The people behind them include former state child welfare directors, family defense attorneys, parent advocates, and conservative policy experts. Many of them have spent their careers trying to keep children safe and families together. I share their goal: fewer children separated from their families when they could safely stay home.

But both reach for the wrong tools and, I believe, capitulate too easily.

For example, each would arbitrarily cap Title IV-E funding, the federal government’s largest child welfare funding stream and the one that, for more than four decades, has grown when children and families needed it to.

UFA would cap nearly all of it. That is a mistake that has been made or attempted many times before, and children paid for it.

Although BPC keeps adoption, guardianship, and prevention as entitlements, it caps foster care and administration in a single formula grant. BPC would adjust the grant for the cost of living, but that is not enforceable and a formula set in advance is still a cap: it may or may not grows by arithmetic, but definitely not with need. Once the principle is conceded, the rest is a matter of time and the next budget deal. BPC also suggests some changes to Medicaid that I believe should be rejected outright (but more on that in a forthcoming blog).

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Some Truths That Should Govern This Debate

Before arguing about federal funding formulas, we should agree on what is true and be sure to keep children centered in this debate.

Child welfare is often argued in black and white terms. One side says the system tears apart too many families and should be dismantled. The other says it leaves too many children in danger and should act sooner. Each is describing something real, and each, taken alone, would hurt children.

The right answers in this field are almost always somewhere in between or in the “grey zone.” Solutions require balance, judgment, and the humility to hold several truths at once. Any proposal that promises a simple fix, whether abolition, more removals, or a single financing formula, should be met with skepticism.

These truths are uncomfortable for nearly everyone. Good policy should honor them.

• Some parents do monstrous things to their children. In 2024, 1,773 children died from abuse or neglect in this country, most of them babies and toddlers. Protecting children from the people who would harm them is a core parens patriae duty of government, not an optional one.

• Families are best for children, and the system too often fails the children it removes. Too many children are taken from homes that could have been made safe, then moved from placement to placement, school to school, until some age out with no family to call their own.

• Poverty is not neglect. A family that cannot pay the rent, keep the heat on, or find child care needs support and assistance, not an investigation.

• Children are not property, of their parents or of the state. They are people with fundamental rights of their own.

• Yet children in our society lack fundamental rights, protections, and voice, including in the child welfare system. Too many children go through child welfare and court proceedings that will decide their lives without their voice and concerns being considered.

• Parental rights deserve respect and protection, but never in a way that enables, facilitates, or shields child abusers. Laws are being proposed at the federal and state levels that codify parental rights in a manner that can threaten children’s health, education, safety, and well-being.

• Outcomes for abused children are deeply troubling, both for those left in abusive homes and for those in the care of the state.

• We should invest far more in prevention, meaning the prevention of abuse and neglect themselves, not just the prevention of foster care placements.

• Child welfare should not be a silo. Child and family well-being is the shared responsibility of many systems: health care, mental health and substance abuse treatment, housing, hunger, and income supports. Child welfare cannot do it alone, and should not be left to try. Reducing child poverty, homelessness, and hunger lowers family stress, and with it both abuse and the neglect cases that pull families into the system.

• This is not a zero-sum game. In a 2022 poll by Lake Research Partners, the American people believe we spend too little, not too much, to address child abuse (66-7%), child poverty (66-10%), homelessness (65-8%), hunger (64-5%), and mental health care (66-9%). By overwhelming margins, the public supports greater investments. Reformers who accept a fixed pot have conceded something the public never asked them to.

• The system should be judged by how children fare, not by counts of removals, caseloads, or dollars moved between funding streams.

• The people who live it belong at the table. Young people and parents who have been through the system know what works and what harms, and policy written without them shows it.

Where They Are Right

Let me start with what these proposals get right.

Too many children are removed from their homes. Most removals are for neglect rather than abuse, and neglect is too often a stand-in for poverty: no stable housing, no child care, a utility shutoff, or an untreated illness. Neglect often involves real problems, like parental substance use or untreated mental illness. But it is also deeply entangled with poverty: families without stable housing, child care, or affordable treatment are far more likely to be reported, investigated, and separated. That burden falls hardest on Black and Native families. Black children are about 14% of the nation’s children but 22% of children entering foster care. Native children are 1% of children and 3% of entries.

