kaiser Family Foundation’s 2016 annual survey of employer-sponsored coverage. This year, families pay $5,277 for coverage on average, 29 percent of the total cost of the plan. Workers’ share of the premium grew 78 percent over the past decade, outpacing the growth in premiums, according to the KFF study.

“They did the math and likely figured CHIP was going to save them money,” said Strane.

There is a lot at stake for children and families as the plan to repeal the Affordable Care Act moves forward. And we need your help!

Personal stories are the most powerful tools we have in our fight to protect access to affordable, high-quality healthcare for all children and their families. By telling your story in support of CHIP, Medicaid and the consumer protections gained under the Affordable Care Act, you help put a face to how kids and families will be impacted by the threat to repeal the Affordable Care Act and dismantle Medicaid and CHIP.

Every Child Matters in NH and Maine are collecting stories from those who have benefitted from Medicaid and CHIP.

Please share this link and help us collect real life stories that we will share with our members of Congress and the new Administration in Washington. We have the data; now we need your story!

Impact of the Affordable Care Act in New Hampshire

Thousands of Granite Staters have gained coverage, and hundreds of thousands more have had their coverage substantially improved.

The U.S. Department of Health and Human Services released an extensive compilation of state-level data illustrating the substantial improvements in health care for all Americans over the last six years. The data show that the uninsured rate in New Hampshire has fallen by 43 percent since the Affordable Care Act (ACA) was enacted in 2010, translating into 63,000 Granite Staters gaining coverage. And, in addition to residents who would otherwise be uninsured, hundreds of thousands more Granite Staters with employer, Medicaid, individual market, or Medicare coverage have also benefited from new protections as a result of the law.

“As our nation debates changes to the health care system, it’s important to take stock of where we are today compared to where we were before the Affordable Care Act,” said Secretary Sylvia M. Burwell. “Whether New Hampshirites get coverage through an employer, Medicaid, the individual market, or Medicare, they have better health coverage and care today as a result of the ACA. Millions of Americans with all types of coverage have a stake in the future of health reform. We need to build on our progress and continue to improve health care access, quality, and affordability, not move our system backward.”

Highlights of the data release include:

Employer Coverage: 853,000 people in New Hampshire are covered through employer-sponsored health plans. Since the ACA was enacted in 2010, this group has seen:

  • An end to annual and lifetime limits: Before the ACA, 545,000 Granite Staters with employer or individual market coverage had a lifetime limit on their insurance policy. That meant their coverage could end exactly when they needed it most. The ACA prohibits annual and lifetime limits on policies, so all New Hampshirites with employer plans now have coverage that’s there when they need it.
  • Young adults covered until age 26: An estimated 9,000 young adults in New Hampshire have benefited from the ACA provision that allows kids to stay on their parents’ health insurance up to age 26.
  • Free preventive care: Under the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no extra cost to consumers. This provision benefits 690,524 people in New Hampshire, most of whom have employer coverage.
  • Slower premium growth: The average premium for New Hampshire families with employer coverage grew 4.8 percent per year from 2010-2015, compared with 7.3 percent over the previous decade. Assuming New Hampshire premiums grew in line with the national average in 2016, family premiums in New Hampshire are $3,300 lower today than if growth had matched the pre-ACA decade.
  • Better value through the 80/20 rule: Because of the ACA, health insurance companies must spend at least 80 cents of each premium dollar on health care or care improvements, rather than administrative costs like salaries or marketing, or else give consumers a refund. Granite Staters with employer coverage have received $2,264,293 in insurance refunds since 2012.

Medicaid: 189,429 people in New Hampshire are covered by Medicaid or the Children’s Health Insurance Program, including 94,622 children and 20,839 seniors and people with disabilities covered by both Medicaid and Medicare. The ACA expanded Medicaid eligibility and strengthened the program for those already eligible.

  • 22,000 Granite Staters have gained coverage through Medicaid: An estimated 22,000 New Hampshire residents have health insurance today because New Hampshire expanded Medicaid under the ACA. Coverage improves access to care, financial security, and health, resulting in an estimated 3,000 more Granite Staters getting all needed care, 3,200 fewer Granite Staters struggling to pay medical bills, and 30 avoided deaths each year.
  • Thousands of Granite Staters with a mental illness or substance use disorder are getting care: Thanks to expansion and improved access to treatment, an estimated 2,000 fewer Granite Staters are experiencing symptoms of depression.
  • New Hampshire is saving millions in uncompensated care costs: Instead of spending $20 million on uncompensated care, which increases costs for everyone, New Hampshire is getting $210 million in federal support to provide low-income adults with much needed coverage.
  • Children, people with disabilities, and seniors can more easily access Medicaid coverage: The ACA streamlined Medicaid eligibility processes, eliminating hurdles so that vulnerable Granite Staters could more easily access and maintain coverage.
  • New Hampshire is improving behavioral health: Under the ACA, CMS is helping New Hampshire link payments with improved outcomes for beneficiaries with co-morbid conditions; customize expansions/ enhancements to specific populations; and spread integration efforts to new areas of the state.

Individual market: 49,114 people in New Hampshire have coverage through the Marketplace. Individual market coverage is dramatically better compared to before the ACA:

  • No discrimination based on pre-existing conditions: Up to 597,050 people in New Hampshire have a pre-existing health condition. Before the ACA, these Granite Staters could have been denied coverage or charged an exorbitant price if they needed individual market coverage. Now, health insurance companies cannot refuse coverage or charge people more because of pre-existing conditions.
  • Tax credits available to help pay for coverage: Before the ACA, only those with employer coverage generally got tax benefits to help pay for health insurance. Now, 31,151 moderate- and middle-income Granite State resudents receive tax credits averaging $261 per month to help them get covered through HealthCare.gov.
  • Women pay the same as men: Before the ACA, women were often charged more than men just because of their gender. That is now illegal thanks to the ACA, protecting roughly half the people of New Hampshire.
  • Greater transparency and choice: Before the ACA, it was virtually impossible for consumers to effectively compare insurance plan prices and shop for the best value. Under the ACA, New Hampshire has received $9 million in federal funding to provide a more transparent marketplace where consumers can easily compare plans, choosing among 32 plans on average.

Medicare: 275,803 people in New Hampshire are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:

  • Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, 21,026 New Hampshire seniors are saving $22 million on drugs in 2015, an average of $1,047 per beneficiary.
  • Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 176,282 New Hampshire seniors, or 74 percent of all New Hampshire seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.
  • Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for New Hampshire Medicare beneficiaries dropped 3 percent between 2010 and 2015, which translates into 152 times New Hampshire Medicare beneficiaries avoided an unnecessary return to the hospital in 2015. 
  • More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. 8 Accountable Care Organizations (ACOs) in New Hampshire now offer Medicare beneficiaries the opportunity to receive higher quality, more coordinated care.

Content created by Assistant Secretary for Public Affairs (ASPA)
Content last reviewed on December 13, 2016

From our friends at the Campaign for a Family Friendly Economy: 

The future of our state depends on lawmakers acting now to enact policies that help New Hampshire become the best state to live, work and raise a family.

Join us Thursday, January 26 in Concord to make our voices heard. RSVP today to attend the Family Friendly Economy State House Day.

Together, we will make sure that our lawmakers act this year to establish paid family and medical leave insurance and make investments in child care so working families can make ends meet while caring for their families. 

Our day of activities will include a breakfast training, small group meetings with legislators, and a press conference to get our message out far and wide. Your voice is critical to our success.

Ahead of January 26, we’ll work with you to schedule a meeting in Concord with your legislator so you can share with them why it’s critical to your family’s future that they act to increase investment in quality child care and establish a family and medical leave insurance program in New Hampshire.

Your legislator needs to hear from you. Join us at our Family Friendly Economy State House Day. RSVP now to be a critical part of creating a brighter future for New Hampshire’s workforce!

Our state’s economic prosperity depends on keeping parents in the workforce and providing for the next generation – our children can’t wait. We must speak out. 

Thanks for your support,

Amanda Sears
Director, Campaign for a Family Friendly Economy

There are a few upcoming events in 2017 that I want to be sure are on your radar. 

Family Friendly Economy State House Day: January 26th 9am-1pm, Concord State House (114 N Main Street). You can find more information about it HERE.

The NH Children’s Trust 6th Annual Strengthening Families Summit is set for Tuesday, March 28th. You can find more information about it HERE.

Granite State Rumblings: Repeal Of ACA Hurts Granite Staters and The NH Women’s Day Of Action & Unity

Congress has already taken steps to begin the repeal of the Affordable Care Act. On Thursday the Senate voted 51-48 on the budget resolution, which includes instructions for nixing the Affordable Care Act, largely along a party-line vote. GOP Sen. Rand Paul (Ky.) was the only Republican to vote against the resolution. On Friday the House of Representatives followed suit by a vote of 227-198. Altogether, only nine Republican lawmakers voted against it.

