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It’s been six months since the passage of the American Rescue Plan Act (ARPA), and provisions designed to decrease child poverty and increase health coverage and access are making an impact. Families have been able to afford food and basic expenses to keep their children healthy because of the expanded Child Tax Credit, Medicaid, the Children’s Health Insurance Program, and rental assistance programs. Many provisions within ARPA, however, are temporary and will end as the public health emergency unwinds. Expanded unemployment benefits and the nationwide eviction moratorium have already lapsed, placing millions of families at risk of financial instability and losing their homes. Congress must act now to make ARPA’s forward-minded solutions permanent and substantially decrease racial, social, and economic inequities.
Everyone is now watching the $3.5 trillion budget resolution and $1 trillion bipartisan infrastructure bill to be voted on by September 27 in the House. This bill can solidify a commitment to families with low incomes, disproportionately Black and brown families, that the health, safety, and prosperity of their children is a priority in our national recovery. Unfortunately, without the inclusion of policies that close loopholes and increase revenue, it's unlikely the funds required to fuel a robust package will come to fruition.
Here are five policies to reduce child poverty, improve child health, and advance racial equity that Congress should enact to build upon ARPA:
1. Make ARPA’s changes to the Child Tax Credit (CTC) permanent and reinstate CTC eligibility for immigrant children.
Early data shows most families used CTC funds to meet basic needs. Nearly half of families that received the Child Tax Credit spent it on food. According to the U.S. Census Bureau, the credit has already slashed food insufficiency by nearly 24% in the mere two months since families began receiving funds. While this is promising, it is important to note racial inequities in childhood hunger persist; for example, Black households report more than double the rate of food insufficiency of white households.
Approximately 40% of parents reported using most or all of their first CTC payment to pay down debts. One in ten parents put their first payment towards childcare. CTC payments are also positively impacting mental and emotional health by decreasing financial anxiety for over half of families surveyed by ParentsTogether Action. This is crucial as we know that families, those with young children in particular, have seen significant increases in mental health problems during the pandemic.
One million immigrant children lost access to the CTC in the 2017 Tax Cut and Jobs Act, and their families are unable to access this lifeline. Reinstating eligibility to receive the CTC will help these families provide for their children and aid in a more complete economic recovery.
2. Expand Medicaid and make the Children’s Health Insurance Program (CHIP) permanent.
Medicaid and CHIP enrollment is at an all-time high of over eighty million, with nearly ten million individuals enrolling since the beginning of the pandemic. This increase in coverage is an important step toward economic recovery for families, but there are still important coverage gaps to close.
Holdout states should take advantage of ARPA’s generous federal Medicaid matching rate (FMAP) increase and finally expand Medicaid. According to Community Catalyst, four million additional individuals would become eligible for coverage (60% of whom are people of color) if all 12 remaining states expanded Medicaid. Additionally, Congress must pass the HEAL Act and remove the five-year bar that prevents immigrants from accessing coverage.
It is past time to make the nearly 25-year-old Children’s Health Insurance Program that nearly ten million children rely on a permanent program. CHIP has reduced the rate of childhood uninsurance by nearly 70% since its creation and more than half its enrollees are children of color. Families are facing enough hardships right now – they don’t need to worry about whether CHIP funding will be renewed every few years.
3. Advance bold housing solutions that ensure every child lives in affordable housing.
Millions of families continue to struggle to afford housing with an estimated 11.4 million renters still behind on payments as of August 2021. The recent Supreme Court decision to overturn the Centers for Disease Control’s national eviction moratorium places families at risk. Large-scale evictions will deepen inequities and make families more susceptible to contracting COVID-19 and suffering other long-term adverse health outcomes.
It’s still too soon to measure the effects of ARPA on housing insecurity, but its Emergency Rental Assistance Program and Emergency Housing Vouchers are critical as many localities end eviction moratoria. To adequately address housing needs, Congress should expand rental assistance by $180 billion (which will fund 2.65 million new housing vouchers), invest $70 billion in public housing infrastructure, and provide $45 billion to the National Housing Trust Fund.
4. Invest in childcare and universal pre-kindergarten for three- and four-year-olds.
Childcare and early learning support the mental and emotional health of children and the ability of parents to pursue work or their own education. Free public early education and care are not universally available in the U.S. until a child enters kindergarten. Across the country, the cost of child care routinely consumes a significant proportion of household budgets and less than one in seven eligible children are able to access childcare vouchers due to limited funding and availability. Childcare is one of the lowest paid professions in the U.S., and providers often struggle to afford the costs of supplying high-quality care while staying afloat – a concern that has been exacerbated by the pandemic. These inequities disproportionately impact women and families of color.
Investing in a high-quality childcare infrastructure that supports families and providers and is truly accessible – affordable and available when parents need it – is critical for ensuring a healthy population and thriving economy. Building on relief provided to the childcare sector in ARPA, Congress should invest at least $450 billion in childcare and early learning over the next ten years. This infusion would make care accessible for low- and middle-income families, enable providers to match the cost of high-quality care, and compensate the childcare workforce with sustainable living wages. Furthermore, the majority of this investment should be used to implement universal pre-kindergarten for all three- and four-year olds. When fully implemented, these expansions would improve the lives of an estimated 8.27 million children.
5. Increase and streamline access to federal nutrition assistance for families to curb high rates of food insecurity.
During the pandemic, researchers estimate that food insecurity more than doubled. An unprecedented nearly one in three U.S. families with children experienced food insecurity during COVID, with the sharpest increases among children of color. Federal nutrition assistance programs, including the Supplemental Nutrition Assistance Program (SNAP), the Special Nutrition Program for Women, Infants, and Children (WIC), the Child and Adult Care Food Program (CACFP), and school meals programs, are evidence-based solutions for reducing food insecurity and improving health.
It is critical that Congress solidifies the Pandemic-Electronic Benefit Transfer (P-EBT) in the reconciliation package to provide financial resources for food to families who lost access to school and childcare meal programs. Additionally, program administrators must continue efforts to reduce barriers to enrollment and access for nutrition assistance programs.
Congress must act swiftly to advance policies that promote health equity for children and families. Building back better means ensuring that all children have opportunities to thrive and reach their full potential. This is a once-in-a-generation moment to invest in the prosperity of our children.
Allison Bovell-Ammon is Director of Policy Strategy at Children’s HealthWatch
Charlotte Bruce is a Research and Policy Analyst at Children's HealthWatch