The UFA framework also contains reforms that should be supported:

• A real right to counsel for parents and children, including before a case is filed, funded outside the child welfare agency

• An end to billing parents for their children’s foster care

• An end to agencies taking foster children’s Social Security benefits to pay for their own care

• Equal support for relatives who take in children, whether through licensing or TANF

• Cutting the tie between foster care eligibility and 1996 welfare rules

The diagnosis is largely right. Most of the remedies are right.

The major problem with the proposal is its financing mechanism, and none of these reforms requires it.

Protecting Children from Harm Is Not Optional

There is another truth that belongs in this debate, and it is too often left out. Child abuse is real and far too common. It creates lifelong and intergenerational harm, and even leads to death.

In 2024, state child protective services confirmed 532,228 children as victims of abuse or neglect. That year, 1,773 children died from maltreatment, most of them babies and toddlers. Researchers and federal auditors have long warned that fatalities are undercounted. Behind every one of those numbers is a child who needed an adult to step in, and too often no one did in time.

A September 2026 audit by the Department of Health and Human Services (HHS) Inspector General found that Arkansas’s child abuse hotline screened out a report from an 11-year-old who said a family member had raped her, because staff thought a young child might not understand the word “rape.” Auditors estimated that an astounding 99% of the reports Arkansas did accept failed at least one requirement for screening, safety assessment, or investigation, and the state cited heavy workloads and staffing shortages. A financing system that rewards states for reducing caseloads, with no room to grow when need does, makes failures like these more likely, not less.

The disparities run in this direction too. Black and Native children are the most likely to be investigated and removed. Black children are also the most likely to die from maltreatment: 548 Black children died in 2024, more than children of any other race, at a rate of about 6 per 100,000. The same families harmed by over-surveillance are also failed when real danger is missed. Both things are true, and a just system has to answer for both.

The harm does not end when the abuse does. Physical abuse, sexual abuse, and severe neglect change how a child’s brain and body develop. They show up years later in school, in mental and physical health, and in the next generation. Children who cannot safely stay home need a real place to go: a relative who is supported, a foster family that is trained and paid fairly, a therapist who takes Medicaid, and a caseworker with a caseload small enough to actually see them.

Conservatives who warn about children left in dangerous homes are right to do so. Family advocates who warn about children torn from loving but poor homes are right too. The answer is neither “abolish” nor “remove when in doubt.” It is a system funded well enough to tell the difference, and to act on it: support for the family that is struggling, protection for the child who is in danger.

In the closing section of the report by the Commission to Eliminate Child Abuse and Neglect Fatalities, Commissioner Jennifer Rodriguez wrote:

We need to invest in rigorous research to develop a knowledge base about the services, supports, and interventions that support families in healing and health. We must offer vulnerable families who are devastated by the impacts of mental illness, substance abuse and poverty concrete resources such as immediate access to mental health and substance abuse treatment that allows parents and children to remain unified, subsidized high quality childcare, and in home supports in lieu of removal whenever possible. And we must engage and listen to the voices of families and youth about what is working, what is needed, and what is not helpful.

That is also why the child welfare financing structure matters. Need in child protection is not predictable. The opioid epidemic drove foster care numbers up for five straight years in the last decade. As the number of children in care rose, so did federal Title IV-E foster care funding. A capped grant would not have grown with the rise in need. No formula written in 2026 can know what the next crisis will bring. When need rises, an entitlement grows to meet it. When need outruns the arbitrary cap, states are forced to choose which children to protect. A child’s safety should not depend on whether a block grant formula guessed right.

What the BPC and UFA Proposals Actually Do

Today, Title IV-E is an open-ended entitlement. When a state spends on foster care, adoption assistance, guardianship, or, since the Family First Act of 2018, prevention services for eligible families, Washington pays a share. No one has to win an appropriations fight for that money to grow when need grows.

