Over the last two decades, our country has made tremendous progress ensuring children and pregnant women have access to high quality, affordable health coverage. Thanks in large part to Medicaid and the Children’s Health Insurance Program (CHIP), the rate of uninsurance among children has dropped to a historic low of less than five percent. Children and pregnant women also receive health coverage through an array of other sources, including employer sponsored insurance, individual and small group commercial health insurance sold through the marketplaces, Medicaid, CHIP, and TRICARE. Despite historic progress in insuring children, close to 3.3 million children continue to lack the health coverage they need to survive and thrive.

As a nation, we must build on what is working for millions of children, pregnant women and their families by keeping Medicaid and CHIP strong and enrolling all eligible children, strengthening private coverage, and working toward a health care system that meets the needs of all children, pregnant women, and their families, regardless of their health or immigration status, family income, or zip code.

Any changes to our health care system must further improve coverage for children and pregnant women. The following document outlines a set of guiding principles for future health care policies, as agreed upon by a coalition of child health care advocacy organizations.

View the principles.

The Family First Prevention Services Act was signed into law as part of the Bipartisan Budget Act on February 9, 2018. This act reforms the federal child welfare financing streams, Title IV-E and Title IV-B of the Social Security Act, to provide services to families who are at risk of entering the child welfare system. The bill aims to prevent children from entering foster care by allowing federal reimbursement for mental health services, substance use treatment, and in-home parenting skill training. It also seeks to improve the well-being of children already in foster by incentivizing states to reduce placement of children in congregate care.

View the summary.

View the section-by-section overview.

Currently, over 20,000 youth age out of the foster care system each year with little to no support as they transition into adulthood. High-quality coordinated care is fundamentally important for children and youth who have been involved in the child welfare system because they tend to have high rates of acute and chronic medical, mental health and developmental needs. According to the Congressional Research Service, 35-60 percent entering foster care have at least one chronic or acute health condition, such as asthma, cognitive abnormalities, visual and auditory problems, dental decay, and malnutrition, and 50-75 percent show behavioral or social competency problems that may require mental health services. Foster youth are also more likely than their peers to be prescribed multiple psychotropic medications.

The Health Insurance for Former Foster Youth Act (S.1797), introduced by Senator Casey (D-PA) and Senator Blumenthal (D-CT) reduces barriers for youth to who have aged out of foster care to get access to health coverage.

In a joint press conference on Thursday, July 20th Senator Lindsey Graham (R-SC) and Sen. Dick Durbin (D-IL) announced the reintroduction of the DREAM Act, a bill to provide legal status and a path to citizenship for certain long-term residents who entered the U.S. as children.  This bill is a bipartisan effort to create a way for nearly 800,000 undocumented children and adults (known as DREAMers), who were brought to the U.S. at no fault of their own, to gain permanent legal status and to pursue their educational and employment goals without threat of deportation.

The DREAM Act of 2017 would address the plight of undocumented youth living in the U.S., many of whom were brought to the U.S. at a young age, have been educated in American schools, and consider the U.S. their only home. Undocumented youth who graduate from high school face significant barriers to everything typically associated with youth of that age, including driving, working, and access to higher education. Reducing these barriers will allow them to increase their contributions to their communities.

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Child poverty in the U.S. remains high, with nearly 1 in 5 children living below the poverty line in 2015. Children continue to disproportionately experience poverty in our society and are 69 percent more likely to experience poverty than adults. Furthermore, poverty is a particularly serious problem for children, who suffer negative effects for the rest of their lives after living in poverty for even a short time.

Beyond consequences for individual children, child poverty negatively affects the entire nation through increased expenditures on criminal justice and healthcare and through lost revenue and economic output. Yet there remains a lack of awareness and government accountability to address the significant problem of child poverty, and proposed solutions are too often politicized and fall along partisan lines.

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Each year millions of families in the U.S. are evicted from their homes and families with children are more likely to be evicted than tenants without children. Children who experience eviction often fact high rates of mobility and unstable living environments that result in negative consequences for their education, physical health, mental health and interpersonal relationships.

Civil legal services and eviction prevention programs help to keep children and families in their home and protect them from the negative effects that occur once a family is evicted. Yet most low-income families lack access to these services. Limited resources are due in part to limited federal funding for the overwhelming need for civil legal services, gaps between legal systems and social service agencies, and lack of awareness for the need for legal services.

The Equal Opportunity for Residential Representation Act of 2017 (H.R. 1146), introduced by Congressman Keith Ellison (D-MN-5^th) would start to address the need for civil legal services by creating a pilot program to provide grants to organizations that provide civil legal services to families facing eviction, landlord/tenant disputes, fair housing discrimination, or other housing-related issues.

Read the fact sheet.

Read the letter.

The Homeless Children and Youth Act of 2017 gives communities the flexibility to use federal funding effectively and appropriately to meet local needs, and ensures that those most in need of assistance receive it.

The bill will also help communities leverage additional resources and support – both public and private – to meet the needs of children, youth, and families.

Read the fact sheet.

Homelessness jeopardizes the health and well-being of record numbers of children and youth, putting future generations at risk of adult homelessness. Communities need to be able to use HUD Homeless Assistance funding more flexibly, effectively, and appropriately to meet the needs of children, youth, and families

The Homeless Children and Youth Act of 2017 restores local decision-making and improves the ability of communities to meet the unique developmental needs of homeless children, youth, and families, which is the best long-term strategy to reduce all forms of homelessness.

Read the fact sheet.

Nearly half of infants and toddlers in the U.S. are living in low-income families. This means that over 5 million young children are living in families that have a hard time covering the cost of their family’s basic needs, including diapers for their young children. The Hygiene Assistance for Families of Infants and Toddlers Act of 2017 (H.R. 1143) will give states flexibility in developing and implementing their program.

View the fact sheet.

The Family and Medical Insurance Leave Act (The FAMILY Act), sponsored by Rep. Rosa DeLauro (D-CT) and Sen. Kirsten Gillibrand (D-NY), will provide family and medical leave for families during crucial childbearing years. This fact sheet details its health and economic benefits to children and families.