In Defense of Children

In the face of a global pandemic, the Biden administration issued a series of measures to sustain millions of low-income children and families. Despite its success, the Public Health Emergency (PHE) and policies enacted under the emergency declaration will expire on May 11. And the pain will be real.

Because of economic hardships and systemic barriers, children and their families should not lose essential, life-saving access to healthcare and resources. One study shows that given the end of the PHE, 5 million children stand to lose Medicaid and healthcare coverage. Cuts to federally funded entitlement programs like Medicare and Medicaid, in conjunction with burdensome reporting requirements like necessitating employment and providing time limits to receiving benefits, further put millions of families at risk of losing essential services. Children are particularly vulnerable to gaps in coverage for healthcare and access to nutrition.

By pushing agencies to provide health support, including waivers, changes to eligibility requirements, and coverage expansions, PHE policies led to historical rates of improvement in healthcare coverage for children, youth, and their families. Compared to 2020, 500,000 more children and youth had healthcare coverage under PHE policies.

From February 2020 to June 2022, under the 2020 Families First Coronavirus Response Act (FFCRA) continuous enrollment requirement, more than 18 million children and adults were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). The PHE made it possible to mandate continuous coverage to address and counteract economic distress felt by millions of households that faced unemployment and fluctuations in income.

Because Black and Brown children are disproportionately affected by not only the pandemic but also access to healthcare, the expansion of eligibility under PHE policies also improved racial health equity. In fact, in the last decade, disparities in health coverage for Black and Brown families were only seen to improve through legislation like the Affordable Care Act and policies enacted under PHE.

The PHE also allowed several federal departments, like the U.S. Department of Agriculture (USDA), to allow waivers and flexibility in administering nutrition services to advance food security for low-income households and families impacted by the pandemic. Because of the far-reaching impacts of PHE policies, the end of the pandemic-era declaration will affect more than just healthcare coverage:

• Temporarily expanded Supplemental Nutrition Assistance Program (SNAP) will end, changing eligibility for students to access food
• Pandemic EBT (P-EBT) benefits, which allowed eligible families to cover food costs for kids, will end for children in child care
• Other nutrition programs like the Child and Adult Care Food Program (CACFP) will no longer offer benefits for young adults in shelters

State and local health agencies and front-line care workers must know about the PHE’s end and its impact on health, food, and nutrition programs to inform and assist families with enrollment. Policy makers must do better for children and their families, but in the meantime, advocates and community members can utilize the following resources:

• Frequently Asked Questions (FAQs) regarding the implementation of the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and the Health Insurance Portability and Accountability Act (HIPAA)
• Program-specific guidance for states preparing for the end of the Public Health Emergency
• Check your Medicaid and CHIP eligibility and coverage

With the PHE ending on May 11, children and families can’t afford to lose access to vital federal programs and services that provide healthcare coverage and food assistance. Congress must act to ensure children, youth, and their families remain at the forefront of our nation’s priorities.