Yet, the UFA framework would replace that guarantee with three capped grants:

• Child Protection: $9.5 billion, consolidating IV-E foster care, adoption assistance, and guardianship assistance

• Family Legal Representation and Court Improvement: $545 million

• Family and Community Support: about $1 billion, consolidating Title IV-B, IV-E prevention, and adoption incentives

Adoption subsidies are long-term commitments to families, often raising children with disabilities. Under UFA they would be paid out of a fixed pot. So would prevention, frozen at $203 million, which is simply what states drew before the program had fully ramped up. UFA concedes this in a footnote: folding IV-E prevention into the new grant “would mean capping it.” Its answer is a recommendation that allocations “account for increased use.” That is a hope, not a mechanism.

Although BPC keeps adoption, guardianship, and prevention as entitlements, it caps foster care and administration in a single formula grant. Once the principle is conceded, the rest is a matter of time and the next budget deal. There is a long, sad history of how capped programs fare for children.

UFA argues that “a central policy question is not whether funding is in an entitlement structure or not, but whether it is stable, transparent, and designed and actually used by states to support better outcomes.” But stability is precisely what the entitlement provides and the adoption of an arbitrary cap takes away. For the children who will need help in the next economic recession, the next drug epidemic, or natural disaster, the structure is the question.

Furthermore, at First Focus on Children, we just released Children’s Budget 2026, which shows that federal spending for kids dropped to just 8.43% in 2026. The Committee for a Responsible Federal Budget (CRFB) has identified the following structural mechanisms that have shortchanged children in comparison to adults and senior citizens. They include:

• While much of spending on adults is mandatory, spending on children is disproportionately discretionary and thus must be reviewed and renewed through the appropriations process every year.

• Spending on children is disproportionately temporary and requires far more regular reauthorization than programs for adults, making it perpetually vulnerable to shifting political winds.

• Spending on adults is rarely limited while spending on children is often capped, constraining what can be spent for most major children’s programs even when need is high.

• Most programs for children lack built-in growth, which causes spending on children to erode relative to spending on adults and relative to the economy over time.

Both BPC and UFA would embrace these very structural mechanisms that have historically shortchanged children.

Another Premise Is Wrong

The case for a cap in foster care funding also rests on a claim: that open-ended federal money pulls states toward removing children. As UFA board member Andrew Brown of the Texas Public Policy Foundation put it to The Imprint, federal funding “rewards family separation.”

The Administration’s own numbers say otherwise. In August, the Department of Health and Human Services (HHS) published a brief on how much of foster care Washington actually pays for. Because eligibility is still tied to 1996 welfare rules, only 33% of children in foster care received a IV-E maintenance payment in FY2024, down from 40% just five years earlier. Counting every child states serve, the federal government covers about 21% of foster care maintenance costs.

In other words, for every dollar a state spends to feed, clothe, and house a child in foster care, the federal government pays about 21 cents. That is a weak pull. It begs the question: “Does it pull at all?”

After comparing each state’s effective federal share, from HHS’s own tables, with how often that state removes children, there is no relationship.

For example, according to HHS, the federal government pays about 7% of Nebraska’s foster care maintenance costs, yet Nebraska removes children at 4.0 per 1,000. In contrast, it pays about 61% of Idaho’s, and Idaho removes children at 2.3 per 1,000. Across all states, those where Washington pays the least have a median removal rate of 3.8 per 1,000; those where it pays the most, 2.6.

This comparison cannot rule out every incentive at the level of an individual case, and removal rates are driven mostly by other forces: poverty, the opioid crisis (look at West Virginia), state law and practice. But those making the causal claim carry the burden of proof, and the federal government’s own data do not support it.

We Have Seen This Before

The proposals’ defenders say this time is different, because their grants come with protections: a hold-harmless so no state gets less than it does today, adjustments for inflation or population, and a state maintenance-of-effort requirement.

We have witnessed this rodeo before. TANF had those “protections” too. In 1996, each state’s TANF grant was built on its own past welfare spending, a hold-harmless in all but name. States had to keep spending 75-to-80% of what they had spent before, a maintenance-of-effort requirement. And the block grant was sold as a way to give states flexibility to do better by poor families.

Here is what happened:

• The federal grant has been frozen at $16.5 billion a year since 1996. Inflation has eaten roughly half its value.