While it is possible that a repeal of the ACA could leave Medicaid and the Children’s Health Insurance Program (CHIP) untouched, and focus only on the private insurance side of the ACA, it doesn’t seem likely given the votes we saw in the Senate early last Thursday morning. 

Senate Democrats presented multiple amendments during the late-night “vote-a-rama,” (back-to-back roll call votes on numerous amendments), seeking to ensure continued access to coverage for people with pre-existing conditions, prevent any changes to Medicare, Medicaid or the Children’s Health Insurance Program, and allow young adults to stay on their parents’ health insurance plans until they turn 26. 

Here are a few of the amendments that were blocked:

  • Protect people with pre-existing conditions

An amendment that would have made it harder to take away coverage from Americans with preexisting medical conditions. 52 million people — about 1 in 4 non-elderly Americans — have preexisting conditions. These Americans are more likely to face significant health costs, and before the Affordable Care Act, were often denied coverage entirely. The amendment also would have protected coverage for people disabilities or chronic health conditions, and prevent plans from discriminating based on health. Only two Republicans — Maine’s Susan Collins and Nevada’s Dean Heller — voted for the amendment.

  • Let young adults stay on their parents’ plan

Democratic Sen. Tammy Baldwin offered an amendment that would have made it easier for young people to stay on their parents’ health care plan until they are 26 — one of the most popular and effective provisions of the Affordable Care Act. Over 6 million young adults have gained health insurance since the law was implemented in 2010, and young Americans now report better physical and mental health. The provision is also overwhelmingly popular — 85 percent favor keeping young people on their parents’ insurance plans. Sens. Heller and Collins were the only two senators who bucked their party on this vote.

  • Ensure Medicaid expansion stays in place

Medicaid expansion under the Affordable Care Act benefited 11 million low-income Americans in 2015 alone and has created thousands of jobs for direct care workers. An amendment by Sen. Bob Menendez (D-NJ) would have sought to continue Medicaid expansion.

  • Protect children on Medicaid or CHIP

An amendment was offered by Senator Brown (D-OH) that would ensure children could keep their health coverage on Medicaid or the Children’s Health Insurance Program (CHIP), both of which provide comprehensive health care services for children including key preventive and developmental care.

~ Source: Think Progress ~

Medicaid is a multi-generational program set up to protect our most vulnerable consumers at any stage in their lives. Under the ACA, Medicaid has expanded in many states to cover people in the coverage gap – those earning too much for traditional Medicaid but too little to qualify for tax credits in the Marketplace. 

Despite its complex features, Medicaid serves two basic functions: to insure low-income adults and children and to fund long-term services and supports for millions of adults and children with serious illnesses or disabilities who are at risk of impoverishment as a result of their health.    

~ Source: The Commonwealth Fund ~

Through the Affordable Care Act, Medicaid and the Children’s Health Insurance Program (CHIP) have worked in unison to dramatically cut the ranks of the uninsured across the country. CHIP has provided coverage to the almost eight million children whose families currently or once lived in the coverage gap. The percentage of uninsured children has dropped from 14.9 percent in 1997 to just 4.8 percent in 2015 — a 68 percent reduction. 

In addition to raising the mandatory financial eligibility standard for the Medicaid program for children ages 6 to 18 from 100 percent to 138 percent of poverty, the ACA provided five years of additional funding for the Children’s Health Insurance Program, while also increasing federal CHIP funding levels. CHIP provides coverage to children in families who earn too much to qualify for Medicaid. States can opt to use their CHIP allotments either to expand Medicaid, fund a separate CHIP program, or create a combination of the two approaches. In 2015 Congress continued CHIP funding through September 30, 2017

While there has been bipartisan support for CHIP, a repeal law could extend the program but make it much more restrictive, for example, by limiting eligibility to the poorest children and eliminating the enhanced funding now available to help states support their programs. This could result in a decrease in current services for children and would most assuredly cause uninsured numbers to rise.

The Affordable Care Act also created new options for coverage of freestanding birthing centers, family planning services, and hospice care for children covered under Medicaid or CHIP.

The ACA also gave special attention to young adults up to age 26 who previously had been in foster care by adding a provision to ensure they would qualify for coverage. This provision parallels the one enabling young adults to remain on their parents’ health plans until they turn 26.

Repeal will also have a devastating impact on children in foster care in the states. For children at risk of entering the foster care system, the ACA provides necessary supports to them through their parents.

Thanks to the ACA, many parents have health coverage, including access to substance use treatment and behavioral health services, for the first time. These services are at the front line of prevention, supporting parents in caring for their children. If Congress chooses to repeal the ACA without offering a more robust, accessible vehicle for health service, these parents will lose access to important, needed services.

Eva Marie Stahl from Community Catalyst writes that repeal of the ACA could lead to an increased number of children being removed from families following reunification because parents will lose access to vital behavioral services and supports. Preventing children from entering into a cycle of foster care means providing needed services and support to parents, ranging from substance use treatment and mental health services to parent coaching and housing support. The ACA is a vital part of the prevention framework – enabling families to access important health services before a crisis hits. It is an important tool needed to keep families strong.

There is a lot at stake for children and families as the plan to repeal the Affordable Care Act moves forward. And we need your help!

Personal stories are the most powerful tools we have in our fight to protect access to affordable, high-quality healthcare for all children. By telling your story in support of CHIP, Medicaid and the consumer protections gained under the Affordable Care Act, you help put a face to how kids and families will be impacted by the threat to repeal the Affordable Care Act and dismantle Medicaid and CHIP.

Every Child Matters in NH and Maine are collecting stories from the families whose children have benefitted from Medicaid and CHIP. Please share this link and help us collect real life stories that we will share with our members of Congress and the new Administration in Washington. 

GROWING UP GRANITE

On Saturday, January 21, 2017, we will unite at the New Hampshire State House in Concord in solidarity with the Women’s March on Washington and in support of our rights, our safety, our health, our families, and our environment. Together, we will send a message to elected officials in New Hampshire and Washington, D.C. that we will stand together to protect the progress we’ve made. We won’t go back!

ALL ARE WELCOME. This is an inclusive day of action and unity. We believe in the strength possible when we act together and are committed to an inclusivity that will allow us to build unlikely coalitions among our diverse voices, guide us, and inspire us. Our aim is to solidify unity by bringing diverse voices together so that in the coming months and years of new national and state leadership, NO ONE is left behind.

PLEASE NOTE: We will be sending an email with more details on speakers and presenters, parking, logistics, etc. in advance of the event to anyone who signs up here with a valid email address. We will share information as it becomes available on our Facebook page. 

FAQS

When is the Day of Action & Unity?

Date: Saturday, January 21, 2017

Time: 10 AM – 3 PM

Program: 

10:00 New Hampshire Women’s Solidarity Rally for Action w/ keynote speaker Jodi Picoult at the State House Plaza (additional speaking program TBA)

11:30-1:15: Activist Training at Phenix Hall hosted by Planned Parenthood New Hampshire Action Fund – FULL

11:30: Drum Circle at the State House Plaza led by Julie Corey and Kathy Lowe. Everyone is welcome, please bring your own chair. 

11:30: Sharing food and conversation hosted by NH Unites at various locations (RSVP required)

1:30: New Hampshire Gathers for Unity at the State House Plaza (speaking program TBA)

Partner Organizations/Causes: ACLU of NH; American Friends Service Committee Program of NH; Equality Health Center; Every Child Matters in NH; Granite State Progress; Greater Manchester NAACP; Joan G. Lovering Health Center; League of Conservation Voters; Moms Clean Air Force; Moms Demand Action; MomsRising; NASW-NH; New Futures; NH AFL-CIO; NH Alliance for Immigrants and Refugees; NH Campaign for a Family Friendly Economy; NH Citizens Alliance for Action; NH Council of Churches; NH PublicHealth Assocation; NH Sierra Club; NH Unites; NH Women’s Foundation; NH Young Democrats; People for the American Way; Planned Parenthood NH Action Fund; The Multicultural Center at St. Anselm College; The Waysmeet Center; YWCA of New Hampshire; the Zonta Club of Concord

Why January 21?

Women’s marches and rallies are taking place on Saturday, January 21 across the nation and worldwide to send a message to our leaders that the United States of America stands for values of human decency, equal rights, and freedom from discrimination.

Why not march in D.C. instead?

