RALEIGH, N.C. - Fifteen thousand North Carolina children lost health insurance coverage between 2016 and 2018, according to a report released today by the Georgetown University Center for Children and Families.

Michelle Hughes, executive director of the advocacy organization NC Child, said the troubling trend is largely the result of state lawmakers' refusal to expand Medicaid.

"Our state Legislature could roll out the welcome mat to enroll the whole family in health-care coverage, but so far has chosen not to," she said, "and that really is probably the biggest factor behind the number of kids who are falling off the insure goals in our state."

Fourteen other states, many located in the Southeast, also are experiencing a widespread loss of children's health coverage, according to the report.

Hughes said health-insurance coverage is a critical first step in making sure children see a doctor early in life.

"Both for preventive care, so getting things like their immunizations, getting screens for developmental delays," she said, "and also for treatment, making sure that for example, if kids have asthma, that they are able to get inhalers."

Joan Alker, executive director of the Georgetown Center, said Medicaid expansion is a key factor, noting that when parents go through the process of enrolling themselves in Medicaid, they are subsequently more likely to also enroll their children in the Children's Health Insurance Program (CHIP).

"When you look at the data, the increase in the rate of uninsured children is nearly three times as large in states that have not expanded Medicaid," she said, "so that is a very clear way that a state could turn this negative trend around."

Even in states that have chosen to expand Medicaid, Alker said, red-tape barriers and a climate of fear and confusion - especially in immigrant communities - has left many families hesitant to enroll their eligible children in Medicaid or CHIP. In 2018, North Carolina had a total of 130,000 uninsured children, the seventh highest number in the nation.

The Georgetown report is online at ccf.georgetown.edu, and a state-specific data hub is at kidshealthcarereport.ccf.georgetown.edu.

Groups working to fight hunger in Iowa say proposed cuts to SNAP benefits would fall squarely on the state's kids, who rely on them for food and other needs.

State lawmakers are considering a measure that would limit what items SNAP recipients could buy.

House File 970 would limit SNAP money to buying so-called "healthy" foods - grains, dairy, meat, eggs, fruits and vegetables, or other items considered necessary for good health.

Food Bank of Iowa's Senior Manager of Food Acquisition and Advocacy Emily Shearer said the change could have a dramatic effect on the one in six Iowa kids who face hunger.

"If there are cuts to SNAP, children will be impacted, seniors will be impacted, those with disabilities will be impacted," said Shearer. "So, the majority of people on SNAP that are able to work are working - it's just not enough to make ends meet."

Backers of the bill say they're guarding against abuse of the program.

If it is approved, the Iowa Department of Health and Human Services would have to request a waiver from the U.S. Department of Agriculture to override the current list of foods and beverages SNAP recipients can currently buy.

A 2016 USDA study found there are very few differences in the buying habits of families using SNAP and those who don't.

Shearer said it's been hard to counter the false claims that low-income Iowans have less healthy eating and buying habits, or that they use their SNAP benefits to buy unhealthy items.

"Nobody's buying tobacco and alcohol with their SNAP benefits. They're just not," Shearer insisted. "But with SNAP restrictions the way they're written currently, they're so vague - there's discussion that something like pasta sauce, or soup or jelly, are those going to be restricted? I don't think anyone would define those as 'junk food.'"

The USDA reports about 130,000 Iowans received SNAP benefits in 2024.

Each legislative session, Oregon's Joint Ways & Means Committee holds a statewide roadshow to hear from residents about their priorities. At the Salem stop April 16, supporters of the Food for All Oregonians bill are urging people to speak up. A coalition of over 180 organizations says bipartisan momentum is growing behind the bill, which would extend food benefits to all of the state's kids, regardless of their immigration status.

Ali King, a member of the Our Children Oregon coalition, said policy experts, parents, and other supporters of the bill have a clear message.

"We've all seen firsthand how our worsening hunger crisis impacts our children and state and it's unacceptable that one in six Oregon children don't have enough to eat," she declared.

King says Food for All Oregonians is one of the top priorities for her organization's 'Children's Agenda,' a package of legislation dedicated to improving the well-being of Oregon's children, youth, and families. The bill is currently in the Ways and Means committee.

A previous version of Food for All Oregonians would have extended food benefits to older adults as well as children. Opponents take issue with providing food benefits to people who are undocumented. King says, though the bill is linked to immigration status, it is not only about immigration.

"We can't allow Oregon's innocent children to become the collateral damage of partisan politics. It's really important that regardless of your views on immigration, we recognize that no one deserves to go hungry," she continued.

Food for All Oregonians would establish a new program in the Department of Human Services to provide food benefits to children up to 6 years old who would otherwise qualify for SNAP but for their immigration status. The estimated cost for this biennium is about $7.5 million. Coalition members say they will continue to work until all Oregonians have access to the food benefits they need.


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More than 7,500 Indiana children were removed from their homes last year because of abuse and neglect. According to The Indiana Youth Institute's 2024 Kids Count Data Book, that number represents a 26% increase from 2022.

Indiana's Child Abuse and Neglect Law includes persistent hunger and ongoing fatigue as symptoms of behavioral abuse.

Jeff Wittman, Prevent Child Abuse Indiana director, said child abuse resulting in bruises, broken bones and some lacerations may be easier to see than less obvious -- and potentially more serious -- forms of abuse.

"But the things that go unnoticed or harder to see are changes in behavior. So it's incumbent upon adults and those in roles of caregiving and authority and things like that, to be aware of children, to know them well enough where you can see changes in behaviors," he said.

Indiana's code lists additional signs of sexual abuse of minors as the child having sexual knowledge well beyond their age, imitating sexual behavior and a preoccupation with their bodies.

Wittman said the agency will occasionally receive calls from concerned citizens who have witnessed an incident or a child's actions and sense that something isn't quite right. He said people are familiar with the phrase 'when you see something, say something,' and are more proactive about picking up a phone and calling the agency. He said, as a society, "This is really where we need to be" to help an abused or neglected child."

"If we see situations that bring to mind or cause us to be concerned, where children might not be getting their basic needs met, or they seem to always be hungry and never have, enough food or maybe they are, crying all the time, or they're running away from their parents," he added.

Wittman explained that Indiana is a mandated reporting state, which means every adult at least 18 years of age has a legal obligation to report child abuse and neglect cases.

To report child abuse and neglect, call the hotline at 1-800-800-5556.