• In 1996, TANF reached 68 of every 100 families with children in poverty, according to the Center on Budget and Policy Priorities (CBPP). Today it reaches about 21.

• Cash help to families fell to less than a quarter of TANF spending.

• In the Great Recession, unemployment doubled but TANF caseloads rose only about 15%. Congress had to pass emergency money because the block grant could not respond.

• Because each state’s grant was frozen at its 1990s welfare spending, the inequities of that era were locked in. Some states still receive several times more per poor child than others.

• Fast-growing states got extra “supplemental grants” to keep up with population growth. Congress let them expire in 2011.

• The TANF block grant not only locked in place vast historical funding disparities and has exacerbated them for children living in poverty.

The Social Services Block Grant tells the same story. It stood at $2.8 billion in the early 1990s. It is $1.7 billion today, before sequestration trims it further.

That last point matters. As Sean Hughes of Social Change Partners told The Imprint, capped programs are hit again and again by sequestration and funding freezes, while IV-E “has always been spared.” The entitlement is not just a funding formula. It is a shield.

And the protections being offered now are weaker than they look. UFA’s grants would be indexed to inflation and child population. Neither is guaranteed and neither tracks a surge in need. And as Wendy Henderson of Evident Change noted, a baseline set from today’s historically low foster care numbers means “a lot of states would end up frozen at a really low level of funding.”

During Senate floor consideration in 1995 of a proposal to convert Medicaid from an entitlement into a block grant and make it unresponsive to changes needs, Sen. Bob Graham (D-FL) told proponents of such a change:

I have a warning. . .or more accurately a proverb for them. The proverb goes as follows: Fish see the worm, not the hook.

The Real Fix

Here is the irony at the center of this debate. Title IV-E is already being capped, quietly, by the 1996 look-back.

A child qualifies for federal foster care support only if the family they were removed from would have been eligible for welfare under the rules each state had on July 16, 1996. Those income limits have never been adjusted for inflation. In Indiana, the limit for a family of three is $320 a month. Every year, fewer families fall below it, and the federal share shrinks. That is the same mechanism that hollowed out TANF: a fixed number left to erode. That is not a model to copy. It is a warning.

Congress knows how to fix this kind of problem. A bipartisan bill, the SSI Savings Penalty Elimination Act, led by Sens. Catherine Cortez Masto (D-NV), Bill Cassidy (R-LA), Ron Wyden (D-OR), and Susan Collins (R-ME) and Reps. Danny Davis (D-IL) and Brian Fitzpatrick (R-PA), would update SSI’s asset limits, frozen since 1989, and index them to inflation going forward.

As Michele Stockwell, President of Bipartisan Policy Center (BPC) Action, put it:

BPC Action commends this effort by Sens. Cortez Masto (D-NV) and Cassidy (R-LA) and Representatives Davis (D-IL) and Fitzpatrick (R-PA) and urges Congress to act on long-overdue bipartisan measures to empower seniors and Americans with disabilities enrolled in Supplemental Security Income to increase their household savings.

At First Focus Campaign for Children, we agree wholeheartedly. No one should propose capping SSI because its asset limit is outdated. The answer is to fix the limit or arbitrary cap. The 1996 Title IV-E look-back deserves exactly the same treatment.

The child welfare financing proposals cited above take the opposite approach. They look at a program starved by a 30-year-old rule, conclude the entitlement is broken, and propose to cap it for good. That gets the diagnosis backwards. The erosion is a reason to repair the entitlement, not to give it up and make the inadequate financing problem even worse.

The erosion may also explain why some see a block grant as worth considering: if your federal share has shrunk, locking in today’s amount can look like a good deal. But the long history of block grants says otherwise, and ending the look-back would remove that temptation entirely.

There is a better path, one that rejects the zero-sum, austerity mindset that we as child advocates accept far too often. Congress should end the look-back and several of the things that these reports propose, without a newly imposed arbitrary cap:

1. End the 1996 look-back so IV-E reaches every child in foster care, not one in three. There are several ways to do this, from updating the 1996 income limits, to tying eligibility to a share of the poverty line, to dropping the income test entirely, each with different costs and options for phasing in.

