WAKE FOREST, N.C. -- Early-childhood educators are finding themselves choosing between basic needs and health care. The median salary for child-care workers in North Carolina is not quite $21,000 - too high to qualify for Medicaid, but leaving many early-childhood educators in the gap.

A new report from one group that advocates for Medicaid expansion in North Carolina interviewed early-childhood educators from across the state, and 1-in-5 said they don’t have health insurance. One educator who asked to be referred to as "Eryka," said she plans her budget very carefully each week for rent, food, electricity, and gas to get to work. But buying private health insurance is far out of reach for her.

She said that means she goes to work even when she’s sick.

"Most of the time, I kind of just have to ride it out and hope I get better. Otherwise, I am going to the ER, wasting their time, or the urgent care, wasting their time, for something small,” Eryka said. “If I had strep throat, I have to go pay $75, $100, to go to urgent care just to get antibiotics. Nothing is easily accessible when you don't have good health insurance."

Two measures in the state Legislature, House Bill 5 and Senate Bill 3, would raise the income level for those eligible for Medicaid. Senate Leader Phil Berger, R-Eden, took aim at provisions in both bills, saying it represents a tax that ultimately will be passed on to patients and taxpayers.

Bills in the House and Senate propose to use federal funding to expand access to Medicaid, as 37 other states already have done. Leaders from both parties and the governor have different approaches to increasing access to health care, but would need to reach a compromise in order to actually pass legislation this session.

Statewide, it's estimated that 500,000 people are in the "coverage gap," earning too much for Medicaid. Among them are thousands of early-childhood educators such as Meranda who said that while she enjoys working with toddlers, the fact that she's been uninsured for more than a year is frustrating.

"If they expanded Medicare, it would be such a huge burden lifted off,” Meranda said. “Then I wouldn't have to worry about getting sick and how long I am going to stay sick for. Am I going to get OK, or is this something serious because I have cancer that runs in my family. All four of my grandparents had it, my great-grandparents had it, my mother had it."

Members of the Early Childhood Advisory Council appointed by Gov. Roy Cooper wrote to legislators last week to share how expanding Medicaid to close the health-insurance coverage gap can help the state's more than 1 million young children.

Reporting by North Carolina News Connection in association with Media in the Public Interest and funded in part by the Park Foundation.


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Virginia is making a financial investment to help tackle the state's childcare shortage.

This year's budget allocates more than $1 billion to expand childcare capacity in 2025 and 2026. Legislation is also streamlining part of the process for people to become childcare providers.

The Center for American Progress finds 47% of Virginians live in areas considered "childcare deserts."

Allison Gibreath, senior director of policy and programs at Voices for Virginia's Children, said the state must also develop its childcare workforce.

"What I'm hearing from providers is they might have a classroom that's completely empty that could fill 15 slots in their community," said Gibreath, "but they cannot open that classroom because they cannot find the workforce to support that classroom."

A Joint Legislative Audit and Review Commission study finds 74% of Virginia's childcare centers are short-staffed, preventing many parents from entering the workforce.

It says a major factor is low pay for early childhood educators, ranging from $29,000 to $33,000 a year.

Gilbreath said the new investments should trickle down, enabling centers to hire more people and increase pay.

Gilbreath said the additional investment and legislation should strengthen the childcare system, but more can be done to alleviate the large-scale challenges a lack of providers creates.

"When a huge employer is looking for a place to either build a new facility or build a new office anywhere in the country," said Gibreath, "when they come to Virginia, they're starting to ask the question, 'If bring my workforce here, will there be enough childcare options for the workforce?'"

Some bills that didn't pass this year could come up again next session.

One would create an Employee Child Care Assistance Pilot Program for small businesses to help cover childcare costs for their workforce.

Another would expand Headstart's availability for parents attending community colleges.




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A Georgia company is showcasing the benefits of supporting workers who want to adopt children.

The Atlanta-based kids' clothing brand Carter's is gaining recognition for its efforts in helping employees expand their families.

Hannah Aarsvold, senior director of site merchandising for Carter's, is one employee who has benefited from the company's adoption support. She shared her own story of fostering and adopting her son Hayden with Carter's assistance.

"My colleagues threw the coolest adoption shower when Hayden was adopted," Aarsvold recounted. "I obviously know Carter's as my place of employment and the largest children's apparel brand in North America, but Hayden knows Carter's as the place of this awesome adoption party."

She pointed out the practical help she received, like time off to handle the logistics of becoming a parent with 24 hours' notice, and the emotional support, made a difference. Carter's was recently recognized as a top retailer for adoption support by the Dave Thomas Foundation for Adoption.

Katie Maclaga, senior director of benefits for Carter's, emphasized the importance of providing a supportive culture and reducing employee stress during the adoption and foster care process. She said the company can help with financial support, among other benefits.

"We also have an innovative benefit around providing 10 days of foster care leave when someone becomes a foster parent," Maclaga stressed. "We think that's really important too, because there's not a ton of awareness around that. But when you become a foster parent, you've got to figure out a lot of things very quickly."

Rita Soronen, president and CEO of the Dave Thomas Foundation for Adoption, explained adoption benefits ensure employees are not penalized at work for pursuing a different path to building their families. She said the benefits help the employers as well as their workers.

"It creates a competitive edge for employers among businesses with whom they're trying to attract employees," Soronen noted. "It becomes very much of an equity conversation; that we believe that, no matter how a family is formed, we're going to support the needs of our employees."

She added the Foundation provides resources for employers looking to support families, noting even modest benefits can make a big impact.

After the tragic death of Kyneddi Miller, a 14-year-old West Virginia girl found dead in her home, some state lawmakers are calling on the governor to pass a bill known as "Raylee's Law" during a special session expected in August.

Named after Raylee Browning, an 8-year-old girl who was removed from public school and home-schooled after teachers reported abuse to child protective services, versions of the law have stalled in the Legislature the past few years.

Del. Joey Garcia, D-Fairmont, said the law would ban county school boards from authorizing home-school instruction if there's a pending child abuse or neglect investigation against a parent or guardian.

"I think what we're looking at is there has to be some level of accountability," Garcia contended. "Just like there is in the public school system, that children are being taught, that they're not being abused."

A 2023 analysis by the Washington Post estimated there are 1 million to nearly 3 million home-schooled children in the United States. In West Virginia, the number is around 13,000, according to the West Virginia Home Educators Association, which said it opposes any oversight of home schooling.

Garcia emphasized the law is designed to help improve one aspect of the state's failing child welfare system. In 2019, current and former foster care children filed a class-action lawsuit arguing the state repeatedly failed to protect children in its care. He added West Virginia has work to do when it comes to child safety.

"Across the aisle, Democrats, Republicans, people of all different beliefs with respect to education, to try to provide for a reasonable and narrowly tailored law that protects children," Garcia explained.

Lawmakers also are in discussion with local school boards about enforcing assessment completion for home-schooled kids. State law requires assessments at certain grade levels and local public school officials have few options to check on children when a parent or guardian fails to submit them. Data show just 37% of home-school households submit assessments.


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