You can, but many of us will not be able to make it to the march in Washington, D.C. due to logistics and costs. But we can come together in our local communities to march for our shared values. The Women’s March provides an international directory and statistics for all women’s marches on that day, including over 100 marches worldwide with 357,000 marchers currently registered. See “FIND YOUR MARCH” and search by state to locate an event near you. Visit the website for more details and information

Can I attend the NH Women’s Day of Action & Unity if I am not a woman?

Yes, everyone who believes that women’s rights are human rights is invited! We march for freedom, human rights, climate justice, racial justice, economic justice, and reproductive justice. 

Can NHWDAU accommodate people with disabilities?

Yes, this event is inclusive of people with disabilities. The State House lawn is wheelchair accessible, however, we cannot guarantee close parking. ASL translation will be provided at the event. If you have questions about accessibility, please contact nhrally2017@gmail.com.

Who can I reach out to if I want to volunteer?

If you are interested in volunteering, please contact nhrally2017@gmail.com and include in the subject “Volunteer on Jan 21”. 

How can I contact the organizer with any questions?

Facebook: https://www.facebook.com/events/186383368499010/

Email: nhrally2017@gmail.com or persechino.sara@gmail.com

Granite State Rumbling: Every Child Matters NH’s Goals For 2017

Now that the elections and Thanksgiving are in our rearview mirror, our attention turns to the holidays of December and the hope of what a new year will bring.

2016 has been a long year for the advocates, organizations, and agencies across the state and across the country who have worked tirelessly to ensure that basic needs are met for our most vulnerable populations. It has been an even longer and much harder year for the children and families who continue to feel the effects of a shredded safety net and an opiate crisis that shows no mercy on those who are afflicted with the disease and the innocent victims caught in the current.

We have watched more of our children slip into poverty, go to bed hungry, and wonder where that bed is going to be tomorrow night. And as December’s cold winds blow through the state we now fear for those who have no place warm to escape them.

The Thanksgiving break afforded me the time to spend time with loved ones, eat some great desserts, watch some football, and reflect on the feelings of frustration and anger I have felt lately. I have regrouped and am now ready to get back to work. That work means playing offense instead of playing defense (stealing some football terminology).

We have gotten pretty good at playing defense when it comes to addressing the difficult challenges that face our state. The primary obstacle we face is not related to a lack of goodwill, but rather to the fundamental way we understand the nature of the problems we face. More times than not, we merely respond to symptoms of a given problem [defense] and don’t pay adequate attention to the problem that is producing the symptoms [offense]. All of which puts the cart before the horse and keeps us from truly moving forward.

Take, for instance, the growing issue of child poverty. When we think about helping those in need (“giving back to those less fortunate,” as the popular adage goes), many of us usually focus on acts of charitable giving. After all it is the season of giving. In the malls we find Christmas trees with cards on them asking for a gift for a child in need. At the grocery store are pre-packaged groceries that we can purchase for a family in need. Charity in its many forms tries to help people who are in need, which is certainly important and worthy of our best efforts.

But even more important is figuring out why people are in need in the first place, and then working toward alleviating the root causes of such need (it’s one thing to give food to a person who is hungry, but it’s another thing entirely to eliminate the reasons they are hungry in the first place). While we can of course celebrate acts of charity that take place in our community, the ultimate goal isn’t simply about responding to symptoms, but abolishing the problems that produce the symptoms.

So, don’t you think that at a time when we see the income gap widening, ninety-five percent of the recovery gains since 2009 going to the top 1%, over ¼ of all jobs in the U.S. paying below poverty wages, and child well-being indicators falling in our state, now is the right time for all of us to rally around a set of common goals that will strengthen families and put them on a course leading to economic security?

Take a look at Every Child Matters’ 5 priority areas in the section below. Is there an area that catches your attention? Give us a call or send us an e-mail and we’ll give you some ideas about how you can help advocate. Your voice is especially important now.  

Many New Hampshire kids are doing fine – but many are not.

1. Equal Opportunity:  Children remain more likely to be poor than any other age group, with more than one in ten in poverty in New Hampshire in 2015 (10.7 percent), and the gap between the haves and have-nots continues to grow.

2. Family and Work:  The Census Bureau data shows that in 58 percent of poor New Hampshire families, at least one person worked, although not always full time or year-round. Even when work and other income helps people to live up to twice the poverty line (up to $37,742 for a family of three), most people recognize that making ends meet is not that easy for those this near poverty. One in five Granite Staters are trying to get by with incomes this low. 

The average cost in New Hampshire for an infant in a child care center is more than $11,800 a year for an infant and for a 4-year-old, it’s more than $21,250.

3. Access to Education:  New Hampshire currently does not have a state-funded preschool program. Only 4 percent of 3-year-olds and 6 percent of 4-year-olds are enrolled in a public preschool program. A year of tuition for an instate student at the University of New Hampshire costs $16,017 plus room, board, books and incidentals $27,000+. The maximum Pell grant award covers only $5,775.

4. Children’s Healthcare:  12,000 New Hampshire children were without health insurance in 2014 and 94,153 children in New Hampshire were enrolled in Medicaid in 2014, increasing 15.1% from 2013. 

5. Children’s Safety: In 2014, New Hampshire had 15,184 total referrals for child abuse and neglect. Of those, 9,289 reports were referred for investigation.

In 2014, there were 646 victims of abuse or neglect in New Hampshire, a rate of 2.4 per 1,000 children, decreasing 21.4% from 2013. Of these children, 79.1% were neglected, 8.7% were physically abused, and 15.5% were sexually abused.

Equal Opportunity. Individual outcomes will always vary. But when every child gets a fair shot at success, America’s families, communities and the economy as a whole will benefit. Lifting children from poverty and removing discrimination or other barriers to development and achievement are a key government function. As noted by the eminent researcher and author Robert Putnam, denial of equal opportunity is a dagger to the heart of the American Dream.

Family and Work. Stagnant incomes and workplace practices that pit being a parent against being a provider strain families and harm kids. Working and having a family shouldn’t be so hard. Paid sick and family medical leave, access to affordable childcare and better incomes can help provide the economic security and flexibility that parents need to build their careers and support their families

Access to Education.  Research demonstrates that 80 percent of a child’s brain development occurs between the ages of zero and five. Yet little is invested at the federal level in early childhood education. All kids should have access to high-quality preschool regardless of parental income or where they live. Later in life, a teenager willing to work hard in college to get skills needed for success should not be blocked due to race and should not be burdened with a level of debt more crushing than that endured by any previous generation.

Children’s Healthcare.  More children have access to health care than ever due to the State Children’s Health Insurance Program (S-CHIP) and children’s protections in the Affordable Care Act (ACA). While not perfect, these laws prohibit insurance company discrimination against children with pre-existing conditions, require insurance companies to cover child preventive care, and help ensure families won’t go broke when their child gets sick. Proposed policy changes must detail how children’s protections will be maintained or enhanced.

Children’s Safety. Every child needs a safe environment in their home, school and neighborhood. Preventing child abuse and neglect, as well as minimizing gun violence, a leading killer of children and teens, are top priorities for voters.

Granite State Rumblings: The High Cost Of Rent On Low-Income Families

In New Hampshire 61% of renter households with incomes below $20,000 spend more than 50% of their income on rent. But only 1 in 4 qualifying renters receives housing assistance due to limited government funding.

A child born today could wait until s/he is 8 years old before his/her family is able to receive a housing voucher. The New Hampshire Housing 2016 Residential Rental Cost Survey shows that the median monthly gross rent for a 2-bedroom unit in NH ranges from a low of $790/month in Coos County to the high of $1,321/month in Rockingham County.

Our friends at the Coalition on Human Needs posted this blog on their weekly Voices for Human Needs page last week.

THREE IN FOUR EXTREMELY LOW INCOME RENTERS SPEND MORE THAN 50 PERCENT OF INCOME ON RENT

By Lecia Imbery

Housing costs eat up an exorbitant amount of low-income families’ budgets. A new report from the National Low Income Housing Coalition (NLIHC) shows that three-quarters of extremely low income (ELI) renter households, defined as earning no more than 30 percent of their area’s median income or the federal poverty guideline, whichever is higher, spend more than half of their income on housing costs alone. The Long Wait for a Home spotlights the problems around Housing Choice Vouchers (HCV) and public housing waiting lists and how the limited supply of housing assistance affects these extremely low income households.

According to the Department of Housing and Urban Development, families who pay more than 30 percent of their income for housing are considered “cost burdened.” Those who spend more than 50 percent are considered “severely cost burdened.” CHN’s recent report, The High Cost of Being Poor in the U.S., used Census Bureau data to show that 59 percent of American renter households with incomes less than $20,000 are severely cost burdened. Of the 13 state reports [the Maine and New Hampshire reports we co-authored with CHN can be found here] we produced with state partners, Florida ranked worst in this category, with 66 percent of Floridians who earn less than $20,000 a year spending more than half of their income on rent alone. When rent eats up this much of a family’s budget, little money is left for other necessary expenses.