2. Fund a right to counsel for parents and children with new money, not money taken from foster care and adoption.

3. End the taking of foster children’s Social Security benefits and the billing of parents for foster care.

4. Pay relatives fairly when they step in to raise a child.

5. Make prevention work: fix the evidence-review bottleneck that keeps proven services from being approved, and let the new federal match do its job.

6. Leave Medicaid’s EPSDT guarantee alone. BPC’s plan to define “medical necessity” with a list of services would turn a floor into a ceiling for every child on Medicaid. That should be rejected but deserves its own discussion in a later blog.

That is a bipartisan reform bill for child welfare. It does not need a block grant to pass, and it does not need one to work.

But these changes are not enough. The deeper problem is that the system is organized around adults: agencies, courts, funding streams, and the rights of parents. Children are too often the subject of the proceedings rather than people with rights in them. Three changes, for example, would help put children at the center:

1. Adopt a national child poverty target. The United Kingdom and Scotland wrote child poverty targets into law, and Canada did the same for poverty overall; both then measured progress against them. We cut child poverty nearly in half in 2021, then let it rise again when the expanded Child Tax Credit expired. A binding target would make reducing child poverty, and the family stress and neglect cases that come with it, a standing national commitment.

2. Create an independent Children’s Commissioner. The Child Safety and Well-Being Act of 2026, introduced by Sen. Ed Markey and Rep. Morgan McGarvey, would establish one: an independent office to investigate system failures, hear directly from children, and hold federal and state agencies accountable when they fall short, just as they do in countries across the world.

3. Enact a Children’s Bill of Rights. Many states have adopted bills of rights for children in foster care, and there has been a federal bill as well. Every child who comes into contact with the system should have rights that are written down and enforceable: to safety, to a lawyer, to stay connected with siblings and family, to a stable school, to health care, and to be heard in decisions about their own lives.

The question at every step should be the one we ask about every policy: “Is it good for the children?” The child welfare system exists to protect the rights, safety, and voice of children. It is time we built it that way.

We Have Stopped Asking for Enough

I began this blog with the truths that should govern this debate because none of them can be honored with a blunt instrument. Children need protection from harm, and they need their families. Good policy refuses to trade one for the other.

A capped grant fails children on both counts. When money runs short, states pay first for what the law requires: court-ordered placements, adoption subsidies already promised, investigations. What gets squeezed is the voluntary help that keeps families together. And when the next crisis drives up serious abuse, a fixed pot cannot grow to meet it.

The deeper problem is in our own field. Too many of us have stopped believing Congress will ever invest new money in children, so we offer to trade away the guarantee in exchange for flexibility. That is negotiating against ourselves before the conversation begins. We should be asking Congress to fix the entitlement, not volunteering to dismantle it.

To my colleagues in the child advocacy community making these proposals: keep the reforms. Drop the cap, and leave Medicaid’s guarantee for children alone. To Congress: a bipartisan bill is sitting in plain sight. It should center children and reject funding mechanisms like block grants that shortchange them.

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We recently released our analysis for the 119^th Congress, for the period between Jan. 3, 2025, and Sep. 8, 2026. These are the two years in which our nation’s leaders made some of the most consequential decisions affecting children in a generation.

The answer is sobering. But it is also, in its own way, hopeful.

This year’s Scorecard recognizes 120 Champions and Defenders of Children — 60 Champions and 60 Defenders, 40 senators and 80 representatives — who repeatedly used their voices, votes, and leadership to put kids first. In a Congress where children were too often treated as an afterthought, or worse, as a target, these members made children a first focus.

As always, the Scorecard is about two things: accountability and gratitude.

It is meant to thank those who lead for children, to encourage others to do more, and to insist that every member of Congress take their obligation to the next generation seriously. And with the midterm elections less than a month away, it is also something more: a record voters can use to decide who has earned the right to keep representing their children.

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A Congress That Failed Children

Let us be blunt. The 119th Congress did not treat children as a national priority.

The share of the federal budget devoted to children has fallen from 12.16% in fiscal year 2022 to just 8.43% in FY 2026 – a more than 30% reduction.

