Guest Commentary: Prioritize children, feed families and strengthen the nation
Dr. Kara Odom Walker is the executive vice president and chief population health officer for Nemours Children’s Health. Dr. Kirk Reichard is the surgical director for perioperative services and clinical director for pediatric surgery at Nemours Children’s Hospital, Wilmington, as well as the president of the Delaware chapter of the American Academy of Pediatrics.
Since early 2020, the COVID-19 public health emergency provided the federal government flexibility to modify a broad range of programs affecting child health, including Medicaid and the Supplemental Nutrition Assistance Program (SNAP), making health care coverage and healthy food more accessible to children and families across the country. However, with these enhanced benefits being terminated, the stability of many families already struggling to make ends meet is now under threat.
Medicaid health coverage and SNAP’s nutritional assistance are critical safety net programs that support and advance the health of millions of families. In Delaware, 39.2% of children are enrolled in Medicaid or the Children’s Health Insurance Program, and 1 in 9 Delawareans received SNAP benefits in fiscal year 2022. Families in the First State depend on SNAP to help them feed their children, with 68% of SNAP participants being families with children.
Supplemental Nutrition not only alleviates food insecurity but also helps lift more families with children out of deep poverty than any other government assistance program. It is particularly important for minority households, as families of color are more likely to be food-insecure, and even short periods of food insecurity can have lasting negative consequences for children’s health.
Some expanded food benefits through SNAP have already ended. Pandemic-era temporary emergency allotments allowed states to provide federal funds of at least $95 per household and reduced the likelihood of a household experiencing food insecurity by around 9%. Effective March 1, the ending of these allotments, combined with inflated food prices and utility costs, have already created a substantial hunger cliff across the country, including in Delaware, where it is estimated that 1 in 7 children face hunger. Black and Hispanic households have been hit the hardest.
Now, the unwinding of the health emergency, coupled with the ending of pandemic-era Medicaid continuous enrollment, is predicted to have a detrimental impact on the health of children nationwide. In addition to reduced nutritional benefits, millions of children and families face potential health coverage losses.
Recent estimates from the Department of Health and Human Services and the Kaiser Family Foundation found that 15 million to 17 million people will no longer qualify for health coverage. Children will be disproportionately affected, as an estimated 5 million kids are expected to lose Medicaid/CHIP coverage. Data show that children with health care coverage are more likely to use preventive health care services, have higher educational attainment and grow up to be more economically secure than uninsured children.
Families need these benefits, which is why we are calling on the U.S. Congress and state legislators to take immediate action to protect America’s children.
At the federal level, Congress should strengthen SNAP by reauthorizing the Farm Bill with policies that support families’ access to nutritious foods to help their children grow up healthy. Specifically, the Farm Bill should improve equitable access to healthy food options, such as fruits and vegetables, both online and in stores. Other policies to prioritize health should include investing in nutrition research with a focus on research that leads to improved health outcomes through SNAP participation and expanding nutrition education to reach more communities, including underserved communities, across the country.
At the state level, Medicaid agencies should continue to collaborate with a variety of stakeholders — including children’s hospitals — on strategies to avoid potential coverage losses and monitor the impact of Medicaid redetermination. States should follow the research to help identify the most effective and scalable outreach strategies. Further, states should consider policy options, such as express lane eligibility, to reach more children who qualify for Medicaid. Express lane eligibility would allow states to identify, enroll and recertify children in Medicaid if they are eligible for other federal programs, including Supplemental Nutrition. States have an important opportunity to review and enhance their Children’s Health Insurance Programs to ensure more children have access to health care.
Policymakers must continue to prioritize building a strong foundation of lifelong health and well-being for children by maintaining critical support in health insurance and nutritious food. Collectively, we should strive to help create the healthiest generations of children. This is what it means to go well beyond medicine — our nation’s future depends on it.
