AUSTIN, Texas – Texas has the highest rate of uninsured women of childbearing age in the nation, with one in four lacking coverage, according to a new report from the Georgetown University Center for Children and Families.

It says states that expanded Medicaid under the Affordable Care Act saw a 50% greater reduction in infant mortality than in non-expansion states.

Laura Guerra-Cardus, deputy director of Children's Defense Fund–Texas, explained that to ensure women have healthy pregnancies and babies, women need health-care coverage throughout their lives.

"States that have expanded Medicaid have seen reduced rates of both maternal deaths and infant mortality. They've reduced health disparities," said Guerra-Cardus. "African-American women are three times as likely to die from childbirth and pregnancy complications."

Texas lawmakers have argued that expanding Medicaid could leave the state on the hook if the Affordable Care Act implodes.

But Guerra-Cardus noted lawmakers are leaving $6 billion a year on the table that could provide health coverage for more than 1 million Texans. She believes the largely partisan opposition to expansion should be put aside to prioritize the lives of women and children.

Joan Alker, executive director of the Georgetown University Center on Children and Families, pointed out that among developed nations, maternal mortality in the United States is going in the wrong direction.

She is convinced that Medicaid expansion is the single most important step states can take to address the crisis, in part because steady, uninterrupted health coverage is critical for healthy birth outcomes.

"Some pretty big states – like Texas, Florida, Georgia – have coverage gaps," Alker said. "And as a result, we see those states that have not expanded Medicaid under the Affordable Care Act, the uninsurance rate for women of childbearing age is nearly twice as high as those states that have expanded Medicaid."

In non-expansion states, many women only get coverage after they find out they're pregnant, which Alker calls problematic when a growing body of research shows that women need to be healthy at the time of conception.

States that expanded Medicaid improved maternal health outcomes by increasing access to preventive care, and also reduced adverse health outcomes before, during and after pregnancies.

The Georgetown report was released in conjunction with the March of Dimes and the American College of Obstetricians and Gynecologists.

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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