Instead of reversing that decline, congressional leadership and President Trump enacted legislation last year that slashed Medicaid and SNAP — two of the most important lifelines for children — and moved to weaken or dismantle the Department of Education, the Department of Health and Human Services (HHS), the U.S. Agency for International Development (USAID), and other agencies that exist to serve and protect young people.

The roll call votes tell the story.

Over the full Congress, we scored 21 child-centered recorded votes (the Scorecard does not include voice votes). Setting aside one where our position was mixed, kids lost 19 of 20.

Many of those losses came down to a handful of votes. For example:

• The House passed the Rescissions Act of 2025, clawing back global health and humanitarian aid, by two votes, 214–212.

• Sen. Ron Wyden’s (D-OR) amendment to strike the budget instruction calling for $880 billion in Medicaid cuts failed 49–50.

• Sen. Susan Collins’s (R-ME) amendment to protect nearly $295 million for UNICEF was tabled 51–47.

• Sen. Mazie Hirono’s (D-HI) amendment to strike a private school voucher scheme failed on a 50–50 tie.

• Sen. Chris Van Hollen’s (D-MD) school meals amendment failed 48–50, and Sen. Angela Alsobrooks’s (D-MD) amendment to increase child care funding for families failed 47–51.

Meanwhile, House and Senate members introduced at least half a dozen bills and constitutional amendments to end birthright citizenship, a constitutional amendment on so-called “parental rights,” and bills to abolish the Department of Education outright.

The lone recorded vote victory for kids came when the House voted 280–142 for Rep. Anna Paulina Luna’s (R-FL) amendment to strip a liability shield for pesticide manufacturers, a bipartisan vote for children’s environmental health. But note: even that vote was only to maintain the status quo and keep things from getting even worse for kids.

Just 1 win in 20. This was not just a Congress of missed opportunities. It was a Congress that repeatedly made choices that left children poorer, sicker, and less secure.

That is precisely why the members who stood up anyway deserve our special thanks.

The Good News: A Roadmap Already Exists

The Scorecard isn’t only a record of what Congress did. It also highlights more than 250 bills that Congress could act on right now to improve the lives of children, the vast majority of which we support.

Over 70 of those had strong bipartisan support, but the vast majority of those were never brought to the House or Senate floor for consideration. For example, members of both parties have introduced legislation to improve the Child Tax Credit, improve children’s health coverage, address our maternal health crisis, make child care more affordable, reduce child hunger, protect the children of immigrants, and keep kids safe online and in school.

Kids don’t necessarily need Congress to invent new ideas. There already were a raft of bills in which there was common ground on bipartisan solutions for children. They just needed congressional leadership to bring the good ones to the floor and for members to “vote for kids.”

The 119^th Congress stands out as a Congress where that rarely happened. Child policy regressed far more than it advanced. This was a choice, and it needs to change.

Who Gets Recognized as Champions/Defenders

Fortunately, there were some important voices for good in Congress. The Scorecard draws a small distinction between our two honors:

• Champions for Children consistently pursued policies that put children first across a broad range of issues. If we were assigning grades, these members would get an A+.

• Defenders of Children repeatedly stepped forward to protect children from harm and to support their well-being when it mattered most. They would earn an A or A-.

Their work spans the full array of children’s issues: health, nutrition, child poverty, early childhood, education, child welfare, safety, immigration, and international policy. To name some examples:

• Sen. Cory Booker (D-NJ) and Rep. Rashida Tlaib (D-MI) stood out in the Senate and House, respectively, as the top point-getters in the session’s Scorecard by their work across the full range of issues of importance to children.

• Sen. Michael Bennet (D-CO) and Reps. Rosa DeLauro (D-CT) and Suzan DelBene (D-WA) led the American Family Act to restore a fully refundable Child Tax Credit.

• Sen. Andy Kim (D-NJ) introduced the MediKids Act to guarantee health coverage for every child.

• Reps. Morgan McGarvey (D-KY), Rosa DeLauro (D-CT), Jimmy Gomez (D-CA), Sara Jacobs (D-CA), and Rashida Tlaib (D-MI) and Sens. Ed Markey (D-MA), Ben Ray Luján (D-NM), Adam Schiff (D-CA), Chris Van Hollen (D-MD), and Elizabeth Warren (D-MA) introduced the Child Safety and Well-Being Act of 2026 to create an independent Children’s Commission, an institution in Washington whose job is to ask whether federal policy is good for children.

