HARRISBURG, Pa. – Some children's advocates are saying the bill introduced in Congress as a replacement for the Affordable Care Act would be bad for kids in Pennsylvania. The American Health Care Act would put a cap per person on Medicaid spending, and set a maximum amount available for individuals based on factors like age or disability.

Joan Benso, the president and CEO of Pennsylvania Partnerships for Children, says if a child is in the category for typically healthy children and has a serious injury or chronic disease like asthma, medical expenses could easily exceed that cap.

"The State of Pennsylvania or their parents would be solely responsible for the full cost of those services, rather than having the historic cost-sharing we've had with the federal government," she explained.

Benso emphasizes that the impact on children with disabilities is still unclear. Those supporting the reform legislation say it would give states more flexibility in health-care spending.

The Medicaid caps could add millions of dollars a year to state health-care costs. And as Benso points out, Pennsylvania is already dealing with a budget deficit of about $3 billion.

"And at the end of the day, what we assume will happen is, services to kids delivered under Medicaid would be cut," she said.

Medicaid currently covers about 2.8 million Pennsylvanians, including 1.2 million children.

Under the Affordable Care Act's Medicaid expansion, more than 600,000 Pennsylvanians got health insurance. But Benso notes the current bill would end that expansion in 2020, leaving the state to pay for any additional Medicaid enrollees, and reducing the federal share for coverage of current expansion enrollees.

"And we assume at that point in time, the state won't be able to pick up that additional cost and adults will lose coverage, including adults that are parents," she added.

Benso also noted that parents' access to health insurance can have a profound effect on their children's health and well-being.


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A new report re-examines how to measure Connecticut's poverty rates. Some findings show Supplemental Poverty Measure-based rates rose more than 12% in 2022 from nearly 8.5% in 2021.

Child poverty rates grew from 2021 to 2022, though this stems from pandemic relief payments being made available.

Patrick O'Brien, research and policy director with Connecticut Voices for Children, said new data examines how certain benefits impact poverty rates.

"So, in Connecticut in 2022, we saw that the public benefits that lifted the most people out of poverty were Social Security, food assistance programs, and housing subsidies. And we saw that the largest contributors to poverty were medical expenses, federal payroll taxes, and work expenses, he explained.

A state-level Child Tax Credit is one recommendation to improve the state's child poverty rates. It can provide a cash benefit to the poorest families in the state and help offset expenses contributing to high poverty rates. One concern is where the money to finance this credit would come from.

O'Brien added the state can decrease its tax gap, eliminate certain tax expenditures like the film industry tax credit, and increase taxes on higher-earning residents.

But these measures aren't entirely accurate. While the official poverty measure is based on cash income, the Supplemental Poverty Measure has a more accurate threshold of whether a family is in poverty. O'Brien said one interesting thing about the breakdowns of the data is how certain programs interact with poverty rates.

"The federal payroll taxes that are funding Social Security have this dynamic where Social Security is lifting primarily seniors out of poverty in part at the expense of pushing working adults into poverty," he said.

Some 218,000 Connecticut residents were lifted out of poverty by Social Security, though 39,000 were put into poverty by federal payroll taxes. But enacting a state Child Tax Credit would support over 1.3 million people statewide, including close to 207,000 kids living in or near poverty.

Washington voters are deciding on the fate of the state's capital gains tax this election. The tax supports child care and schools.

If passed, Initiative 2109 would repeal a 7% tax on capital gains for assets worth more than $250,000. Supporters of the repeal said capital gains taxes are volatile and it could lead to an income tax down the road.

Wesley Tharpe, senior adviser for state tax policy at the Center on Budget and Policy Priorities, noted 42 states have capital gains or income taxes and capital gains taxes are one of the most effective tools to balance out tax codes.

"Things like personal income taxes, corporate income taxes, capital gains taxes, those are going to collect a bit more from those at the top," Tharpe explained. "That helps balance out the fact that lower- and middle-income people are contributing a much larger share in things like sale taxes and fees - and to some degree, property taxes as well."

Last year, Washington state's capital gains tax pulled in about $786 million. The first $500 million collected from it goes toward schools, early learning and child care. Money collected beyond it is used for school construction. Washington has historically had one of the most regressive tax systems in the country.

Suzette Espinoza-Cruz, a Washington state lead volunteer for the Save the Children Action Network, said early childhood learning has benefited her niece's child, who was ready on his first day of kindergarten because of the state's Early Childhood Education and Assistance Program. Her niece's other child needed help in school and Espinoza-Cruz emphasized she was able to get help.

"What worries me about Ballot Initiative 2109 is that programs that are supplementing students' learning could be cut if we have less funding available for our pre-K through 12 system," Espinoza-Cruz stressed.

Tharpe pointed out there would be long-term effects from repealing the capital gains tax from investing less in quality education, early learning and child care.

"You're going to wind up down the road with a less competitive workforce, communities that are not as attractive of places to live and work," Tharpe projected. "There really is some significant economic risk to taking away that source of revenue for those public priorities."

Workers responsible for nurturing and educating young children during their most critical years of development struggle with poverty-level wages, in Colorado and every other state, according to a new report.

Senior Researcher and Policy Associate Anna Powell with University of California Berkeley's Center for the Study of Childcare Employment said the median wage nationally for early childhood educators is $13.07 an hour.

"In Colorado that would be $15.06 an hour, so a little bit higher," said Powell. "But these are wages that are typically at or near minimum wage, and lead people to require public assistance in order to make ends meet."

In Louisiana, these educators are paid just $10.60 an hour. The 2024 Early Childhood Workforce Index found that hourly wages do not equal a living wage for a single adult in any state.

Nearly half of childcare workers turn to public assistance programs, including food stamps and Medicaid.

Early childhood educators earn less than 97% of all other occupations. Powell said the data also show serious inequities in wages.

"So, while the overall wages are low, Black and Latino women are earning even less on average," said Powell, "up to $8,000 less a year regardless of their education level."

The study's recommendations include increasing public funding for the early childhood education sector.

The U.S. currently invests just $4,000 per child, per year, compared to $14,000 invested in other wealthy nations.

The pandemic exposed just how essential these educators are to the economy, and Powell said effective use of COVID relief funds shows that solutions are available.

"And many states and localities were experimenting with helping to provide stipends or other creative ways to increase wages," said Powell. "So, all of these are excellent proof points about how we can be making different policy choices."




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