ATTENTION: This is a beta website, the final version will look significantly different. Thanks for bearing with us while HJM is under construction! Posts can now be found here.

The State of America’s Children

February 4, 2020

Topics: Quote of the Day

Children’s Defense Fund, February 3, 2010


For years our country has fallen short of its promise to its children, and as we enter a new decade, the situation for many children is only growing more dire.

One in six children in America lives in poverty, with income inequality having grown to the widest gap our nation has seen in 50 years. Millions of children are homeless and millions more are just one missed paycheck away from losing their homes. Far too many children lack access to quality early childhood care during the most critical years of brain development. For the first time in a decade, the number of children without health coverage is on the rise. And across the country, from urban centers to rural towns, our nation’s gun violence epidemic is killing more children, more often.

Even more damning is that as we reach a critical turning point in 2020, when children of color will become the majority of children in America, we are failing these children worst of all.

Of the nearly 12 million children living in poverty, 73 percent are children of color. One in six children in America lives with food insecurity, with Black and Hispanic children twice as likely to not have enough nutritious food to eat. Our schools have slipped backwards into deep and damaging patterns of racial and socioeconomic segregation, perpetuating achievement gaps. Children of color are targeted by a discriminatory school discipline and youth justice system that fuels a cradle-to-prison pipeline. At our borders and around the country, we tear immigrant and refugee children from their parents and put them in cages.

This is why 2020 is such a crucial year for this country and our children. We have an opportunity to decide who we are. Are we a nation that delivers on its promises to its children? Are we a country that abandons and neglects our most innocent and vulnerable citizens? Are we a society that not only condones but promotes a cycle of poverty that prevents millions of children from ever having the chance to live up to their potential?

We know that to succeed, children need stable homes, quality health care, ample nutritious food, good schools, safe neighborhoods, and access to resources and opportunities that enable them to reach their potential. This report makes it clear that for too many of our children, especially children of color, these basic building blocks are out of reach.

And yet, in the wealthiest nation on Earth, the proportion of federal dollars invested in children has fallen to its lowest level in a decade. The shameful state of our children is not an inevitability—it is a choice. We don’t lack the resources to make sure every child has a chance to succeed. We just choose to invest them elsewhere.

Within this report you will find stories of real children and families, as well as statistics, data and trends that show in the clearest terms how we are failing our children. We have provided the latest available information on the state of America’s children across a range of issues that impact their lives, from poverty, housing and hunger to health and welfare to gun violence. Because immigrant and refugee children have faced particularly cruel attacks that impact them in a variety of ways, we have included spotlight features throughout each chapter of this report to demonstrate how our current policies are harming these children.

While there are promising proposals and signs of meaningful progress in many areas, our steps forward are too small and too slow compared with the obstacles and barriers our children face because of our collective inaction. As a result of our continued failings, the state of our children is unjust, unacceptable and short-sighted. We neglect our children at our own peril.

We urge advocates, policymakers, parents and families, community and faith leaders, educators and all those who stand up for our children to use the information in this report to push for America to make a different choice. Let us choose, finally, to recognize that every single child is precious and full of potential. Let 2020 be the year we give every single child the chance to succeed.

Alarming Coverage Declines After Decades of Progress

After decades of hard-fought progress to expand access to comprehensive, affordable health coverage for children through expansions of Medicaid, the Children’s Health Insurance Program (CHIP) and the Affordable Care Act (ACA), our nation had brought the rate of uninsured children to a record low. But children’s health coverage is sliding perilously backwards: 2017 and 2018 marked the first increases in the number of uninsured children in the U.S. in a decade.

  • In 2018, 1 in 18 children under age 19 were uninsured—nearly 4.3 million. School-aged children (ages 6-17) represented more than 3 million of the nearly 4.3 million uninsured children in 2018.
  • The number of uninsured children in the United States increased by 425,000 between 2017 and 2018.
  • Children’s coverage losses were widespread, with 15 states showing statistically significant increases in the number and/or rate of uninsured children—Alabama, Arizona, Florida, Georgia, Idaho, Illinois, Indiana, Missouri, Montana, North Carolina, Ohio, Tennessee, Texas, Utah and West Virginia. Only one state—North Dakota—made positive progress.
  • Following steady increases in child enrollment in Medicaid and CHIP since 2007, 2017 was the first year to not see an increase despite a strong economy. Child enrollment in Medicaid and CHIP decreased by over 828,000 between 2017 and 2018, a 2.2 percent decline in only one year.
  • These programs provide lifelong benefits that far outweigh the short-term costs. The National Bureau of Economic Research compared children eligible for Medicaid during childhood with those not eligible and found Medicaid-eligible children were more likely to attend college and make greater contributions as adult taxpayers.
  • States that have not expanded Medicaid to parents and other adults under the Affordable Care Act have seen increases in their rate of uninsured children three times as large as states that have.

The increase in uninsured children and decrease in Medicaid and CHIP enrollment has been attributed to a number of factors, including unnecessary paperwork and bureaucratic red tape that make it harder for families to enroll or renew their eligible children in Medicaid or CHIP. But these factors also include attempts to repeal the ACA and deeply cut Medicaid, such as cutting outreach and enrollment funds, eliminating the ACA’s individual mandate penalty and creating a pervasive climate of fear and confusion for immigrant families. The latter has left many of these families reluctant to enroll their citizen children in public coverage for fear of having it held against them or seeing their families ripped apart.



By Don McCanne, M.D.

How can President Trump boast about the state of the union when he neglects the state of our children? The future of the nation is dependent on our children. The current status cries out for public policies, yet the president is moving the process backwards, particularly evident in the decline in health care coverage for children.

It is rumored that he is going to boast about his health care proposals while condemning socialism in health care – specifically condemning Medicare for All. It is reported that his speech writing team is supervised by Stephen Miller. We should listen carefully to his rhetoric that is devoted to the children, and then see whether or not he follows through on it. What future will our children have under this president?

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

See All Posts

You might also be interested in...

© Health Justice Monitor
Facebook Twitter