The vast majority of recipients of Housing Choice Vouchers and public housing are ELI households; in fact, according to NLIHC’s report, 71 percent of the nearly 1.1 million public housing households and 74 percent of the nearly 2.2 million HCV recipient households fall into the extremely low income category. However, this doesn’t mean that the supply is meeting the demand – far from it, in fact. There are 10.4 million ELI renter households in the U.S., but the private and subsidized rental markets make available only 3.2 million affordable homes for them. This results in a national shortage of 7.2 million rental homes. As CHN noted in our report, the number of families with children receiving rental vouchers dropped by 250,000 (a 13 percent decline) since 2004.

This discrepancy between the number of affordable homes available and the number of families in need means that far too many ELI renter households are put on waiting lists for housing assistance, and that wait can stretch into years. Seventy-four percent of households on the average Housing Choice Voucher waiting list and 67 percent of households on the average public housing waiting list were extremely low income. Families with children accounted for 60 percent of households on the average HCV waiting list. HCV waiting lists had a median wait time of 1.5 years for housing assistance, with 25 percent of HCV waiting lists having a wait of 3 years or longer. More than half (53 percent) of HCV waiting lists were closed, meaning they were turning away new applicants. Public housing waiting lists aren’t much better. The median wait time there is 9 months, with 25 percent of public housing waiting lists stretching to more than 1.5 years. Eleven percent of public housing waiting lists were closed.

Rental vouchers limiting the amount low-income families pay for rent make a tremendous difference in child health, educational outcomes, and future earnings, and housing subsidies lifted 2.5 million Americans above the poverty line in 2015. 

That’s why CHN’s report calls on Congress to increase funding for Fiscal Year 2017 to provide millions more low-income Americans in need with access to safe, stable housing. Additional funding over FY16 levels is also needed to ensure existing housing vouchers keep pace with inflation and to expand the supply of vouchers for those left out in the cold. Beyond these immediate needs, CHN also calls on Congress to fully fund President Obama’s request for $11 billion to end family homelessness by 2020 (providing housing for 550,000 families).

The reports from both CHN and ECM and the National Low Income Housing Coalition (a member of CHN) reach the same conclusion – we must expand housing resources for our nation’s lowest income renters.


GROWING UP GRANITE

Please join us on Thursday, November 17th for a Children’s Policy Summit.

What About the Kids? The Invisible Victims of the Opiate Crisis

Join providers, policy advocates, parents & grandparents, and policymakers for an interactive discussion on the opiate crisis and how it impacts New Hampshire’s most vulnerable population: Our Children.

This epidemic is affecting the lives of too many Granite State kids. Learn about the programs and resources that are emerging to support them and brainstorm with us about what still needs to be done.

Every Child Matters in NH is awarding scholarships to grandparents who are caregivers to their grandchildren to attend this event. If you would like to sponsor a grandparent to attend this event, please select “Sponsor a Grandparent” while selecting your tickets. 

The Children’s Policy Summit is sponsored in partnership by Every Child Matters in NH and Child and Family Services of NH.

Lunch will be served. 

Date and Time: Thursday, November 17th  11:30 am to 4:00 pm

Location: Holiday Inn, 172 North Main Street, Concord, NH 03301

Register HERE

Granite State Rumblings: 5 Facts About The Early Childhood Workforce

From our friends at Child Trends comes this list of 5 critical facts about the early childhood workforce. 

About 3 in 4 young children are in non-parental care. Research on early brain development highlights the importance of quality early care and education, yet low wages make it difficult to attract and retain qualified staff.  

Half of the early childhood workforce are home-based care providers.

When you think of an early educator, you might imagine a preschool teacher in a classroom full of children. In reality, only half of the 2 million early educators and caregivers in the early childhood workforce work in formal settings like schools and centers. The other half of paid early childhood caregivers and teachers provide care through formal and informal arrangements in homes. Of the 20 million U.S. children under age 5, nearly 7 million receive care in a center-based program and 3 million are cared for in home-based settings. An additional 4 million children are cared for by an unpaid caregiver who is not their parent.

The average early childhood teacher or caregiver has 10 to 14 years of experience.

There is a popular misconception that early educators are inexperienced and do not have much knowledge of the field. But the recent National Survey of Early Care and Education reveals that the average educator or child care provider has 10 to 14 years of experience. In addition to having experience in the field, early educators across settings tend to work full-time hours. The average center-based teacher works 39 hours per week; the average home-based caregiver works nearly 54 hours per week.

Low wages result in significant percentages of early childhood teachers and caregivers receiving public assistance.

According to the National Survey of Early Care and Education, the average hourly wage for an early childhood caregiver is $10.60. Hourly wages vary depending on the age of the children in care. For example, caregivers serving infants and toddlers average $9.30 per hour, while their counterparts serving preschoolers make $11.90 per hour. Wages also depend on the setting in which teachers and caregivers work. A preschool teacher with a bachelor’s degree working in a public school earns an average of $22.90 per hour, but a provider operating a child care business in their home earns only $12.44 per hour. Nearly 1 in 3 preschool teachers and almost half of home-based providers are enrolled in a public assistance program to obtain health insurance, food support, and/or income support for their own families.

A call for increased qualifications for early care and education teachers and caregivers will require significant investments.

Last year, the Institute of Medicine released a report on transforming the early childhood workforce that calls for all early childhood lead teachers to have a bachelor’s degree by 2025.While policy initiatives through Head Start have had some success in increasing the qualifications of early childhood workers, additional strategies will be required to meet this goal across settings. As of 2012, only 45 percent of center-based preschool teachers, 19 percent of center-based infant-toddler teachers, and 16 percent of home-based providers had earned bachelor’s degrees. The Institute of Medicine recommends strategies, such as scholarships and tuition reimbursement, that increase the affordability of higher education, and supports to improve access to higher education.

Moving up in an early childhood career is challenging, but efforts are underway to support growth.

Many early educators find it difficult to advance their careers. A 2016 policy statement from the federal Administration for Children and Families calls for states to take action in several policy areas, such as 1) creating shared terminology for credentials across early care and education sectors, 2) aligning credentialing and higher education systems, 3) increasing access to professional development and higher education, and 4) tracking their state’s early childhood workforce (for example, through Workforce Registries). Some states, such as Wisconsin, Vermont, Nebraska, Indiana, and North Carolina, have already begun such efforts by engaging in statewide early childhood workforce surveys. However, even with better alignment and access to higher education, the Center for the Study of Child Care Employment points out that low wages dissuade early educators from pursuing a higher degree. For many early educators, the cost of higher education is not worth the low wages that await them when they complete their degree.


GROWING UP GRANITE

They say a picture is worth a thousand words. So here are 5 pictures that tell the story of why investing in early childhood education and our young children is imperative to building strong children and a strong economy.

2-5gsr 2-4gsr 2-3gsr 2-2gsr 2-1gsr

Granite State Rumblings: The High Cost of Being Poor in New Hampshire

Anti-Poverty Programs Help Alleviate Costs, But More Must Be Done to Reduce Burdens

It is welcome news that the poverty rate in New Hampshire declined from 9.2 percent in 2014 to 8.2 percent in 2015 and declined nationally from 15.5 percent in 2014 to 14.7 percent in 2015.1 Sustained economic gains, strengthened by federal and state policies that increase income or reduce expenses, have finally begun to reach our low-income neighbors. 

The decline in poverty is good news, and with job growth continuing, we ought to be able to take steps to accelerate the pace of poverty reduction. But the precarious situation for the poor and near poor stands in the way of substantial progress. The fact is, it is expensive to be poor in the United States. New data released in September by the Census Bureau show that more than 106,000 adults and children remain in poverty in New Hampshire – and they need to pay every dime they have for necessities like rent, child care and groceries. They pay a premium for rent and food because of bad credit and inability to get to cheaper markets. Getting less value for their limited dollars, poor families are exposed to threats to health, child development, and employment. When expenses outstrip income, late fees and fines make things worse. For too many low-income Americans, predatory loans are a desperate attempt to stave off eviction or loss of a vehicle, leading instead to a trap of debt and poverty. While New Hampshire has restrictions against predatory payday lending, we must ensure this protection is not weakened, putting more Granite Staters at risk. 

The new Census Bureau data also show that effective anti-poverty programs, like housing assistance, child care subsidies, and the Supplemental Nutrition Assistance Program, (SNAP, formerly known as food stamps) lift millions out of poverty and reduce the cost of poverty for millions more. But more needs to be done to reduce the burden of poverty even further, and for more Granite Staters living in and near poverty every day.

