Parents' back-to-school checklist in Arizona might include double-checking to make sure their children still have health insurance.
Arizona was one of the first states to start re-checking the eligibility status of everyone receiving Medicaid coverage when the pandemic public health emergency ended.
Director of Health Policy at Children's Action Alliance Matt Jewett said since April, Medicaid enrollment in Arizona has already decreased by several hundred thousand - which he calls "concerning."
Jewett said kids are among those being dropped from coverage - many for reasons as simple as filing errors, or families not updating their contact information - and getting new insurance may be challenging.
"A lot of the population that we are seeing is those children who are either aging out of KidsCare," said Jewett. "We're also seeing folks in rural areas who may not have as many organizations providing help. We're also seeing that in tribal areas, there are a lot of people at risk."
Jewett added that the state's Medicaid program for children, called KidsCare, will increase the income eligibility from 200% of the Federal Poverty Level to 225% this fall.
That should mean an additional 12,000 kids could be enrolled for coverage.
Joan Alker, executive director of the Georgetown University Center for Children and Families, said it is worrisome that many of the Medicaid losses aren't because a state determines someone isn't eligible - but because many haven't gone through the renewal process.
She said if your child has lost Medicaid coverage, there's a good chance they're still eligible.
"We're in this unprecedented historic situation where states that are generally understaffed, have to process eligibility checks for everybody on the program," said Alker. "And that includes half the children in the country, so this is a massive undertaking."
Alker said coverage gaps are a problem, no matter how long they last.
She adds even though children aren't expensive to cover, they're what she calls "regular utilizers of care," and she doesn't want families showing up at a pharmacy or doctor's office and being turned away.
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Today is National Brush Day and experts across Kentucky are reminding residents to brush their teeth twice a day, floss, avoid smoking, and especially for pregnant women and children, make an appointment for a cleaning and checkup with a dentist.
Julie Smith, registered dental hygienist and director of dental services for Cumberland Family Medical Center, which provides preventive and restorative oral health for more than a dozen school districts in the region, said without the program, most children would go the entire school year without seeing a dentist.
"It is not uncommon for us to see students who tell us they've never had a toothbrush or they've never had a toothbrush of their own because their entire family shares a toothbrush," Smith explained. "It's not uncommon to meet a child who says, 'When I am at one parent's house I have a toothbrush, but I don't have a toothbrush at the other parent's house.'"
The Kentucky Oral Health Coalition has launched a new series of free oral health materials for communities, dental offices, schools, libraries and other locations.
Dr. Jill Keaton, professor and dean of the Tanner College of Dental Medicine at the University of Pikeville and a member of the Kentucky Oral Health Coalition, said the new resources include information on dental insurance, and oral health tips for pregnancy, children, older adults, and people with substance use disorders.
"I love the fact that these resources are free and something that dentists or dental hygienists, dental assistants can print on their own and then distribute to patients or even other stakeholders," Keaton emphasized.
Smith advised as children have bags full of Halloween candy, it's important not to let them keep it in their rooms or have constant access to sugar, which causes tooth decay.
"Instead, keep it somewhere that maybe they get a couple of treats at meal time after their meal when it's going to do a lot less damage," Smith recommended. "Make the candy last."
According to a 2023 report by the University of Kentucky's Center for Excellence in Rural Health, the Commonwealth ranks ninth among states for oral cancer rates, and fifth in the percentage of adults with tooth extractions.
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Pennsylvania is facing what children's advocacy groups call a historic child care crisis, leaving thousands of young children without access to early learning programs.
A new report estimates Pennsylvania loses $6.65 billion annually when families do not have child care and preschool options.
Kari King, president and CEO of Pennsylvania Partnerships for Children, said the report examines the policies on child care and pre-K, and highlights workforce challenges affecting many families with young children.
"Both in terms of parents and families in the workforce, and the need for child care to be able for parents to work," King outlined. "We know in the report, just over 70% of families with children currently have both parents or caregivers in the workforce."
In his latest budget proposal, Gov. Josh Shapiro addresses some of the workforce challenges with a $17.7 million boost to early childhood education. $15 million is proposed for Pre-K Counts and $2.7 million for Head Start Supplemental Assistance, investments he said are crucial for working parents' economic stability.
King pointed out Pennsylvania child care workers earn just over $15 an hour, or less than many retail jobs, and half of pre-K programs are delivered through child care centers. But some centers struggle to attract and keep qualified staff.
King observed the wage gap leaves some centers with not enough revenue to pay competitive salaries and keep care affordable.
"That's where we've seen there's been quite an impact since the pandemic, with quite a few programs that have actually closed their doors," King noted. "Over 600 child care providers have been lost since right before the pandemic. So, I think you're seeing a lot of those businesses again in that untenable situation."
The report pointed out pre-K teachers in Pennsylvania earn annual salaries about half those of kindergarten teachers. One recommendation is to provide pay for pre-K teachers on a par with elementary school educators.
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Advocates for children in New Hampshire said the state needs elected officials who will put kids' futures first.
With biennial budget negotiations to begin next year, they said access to quality early education, school meals and services are all on the line this election.
Megan Brabec, New Hampshire state manager for the Save the Children Action Network, said children cannot vote but they are on the ballot.
"It's really important that we have Senators and representatives that are aware of these issues," Brabec stressed. "That are prioritizing these issues and recognize the role for government in addressing these issues."
Brabec pointed out with child care for two children younger than five now topping $30,000 a year, too many children are forced to go without the early education known to improve their long-term outcomes.
A bipartisan mix of candidates is offering solutions, including the establishment of universal Pre-K to ensure all kids start kindergarten on the same footing. Others want to simplify eligibility for free or reduced-price meals using Medicaid data or create a state fund to finance early educator recruitment and retention.
Ella Bender, a child advocate and student at the University of New Hampshire, has been registering voters and encouraging them to think of future generations.
"We want students to know that the power is in their hands to vote for officials in the state of New Hampshire that are going to put children's needs first," Bender emphasized.
Bender argued every child in New Hampshire deserves a quality education and to have their basic needs met.
A recent Save the Children Action Network survey found a majority of likely voters across the United States feel more favorable about a political candidate who supports greater investments in child care or programs to relieve food insecurity.
Disclosure: Save the Children contributes to our fund for reporting on Children's Issues, Early Childhood Education, Education, and Poverty Issues. If you would like to help support news in the public interest,
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