• Rep. Bobby Scott (D-VA), Rep. Katherine Clark (D-MA), and Sen. Patty Murray (D-WA) led the Child Care for Working Families Act.

• Rep. Nanette Barragán (D-CA) introduced the Children’s Health Insurance Program Permanency (CHIPP) Act.

• Sens. Catherine Cortez Masto (D-NV), Bill Cassidy (R-LA), Ron Wyden (D-OR), and Susan Collins (R-ME) and Reps. Danny Davis (D-IL) and Brian Fitzpatrick (R-PA) introduced the SSI Savings Penalty Elimination Act.

• Sens. Ed Markey (D-MA) and Bill Cassidy (R-LA) spearheaded the Children and Teens’ Online Privacy Protection Act (COPPA).

Children Are a Bipartisan Cause, Or At Least They Should Be

The Scorecard calls balls and strikes. Members earn points for sponsoring, cosponsoring, and voting for legislation that primarily or disproportionately affects children, and lose points for supporting legislation that harms them. Although Democrats make up the majority in this year’s Scorecard, every year, Republicans have earned recognition, and 2026 is no exception.

Before proceeding with that list, it is important to note that more Republicans would have been named if House and Senate leadership had chosen to bring more bipartisan pro-child bills to the floor rather than a slew of bills that were harmful. Those negative votes against children disproportionately hurt Republican members in the last two years. Again, this was a choice.

Yet, Rep. Brian Fitzpatrick (R-PA), once again the highest-scoring Republican, is a 2026 Champion for Children. He co-led the MODERN WIC Act with Rep. Suzanne Bonamici (D-OR), the Kids’ Access to Primary Care Act with Reps. Kim Schrier (D-WA) and Kathy Castor (D-FL), the Fairness to Kids with Cancer Act, the Mental Health Services for Students Act, and the Global Child Thrive Reauthorization Act, among others. He repeatedly chose to champion the needs and best interests of children in his work in the halls of Congress.

Sens. Susan Collins (R-ME) and Lisa Murkowski (R-AK) and Reps. Mike Lawler (R-NY) and María Elvira Salazar (R-FL) were also honored in the Scorecard. As an example, Sen. Collins joined Democratic appropriators and honorees like Rep. Rosa DeLauro (D-CT) and Sen. Patty Murray (D-WA) to protect many children’s programs from substantial cuts proposed by the President’s budget.

Children desperately need far more of this bipartisan engagement on their behalf. Kids are not a partisan issue, and they should never be a political bargaining chip.

To be clear, many members of Congress who are not on these Champions and Defenders lists took meaningful actions for kids, including behind-the-scenes work that is hard to score. We see them, and we are also grateful to them as well.

Women Continue to Carry the Load

As in every year, one of the most striking findings is the gender divide.

Women in Congress were 2.6 times more likely than men to be Champions or Defenders of Children. More than 39% of women in Congress earned the distinction. And women made up exactly half of the 120 honorees, despite holding just 28.8% of the seats in Congress.

The Congressional Mamas’ Caucus stands out even among high-performing women: its members were 2.6 times more likely to be Champions or Defenders than women outside the caucus.

Men Must Do Better by Children, but the Dads Caucus Is Stepping Up

In February, we wrote that the creation of the Congressional Dads Caucus was one of the most encouraging developments for kids in Congress. The full-Congress data makes the case even stronger. Men in the Dads Caucus were 5.7 times more likely to be Champions or Defenders than men outside it, up from 3.8 times in our first-session report.

Clearly, when men organize around fatherhood, children stop being “soft” issues and start becoming a priority. Kids don’t need men in Congress to be perfect. Just as members of the Dads Caucus are doing, children need more men to show up.

Where Kids Have Allies, and Where They Don’t

Map the Champions and Defenders, and a familiar story emerges: a child’s zip code shapes whether their members of Congress treat them as a priority.