Progress to Build on

There were 2 million fewer poor people across the U.S. in 2015 than in 2014 and nearly 12,000 fewer poor Granite Staters. From 2011 to 2015, unemployment declined nationally from 10.3 percent to 6.3 percent. The proportion of Americans without health insurance plunged from 15.1 percent to 9.4 percent over the same five years. 

While communities of color in general saw substantial improvement, they remain disproportionately affected by poverty – and its associated costs. While 10.4 percent of non-Hispanic whites in the U.S. were poor in 2015, the poverty rate was 25.4 percent for African Americans and 22.6 percent for Latinos.2  

People aged 65 or older saw their poverty rate drop from 9.5 percent to 9.0 percent from 2014 to 2015 nationally, and in New Hampshire 6.1 percent of seniors were poor, statistically unchanged from the previous year. However, the Census Bureau’s Supplemental Poverty Measure counts income and expenditures more fully, and the differing budgets of seniors (such as more medical expenses) leads to a nationwide poverty rate of 13.7 percent for this group using this alternative measure.

3ecmnhreportChildren remain more likely to be poor in America than any other age group, with more than one in ten in poverty in New Hampshire in 2015 (10.7 percent), down from 13.0 percent in 2014. As with adults, children of color experience poverty at much higher rates that their white peers. In fact, African American and Latino children are roughly 2.5 times more likely to be poor than white children. In 2015, 12.5 percent of non-Hispanic white children in the U.S. lived in poverty, while 36.5 percent of African American and 30.5 percent of Latino children were poor.3 While their parents struggle to pay for necessities, children in poverty may pay in other ways, from damage to brain development to poorer physical and mental health, education and employment outcomes. 

Those with jobs are not immune – the Census Bureau data also show that in 58 percent of poor New Hampshire families, at least one person worked, although not always full time or year round. Even when work and other income helps people to live up to twice the poverty line (up to $37,742 for a family of three), most people recognize that making ends meet is not that easy for those this near poverty. Here, one in five Granite Staters are trying to get by with incomes this low. High costs affect them too, and may lead to the downward spiral to debt and poverty that the right policy choices can prevent. 

The High Cost of Being Poor

The poor pay more in many different areas of daily living. The Census data show that 61 percent of New Hampshire households with incomes less than $20,000 a year spend more than half of their income on rent alone.4  On average, low-income households face slightly higher food prices than other households face for the same basket of food,5 forcing them to choose lower quality items to reduce the cost. They get less for what they have to spend, and still end up spending a larger portion of their income on food than higher-income families.

The high cost of being poor is a major burden for all living in poverty, but for those in deep poverty – living below half of the federal poverty line – the burden is that much heavier to bear. For a family of four in 2015, the official poverty line was $24,257. According to the Census Bureau, 6.8 percent of Americans – 20.4 million people – live in deep poverty. Nearly 1 in 11 children is this deeply poor. That’s down from the previous year, but a higher proportion than in 2007, before the Great Recession. Locally, nearly 47,000 Granite Staters live in deep poverty.6 These families are especially prone to late fees for unpaid rent and eventual evictions, leading to frequent moves. Once they do find new housing, they often start out in the hole with a new landlord because they can’t afford the first and last month’s rent along with a security deposit.7  

2ecmnhreportTenants with evictions on their records can also be banned from affordable housing programs and often lose their only possessions as a part of the eviction.8 Young children living in poor housing conditions and/or subject to frequent moves or homelessness are more likely to suffer health problems. For example, a Boston area study found that infants and toddlers in low-income families that had moved two or more times in the past year were 59 percent more likely to be hospitalized than similar children in more secure housing.9 Rental vouchers limiting the amount low-income families pay for rent make a tremendous difference in child health, educational outcomes, and future earnings, but since 2004, the number of families with children receiving rental vouchers dropped by 250,000 nationwide (a 13 percent decline).10 Families do not have to be deeply poor to risk eviction, although they are likely to be among the quarter of low-income tenants across the U.S. who are paying at least 70 percent of their income on rent, and so are especially at risk of being unable to pay each month. However, even among New Hampshire households with incomes up to $35,000, 45 percent are paying half or more of their income on rent. 

Low-wage workers are more likely to lack paid sick days and paid leave, and they are less likely to have predictable work schedules, leaving them with even less money to cover expenses. Some gains for low-wage workers have been made in cities and states that have raised the minimum wage and adopted paid sick leave and other family-friendly policies, but not all states have taken these steps, and national standards leave too many low-wage workers out in the cold. Their struggle to pay rent each month can also take its toll on employment. The Milwaukee Area Renters Study found that workers leaving housing involuntarily were 20 percent more likely to lose their jobs afterwards than comparable workers who did not have to leave their dwellings.11  

Quality, affordable child care is critical for both the economic security of low-income parents, as it allows them to work, and for the development of children. Yet the cost puts quality child care out of reach for many families. The average cost in New Hampshire for an infant in a child care center is more than $11,800 a year; for an infant and a 4-year-old, it’s more than $21,250.12 A family at the poverty line with an infant and toddler in child care would therefore have to spend 88 percent of its income on child care, if paying the state average cost. Without a subsidy, low-income families have no choice but to make cheaper and often less reliable arrangements. 

Medical costs can have devastating effects on already-strapped family budgets. The Census data show that 11.2 million more people across the U.S. would be in poverty if out-of-pocket medical costs were taken into account, showing the importance of quality, affordable health insurance. Medical costs are even more of a burden for the poor in states that have not taken advantage of the Affordable Care Act option to use federal Medicaid dollars to expand health coverage to low-income adults. Low-income adults in the 19 states that have not made this move are uninsured at nearly twice the rates of those in states that have taken this step to expand coverage.13 They are too poor to qualify for health insurance subsidies through the Affordable Care Act, but are denied Medicaid, leaving them at even greater risk for overwhelming medical costs and, too often, forcing them to forgo necessary medical treatments. In New Hampshire, the percentage of uninsured people has remained unchanged from 2011 to 2015 at 6.2 percent.

With few other options, many low-income Americans in a majority of states feel they must turn to payday loans and similar practices to cover these higher expenses. Unfortunately, this leads to higher costs still. These predatory lenders target low-income Americans and communities of color – nearly half of payday borrowers have a family income of under $30,000. Nearly one in five borrowers relied on Social Security or some other form of government assistance.14 Payday lenders have been shown to be 2.4 times more concentrated in African American and Latino communities.15 Payday loan companies charge exorbitant interest rates – between 300 and 400 percent, on average, and fees that quickly rack up when borrowers are forced to take out loan after loan just to repay the previous loan. This traps the borrower in a cycle of debt. In fact, the average payday loan customer who borrows $400 for a loan to help them get by until their next paycheck winds up paying back $950 over 11 loan cycles in a year.16 In one-third of these cases, the borrower is forced to overdraw his or her checking account to pay off the loan, thereby incurring additional fees.17 Because of these abusive practices, New Hampshire has restrictions against payday lending. 

Vehicle title borrowers are similar to payday borrowers, but the consequences of failing to pay back a loan can be even more severe. One in five car title loan borrowers who agrees to repay the loan in a lump sum, plus interest and fees, loses his or her car,18 creating an even larger burden when he or she can’t get to work, to school or to the child care center. Every form of debt gets worse when it’s passed along to collection agencies. In December 2015, 18 percent of consumers in low- and moderate-income neighborhoods in New Hampshire had debt in collections.19 

While the cost of poverty is extremely high for those in poverty, it is also high for our society as a whole. In fact, child poverty alone costs the U.S. economy an estimated $672 billion each year, or 3.8 percent of our gross domestic product (GDP).20 Child poverty results in a less-educated workforce, which reduces productivity and economic output years later. It raises the incidence – and cost – of crime, while also increasing physical and mental health costs. 

Effective Anti-Poverty Programs Reduce the Cost of Being Poor

The Census Bureau’s Supplemental Poverty Measure, which counts income sources such as federal tax credits and food and housing assistance, shows that federal programs increase incomes for millions of Americans, lifting them out of poverty and reducing the burdens of poverty for millions more. More than 9 million people were lifted out of poverty by low-income refundable tax credits in 2015 nationally; 2.5 million fewer were poor because of housing subsidies.21 Other analyses show that 16,000 Granite Staters were lifted out of poverty by low-income tax credits each year on average from 2011 to 2013 and 14,000 fewer were poor, each year on average from 2009 to 2011, because of housing subsidies.22 

The Supplemental Nutrition Assistance Program lifted 16,000 Granite Staters out of poverty each year on average from 2009 to 2011, and lifted 4.6 million Americans out of poverty in 2015. The Women, Infants and Children (WIC) program served more than 8.6 million women, infants and children across the U.S. in 201323 and lifted 371,000 of them out of poverty last year. More than 21 million children nationally received free and reduced-priced lunch during the 2014-2015 school year through the National School Lunch Program,24 lifting 1.3 million people out of poverty.

Child care subsidies reduce the cost of care, allowing parents to go to work or school and providing children with quality educational experiences in the critical early years. Single mothers were more likely to be employed, more likely to be employed full time, and more likely to have stable employment when receiving child care subsidies.25 Nationally, families headed by single mothers with at least one full-time, year-round worker had a poverty rate of 11.5 percent, while similar families where workers only had part-time or part-year employment were five times as likely to be poor (55.3 percent rate).26

States that raised their minimum wage saw faster wage growth for low-wage workers in 2015 than states without an increase.27 More money in the pockets of low-income workers resulting from a higher minimum wage and more paid, predictable hours is better for workers, their families, and our economy.

But many of these effective programs do not reach enough of the people they are designed to help, and others, like SNAP, could do more good if their benefits were higher. Across the country, only one in four qualifying renters receives rental assistance because Congress has not provided enough funding.28 Nationally, only one in six low-income children who ate a school lunch during the regular 2014-2015 school year were reached by federal summer nutrition programs.29 More than 13 percent of New Hampshire households without children experienced food hardship in 2014-2015. Households with children in New Hampshire fared worse: 16.3 percent suffered food hardship over the same period.  

More than six out of seven children eligible to receive federal child care assistance nationally are not getting any help,31 and 2,300 New Hampshire children in need have lost access to child care since 2006,32 leaving families to struggle to pay for care or forego jobs to stay home and provide care. In addition, while the 2014 reauthorization of the Child Care and Development Block Grant (the primary source of federal funding for child care subsidies for low-income working families) included many improvements that were long overdue, the bill did not include a guarantee of federal funding to implement the changes. This lack of funding threatens care for even more children.

1ecmnhreportThe Earned Income Tax Credit (EITC), an extremely effective anti-poverty and pro-work tax credit, provides far less help to low-income workers who aren’t raising children. This group has an unenviable distinction as the only group of Americans who are taxed into poverty. Expanding the EITC to these workers would benefit up to 74,000 Granite Staters.33 Similarly, families with children earning under $3,000 a year are excluded from claiming the Child Tax Credit (CTC), denying help to children because their parents, despite working, are too poor. Expanding the CTC to these poorest children and families would benefit millions across the U.S. every year. 

Because predatory lending practices are so hurtful to low-income people, 14 states, including New Hampshire, and the District of Columbia have restrictions against payday lending, and the consumer watchdog agency the Consumer Financial Protection Bureau (CFPB) issued a proposed rule in June to rein in predatory payday, car title, and certain high-cost installment loans. The proposed rule would require lenders to determine whether borrowers can afford to pay back their loans, known as the ability-to-repay requirement. While the CFPB proposed rule is a necessary first step, it contains loopholes pushed for by payday lenders that could hurt consumers in all states. For example, the proposal exempts six high-cost payday loans from the ability-to-repay requirement and doesn’t go far enough to ensure that, after repaying the loan, the borrower will have enough money left over to cover other basic living expenses without reborrowing.34 This leaves consumers in states that have restrictions against payday lending vulnerable, as a weak CFPB rule will give the payday lending industry a leg up in trying to get New Hampshire and other states to weaken or even undo their existing laws. Protections that have helped low-income people out of the debt trap could be eroded. 

We Can Further Reduce the Cost of Poverty

We can – and should – do more to further reduce the high cost of poverty on millions of Americans and close the ever-widening opportunity gap our children face. To achieve this goal, Every Child Matters in New Hampshire and the Coalition on Human Needs recommend the following:

  • Increase federal funding for housing subsidies and child care subsidies. As Congress continues its Fiscal Year 2017 appropriations process, it should increase funding to provide millions more low-income Americans in need with access to safe, stable housing and quality, affordable child care. One analysis estimates that an additional $1.2 billion investment is needed in FY17 funding to allow for full implementation of improvements contained in the reauthorization of the Child Care and Development Block Grant without the loss of additional spots for children.35 Additional funding over FY16 levels is also needed to ensure existing housing vouchers keep pace with inflation and to expand the supply of vouchers for those left out in the cold. Beyond these immediate needs, proposals such as President Obama’s call for $82 billion over 10 years to fund child care assistance for children younger than four and $11 billion to end family homelessness by 2020 (providing housing for 550,000 families) should be implemented.
  • 6ecmnhreportExpand the Earned Income Tax Credit to workers not raising children and expand the Child Tax Credit to families making less than $3,000 a year. President Obama, House Speaker Paul Ryan (R-WI), and Senator Sherrod Brown (D-OH) are among the bipartisan supporters of expanding the EITC, so helping workers without dependent children should be a top priority for Congress. Congress should also act to ensure all low-income children benefit from the CTC.
  • Increase SNAP benefits and pass a Child Nutrition Reauthorization bill to ensure that low-income children have access to healthy and nutritious foods. As part of the reauthorization, Congress should streamline and expand the summer food program, expand WIC eligibility for children not in full day kindergarten from age five to age six, reject attempts to deny free and reduced-priced meals to students in high-poverty schools, and reject attempts to block grant school meal programs. Congress should also protect SNAP from cuts, increase SNAP benefits to align with the cost of the Low-Cost Food Plan rather than the inadequate Thrifty Food Plan currently used, and end the harsh time limits on SNAP benefits for certain jobless adults willing to work. 
  • States that haven’t yet expanded health coverage to low-income Americans by drawing down federal Medicaid dollars should do so. Governors of states that have continued to deny health coverage to low-income residents should end this costly failure to take advantage of federal dollars on the table to provide necessary health care to those who can least afford it. 
  • A strong rule from the Consumer Financial Protection Bureau, without loopholes, is needed to stop predatory lending, help low-income Americans break out of the dangerous debt trap, and ensure that consumers in states like New Hampshire where the practice is already restricted remain protected from these harmful practices. Low-income advocates should encourage the CFPB to strengthen the rule to protect all low-income consumers. The CFPB is accepting public comments on its proposed rule until October 7.
  • Raise the minimum wage and help workers get more paid hours through paid sick leave and more predictable hours. Low-wage workers need more hours and higher pay. The federal government, along with states that haven’t already done so, should increase the minimum wage and adopt paid leave requirements and predictable scheduling laws.

As Election Day draws nearer, we should be thinking hard about our priorities as a nation. Reducing poverty and the high costs of being poor clearly should be a top priority. The evidence from 2015 shows that proven anti-poverty programs like SNAP, housing assistance, and low-income tax credits are effective at lifting millions of people out poverty, reducing the costs associated with poverty and building family economic security. Other research and common sense tell us that child care, by helping parents to work and helping children to develop and thrive, can spur poverty reductions over two generations. But as overall poverty and child poverty rates in New Hampshire remain higher than in 2007, before the Great Recession,36 we must invest more to reduce the burden of poverty even further, and for more Granite Staters. And if we are concerned about trapping people in poverty, we need to maintain strong protections against harmful practices and state policies that place unnecessary burdens and requirements on low-income people that aim to keep them down. 


This report was prepared by Every Child Matters in New Hampshire and the Coalition on Human Needs.

  1.   U.S. Census Bureau, 2015 American Community Survey, released September 15, 2016, http://www.census.gov
  2.   U.S. Census Bureau, 2015 American Community Survey, released September 15, 2016, http://www.census.gov 
  3.   U.S. Census Bureau, 2015 American Community Survey, released September 15, 2016, http://www.census.gov 
  4.   U.S. Census Bureau, 2015 American Community Survey, released September 15, 2016, http://www.census.gov 
  5.   U.S. Department of Agriculture, http://www.ers.usda.gov/media/921672/aer759.pdf 
  6.   U.S. Census Bureau, 2015 American Community Survey, released September 15, 2016, http://www.census.gov
  7.   “The Eviction Economy” by Matthew Desmond, as printed in The New York Times, http://www.nytimes.com/2016/03/06/opinion/sunday/the-eviction-economy.html 
  8.   “Poor Black Women Are Evicted at Alarming Rates, Setting Off A Chain of Hardship,” by Matthew Desmond, for the MacArthur Foundation, https://www.macfound.org/media/files/HHM_Research_Brief_-_Poor_Black_Women_Are_Evicted_at_Alarming_Rates.pdf 
  9.   Children’s HealthWatch, http://www.childrenshealthwatch.org/wp-content/uploads/MAhousing_brief_Oct2012.pdf
  10.   Center on Budget and Policy Priorities, http://www.cbpp.org/research/housing/rental-assistance-to-families-with-children-at-lowest-point-in-decade 
  11.   University of Wisconsin-Madison Institute for Research on Poverty, http://www.irp.wisc.edu/publications/fastfocus/pdfs/FF22-2015.pdf 
  12.   Child Care Aware of America, http://usa.childcareaware.org/advocacy-public-policy/resources/reports-and-research/costofcare/ 
  13.   The Commonwealth Fund, http://www.commonwealthfund.org/publications/issue-briefs/2016/aug/who-are-the-remaining-uninsured and U.S. Census Bureau, Current Population Survey Health Insurance Coverage, released September 13, 2016, http://www.census.gov/library/publications/2016/demo/p60-257.html
  14.   Consumer Financial Protection Bureau, http://files.consumerfinance.gov/f/documents/Rulemaking_Payday_Vehicle_Title_Certain_High-Cost_Installment_Loans.pdf 
  15.   Center for Responsible Lending, http://responsiblelending.org/research-publication/predatory-profiling-0 
  16.   Stop the Debt Trap Coalition, https://medium.com/@stoppaydaypreds/five-things-you-need-to-know-about-payday-lending-d30a94ddcd44#.7m5gyyyt8 
  17.   Center for Responsible Lending, http://www.responsiblelending.org/payday-lending/research-analysis/finalpaydaymayday_defaults.pdf 
  18.   Consumer Financial Protection Bureau, http://files.consumerfinance.gov/f/documents/Rulemaking_Payday_Vehicle_Title_Certain_High-Cost_Installment_Loans.pdf 
  19.   FRBNY Consumer Credit Panel/Equifax data, tabulated by the Federal Reserve Banks of Philadelphia and Minneapolis and accessed via the Consumer Credit Explorer (accessed Sept. 2016). https://www.philadelphiafed.org/eqfx/webstat/index.html 
  20.   https://cdn.americanprogress.org/wp-content/uploads/2015/08/11114756/ChildAllowance-report.pdf 
  21.   U.S. Census Bureau, 2015 Supplemental Poverty Measure, released September 13, 2016, http://www.census.gov/library/publications/2016/demo/p60-258.html 
  22.   Center on Budget and Policy Priorities, http://www.cbpp.org/blog/state-data-on-safety-nets-impact-in-one-place
  23.   Food Research and Action Center, http://frac.org/pdf/cnr_primer.pdf 
  24.   Food Research and Action Center, http://frac.org/federal-foodnutrition-programs/national-school-lunch-program/ 
  25.   Center for Law and Social Policy, http://www.clasp.org/resources-and-publications/publication-1/CCDBG-Advocacy-Fact-Sheet.pdf 
  26.   U.S. Census Bureau, 2015 Current Population Survey, released September 13, 2016, http://www.census.gov/library/publications/2016/demo/p60-256.html
  27.   Economic Policy Institute, http://www.epi.org/publication/wages-grew-more-for-low-wage-workers-in-states-that-raised-their-minimum-wage-in-2015/ 
  28.   Center on Budget and Policy Priorities, http://www.cbpp.org/research/housing/policy-basics-federal-rental-assistance 
  29.   Food Research and Action Center, http://frac.org/federal-foodnutrition-programs/summer-programs/ 
  30.   Food Research and Action Center, http://frac.org/pdf/food-hardship-report-households-with-children-sep-2016.pdf
  31.   U.S. Department of Health and Human Services, https://aspe.hhs.gov/sites/default/files/pdf/153591/ChildEligibility.pdf 
  32.   Center for Law and Social Policy, http://www.clasp.org/issues/child-care-and-early-education/in-focus/child-care-assistance-spending-and-participation-in-2014 
  33.   Center on Budget and Policy Priorities, http://www.cbpp.org/research/federal-tax/strengthening-the-eitc-for-childless-workers-would-promote-work-and-reduce 
  34.   Stop the Debt Trap Coalition, http://stopthedebttrap.org/wp-content/uploads/2016/06/stdt_payday_proposed_rule_works_jun2016.pdf 
  35.   Center for Law and Social Policy, http://www.clasp.org/issues/child-care-and-early-education/in-focus/child-care-assistance-spending-and-participation-in-2014 
  36.   U.S. Census Bureau, 2015 American Community Survey, released September 15, 2015, calculations by the Center on Budget and Policy Priorities 

Granite State Rumblings: Strengthening Head Start Programs

school-bus-thoseguys119-flikr-cc

Head Start School Bus (Image by THOSEGUYS119 FLIKR CC)

Head Start programs are undergoing major requirement revisions for the first time since 1975. Announced on September 1st the Obama administration’s proposals include expanding Head Start to a full day for everyone, raising professional development and curriculum standards, and beefing up services for children with disabilities or who still need to learn English.

“Today we’re unveiling some of the most significant improvements we’ve ever made to Head Start,” said Health and Human Services Secretary Sylvia Burwell, who herself attended the early childhood education program as a child in West Virginia. “The new standards strengthen educational practices and are based on the best research about how children learn and develop.”

Head Start, which targets low-income families, enrolls nearly 1 million children every year, and has served more than 33 million children since its inception in 1965. These new standards are the largest revision of the program since 1975 according to the U.S. Department of Health and Human Services.

One of the biggest changes included in the overhaul is the requirement that Head Start centers offer childcare for a full day over the course of a full school year, which will be phased in over the next five years. Currently Head Start preschool programs are required to operate at least 128 days a year and offer at least a 3.5 hour day. 

A second major focus of the new standards is to solidify the critical role of parents in the program, which has been a long-standing cornerstone of the Head Start program. 

The new Head Start Program Performance Standards are effective as of November 7, 2016. However, in order to afford grantees a reasonable period of time to implement certain provisions that have changed significantly from previous standards, the final rule allows programs additional time to comply with some specific provisions.

Here are some of the highlights of the new requirements from the Administration for Children and Families at HHS:

  • Education services which focus on effective teaching practices and key areas of child development, using stronger curriculum requirements and child assessment data, to ensure effective teaching in Head Start, so that children are academically and socially competent. 
  • Reduce bureaucratic burden on programs by cutting the current 1,400 Head Start regulatory standards by approximately 30 percent. This will improve regulatory clarity and transparency by eliminating unnecessary and duplicative rules while setting high standards that will drive program performance. This will allow programs to focus on outcomes over process and plans. 
  • Over time, programs will serve Head Start preschoolers for a full school day and a full school year, which is based on research and evidence that shows that students who spend more time in high quality early learning programs learn more and are better prepared for kindergarten. 
  • Programs will create a system of evidence-based, individualized professional development that builds teacher skills and core competencies which includes the use of targeted intensive mentoring and coaching. 
  • Produce higher returns on taxpayer investment. When children start school ready to succeed, they benefit and the entire nation benefits. High quality Head Start programs have demonstrated outcomes that are just as strong as, if not stronger than, the best public pre-k programs in the country. Research has shown that comprehensive services – physical and mental health and family engagement – are critical to promoting children’s school readiness and to reaping the economic return on investment in early childhood.

The release is especially timely, since the findings of two research reports published in August found long-term gains for Head Start graduates. For example, a study from the Hamilton Project says Head Start participation increased the probability that children would later graduate from high school and attend college. What’s more, there was evidence for social-emotional growth in such areas as self-control and self-esteem. You can download the full report from the website for The Hamilton Project, an economic policy initiative of the Brookings Institution. 


NHStepUp2016

Granite State Rumblings: TANF At 20 and Step Up Kids NH

Next Monday, August 22, 2016, marks the 20th anniversary of “welfare reform” in America. Congress created the Temporary Assistance for Needy Families (TANF) block grant through the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, as part of a federal effort to “end welfare as we know it.”

Prior to welfare reform there was Aid to Families with Dependent Children or AFDC which served as the nation’s major cash welfare program.

AFDC was established in 1935, as part of the New Deal. It provided financial support for single mothers and children living in poverty.

Under TANF, the federal government provides a block grant to the states, which use these funds to operate their own programs.  In order to receive federal funds, states must also spend some of their own dollars on programs for needy families (they face severe fiscal penalties if they fail to do so).  This state-spending requirement, known as the “maintenance of effort” (MOE) requirement, replaced the state match that AFDC had required.

States can use federal TANF and state MOE dollars to meet any of the four goals set out in the 1996 law:  “(1) provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives; (2) end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; (3) prevent and reduce the incidence of out of wedlock pregnancies and establish annual numerical goals for preventing and reducing the incidence of these pregnancies; and (4) encourage the formation and maintenance of two parent families.”

States have used their TANF funds for a variety of services and supports, including:  income assistance (including wage supplements for working-poor families), child care, education and job training, transportation, aid to children at risk of abuse and neglect, and a variety of other services to help low-income families.  Since the four TANF goals are extremely general, states can use TANF funds much more broadly than the core welfare reform areas of providing a safety net and connecting families to work; some states use a substantial share of funding for these other services and programs.

~ Source: Center on Budget and Public Policy Priorities

The 1996 law authorized TANF funding through federal fiscal year 2002.  After several short-term extensions, Congress reauthorized TANF for another five years in the Deficit Reduction Act of 2005 and made some modifications to the program.  Since October 2010, Congress has again continued to extend TANF with short-term extensions rather than a full reauthorization.

The TANF program is long overdue for reform. The basic TANF block grant has been set at $16.5 billion each year since 1996; as a result, its real value has fallen by one-third due to inflation.

Back then we really didn’t know how living in poverty impacted children. Now we do. Researchers have found that the consequences of living in poverty and economic uncertainty for children and youth is especially harsh and could linger for years. Numerous studies have shown that children who grow up poor are more likely to suffer from poor health, developmental delays, behavioral problems, and lower academic achievement. Even temporary spells of poverty can have negative long-term effects on child development.

So the question is: Has TANF worked?

Some policymakers have pointed to TANF as a model for reforming other programs, but the facts suggest otherwise. TANF provides a greatly weakened safety net that does far less than AFDC did to alleviate poverty and hardship, as the Center on Budget and Public Policy Priorities’ LaDonna Pavetti and Liz Schott point out in their newly released report:

TANF at 20: Time to Create a Program that Supports Work and Helps Families Meet Their Basic Needs

TANF’s combination of nearly unfettered state flexibility, fixed block grant funding, narrowly defined work requirements, and time limits has created a system that provides a safety net to very few families in need and does little to prepare low-income parents for success in today’s labor market.  Federal policymakers can address these problems by adopting policy changes in three broad areas:  providing an effective safety net to poor families with children, creating effective work programs to help parents prepare for work, and ensuring adequate resources are available for achieving these goals.

Twenty years’ experience under TANF has provided more than enough information to see that the program is not working as intended and is leaving many children worse off than they were under AFDC. States certainly could have done a better job to further TANF’s twin goals of providing a safety net and connecting parents to work, but the law itself is a large part of the problem. It contains poorly designed incentives and requires no state accountability for providing a safety net. It does not promote effective work programs or hold states accountable for creating them. States have used TANF’s flexibility to spend the money in ways Congress never imagined, with less than a third of the funds going to providing a safety net or effective work programs. Given states’ dismal track record, federal law should change to hold states accountable in these key areas.

You can read the full report Here.

Writing in a blog post for The Hill, Melissa Boteach, Vice President of the Poverty to Prosperity Program, and Rebecca Vallas, Managing Director for the Poverty to Prosperity Program at the Center for American Progress (CAP) said this about the TANF program:

While a robust economy in the late 1990s, along with expansions in tax credits for working families and childcare investments initially helped spur a dramatic reduction in poverty, once the economy slowed down, TANF’s flaws began to surface.

The program was not designed to respond to recessions. Indeed, during the worst economic downturn since the Great Depression, many states actually cut back on assistance while unemployment and hardship were quickly rising. States began diverting TANF funds to plug budget holes, leaving just one in every four TANF dollars for income support to struggling families.
The result? Today, just one-quarter of poor families with children are helped by TANF, and assistance is so meager that in no state are benefits for a family of three enough to make rent on a two-bedroom apartment. In fact, TANF’s ineffectiveness at mitigating hardship has directly contributed to the rise in deep poverty.

In addition, a wealth of evidence now demonstrates that TANF’s work requirements are ineffective at boosting employment. That’s not surprising, given such requirements do nothing to address the lack of good jobs or barriers to work like childcare and transportation.

…..Without vital programs such as Social Security, nutrition assistance, and tax credits for working families, our nation’s poverty rate would be nearly twice as high as it is today. Moreover, these investments not only mitigate poverty today, they boost economic mobility tomorrow, improving children’s health, education, and employment outcomes in adulthood.

Ensuring an adequate safety net is something we all have a stake in. Job loss, low wages, ill health, and the birth of a child are the most common triggers of poverty spells in the U.S. More than half of Americans will experience at least a year of poverty or teetering on the economic brink during their working years, and fully 70 percent will need to turn to the safety net at some point.

We must take steps to strengthen the program so it can protect kids and families from hardship. Benefit adequacy, meaningful accountability, and reforms to support TANF recipients in obtaining the education and skills they need to get ahead are key priorities.

But we cannot stop there. To dramatically reduce poverty and expand opportunity, we must also pursue a bold agenda to build an economy that works for everyone—not just those at the top of the income ladder. This includes supporting job-creating investments in infrastructure, research, and education, and pathways to good jobs such as apprenticeships and subsidized employment. It’s long past time to raise the federal minimum wage so it ceases to be a poverty wage, and to adopt paid leave and paid sick days so working parents are not forced to choose between work and caregiving.

We should also protect and strengthen key investments in nutrition, housing, income security, and healthcare—including women’s reproductive healthcare and rights—to ensure basic living standards for all families. And we must invest in the next generation by ensuring affordable high-quality childcare, pre-K for all, and access to higher education.

Twenty years later, it’s not just time to fix TANF; it’s time to enact an agenda that will dramatically bolster family economic security once and for all.

We agree.

GRANITE STATE RUMBLINGS

Mark your calendars for our 8th annual Step Up for Kids Day! We will be back on the State House lawn on this year with plenty of fun activities, games, and musical entertainment for kids of all ages!

NHStepUp2016

Granite State Rumblings (Part 2): The Relationship Between Healthcare And Healthy Development

GROWING UP GRANITE

(This is part two of this week’s Granite State Rumblings. Part 1 can be found here)

CLASP and Georgetown University Center for Children and Families (CCF) released a new report on the important but often-overlooked link between adult health care coverage and children’s healthy development – specifically, the connection between health care coverage and identifying and treating maternal depression, so that children can thrive.  Because of the powerful connection between mothers’ mental health and children’s wellbeing and long-term success, Medicaid expansion is a critical tool to help children and should be front and center for child-focused advocates and policymakers.

We are especially excited about this report because of the complementary expertise of our two organizations – CCF on health and CLASP on child care and early childhood development.  Thank you to our co-authors Stephanie Schmit and Alisa Chester for their hard work synthesizing the research about child development, Medicaid expansion, and maternal depression.  The report, Medicaid Expansion Promotes Children’s Development and Family Success by Treating Maternal Depression, distills the research to support four key conclusions.

  • Untreated maternal depression is a major public health problem that affects large numbers of women, especially low-income women and their children. More than half (55 percent) of poor infants have a mother who is experiencing some level of depressive symptoms. Maternal depression has been shown to undercut children’s healthy development and stymie families’ efforts to escape poverty. Maternal depression can affect children’s cognitive, socio-emotional, and behavioral development, as well as academic achievement and employment opportunities throughout their lifetime.
  • While safe and effective treatments exist, low-income and uninsured women are far less likely to get treatment. More than one-third (37 percent) of low-income mothers with young children who have had a major depressive disorder do not receive any treatment. The cost of mental health care is a major barrier to care, particularly for uninsured mothers.
  • States that used the Affordable Care Act (ACA) to expand Medicaid coverage for low-income parents have new opportunities to ensure that women are enrolled and receiving coverage. In the 19 states that have not expanded Medicaid, half a million mothers fall into a coverage gap. They earn too much to qualify for Medicaid coverage but earn too little to qualify for premium assistance through the ACA’s health insurance marketplace. The Medicaid income eligibility threshold for parents in most non-expansion states is extremely low. (See chart).
  • Mothers without health insurance face significant financial barriers to getting the care they need to treat maternal depression.  As research cited in the report demonstrates, expanding Medicaid coverage to more low-income adults (including mothers) would remove those barriers and help increase access to screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and families’ economic security. Access to Medicaid has been shown to reduce the incidence of depression by increasing access to mental health services and diminishing financial barriers to care. For example, new research indicates that Medicaid expansion has not only resulted in improved access to medical benefits but has also resulted in improved access to behavioral health treatment for newly eligible enrollees.

The report concludes that Medicaid expansion for low-income mothers can greatly improve women’s access to treatment for depression, which is vital to children’s healthy development.

Extending Medicaid coverage to more low-income mothers would help increase screening, identification, and treatment of maternal depression—thereby promoting young children’s healthy development and family economic security.

If more states were to accept Medicaid expansion funding, more mothers would gain access to maternal depression screening and treatment and more children would have improved opportunities to reach their full potential.

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