• Northeast: 40.4% (44 of 107 members)

• West: 35.9% (33 of 91)

• Midwest: 17.0% (17 of 98)

• Southeast: 11.7% (16 of 135)

• Southwest/Plains: 11.5% (12 of 103)

As Bruce wrote this summer, the South is the only region of the country where the child population is still growing, and it is also the region with the worst outcomes for kids and the fewest leaders willing to fight for them.

The lowest-scoring members of Congress reinforce that pattern. Sens. Marsha Blackburn (TN), Cynthia Lummis (WY), Bernie Moreno (OH), Eric Schmitt (MO), and Rand Paul (KY), along with Reps. Ralph Norman (SC), Ben Cline (VA), Mary Miller (IL), John Rose (TN), Greg Steube (FL), Brandon Gill (TX), Andy Biggs (AZ), and Andy Ogles (TN). These members repeatedly sponsored, cosponsored, and voted for legislation that would cut children off from health care, take food from hungry kids, undermine public schools, and strip away the protections of citizenship.

If they simply asked themselves, “Is it good for children?”, they would have had to recognize that the answer was a resounding NO.

Consider Texas. It ranks 44th in child well-being in the 2026 KIDS COUNT Data Book, yet just three members of its delegation, Reps. Joaquin Castro, Veronica Escobar, and Sylvia Garcia, are Champions or Defenders. Thank you to all three, but they represent just 7.5% of the Texas delegation. Children desperately need Texas voters to send more pro-child congressional members to Capitol Hill to join Reps. Castro, Escobar, and Garcia.

In sharp contrast, Massachusetts ranks 2^nd in the child well-being index, and five of its members, or 45% of the delegation (6 times more likely to be a Champion/Defender than the Texas delegation), are recognized as Champions or Defenders. Thanks to Sens. Ed Markey and Elizabeth Warren and Reps. Jim McGovern, Ayanna Pressley, and Katherine Clark for their strong support of children. Massachusetts invests in its children, and its voters send policymakers to Congress that reflect that commitment to kids.

The link to child well-being holds more broadly in states all across the country. It should come as no surprise that in the 25 states ranked “best” or “better” for kids by KIDS COUNT, 28.6% of the congressional delegation were Champions or Defenders. In the 25 states ranked “worse” or “worst,” it was just 18.6%.

We should not overstate this. It isn’t a randomized experiment. But it points to something families already know: politics is part of the ecosystem that determines whether children thrive. Communities that prioritize children elect leaders who act like it, and leaders who prioritize children help build communities where kids do better.

We need to build more favorable social and political environments for children in many places across this country, but particularly in the Southeast, Southwest, and the Plains. Voters can make direct some of those decisions when they go the polls to elect for every member of the House on Election Day: Tuesday, November 3.

Why Gratitude Matters

If children had a vote, if toddlers had a PAC, if fourth-graders could flood Capitol Hill with lobbyists and campaign checks, we wouldn’t need a Scorecard to remind Congress that kids deserve attention.

But children don’t have those tools. So, we use the ones we do have.

Public gratitude is a form of political power. It tells lawmakers that showing up for kids isn’t invisible. It tells their staff that child-focused work is valued. And it signals to every other member of Congress that there is credibility and momentum on the side of putting kids first.

To our 2026 Champions and Defenders of Children: we are deeply appreciative. You made children a priority.

To those at the bottom of the list, we simply say, “DO BETTER.”

What You Can Do

Take five minutes today to look up your senators and representative in the Scorecard.

• If they’re a Champion or Defender of Children: Call their office and say thank you. Post on social media. Mention it at a town hall. Their support for kids should be recognized. Public reinforcement creates the incentive structure children cannot create for themselves.

• If they’re not on the list: Ask them why not, and ask them which of the hundreds of positive bills for children in the Scorecard they will commit to supporting in the next Congress.

• When you are voting this fall: Every candidate should have to answer this one simple question: “Is it good for the children?” When you look at their records, see whether their actions match their answer and whether they make children a priority in their work.

Kids can’t vote. But you can.

#VoteKids

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The numbers are damning. The children’s share of federal spending has fallen more than 30% since FY 2022, from 12.16% to just 8.43% in FY 2026. The decline is accelerating: the Trump Administration’s proposed FY 2027 budget would allocate just 7.90% to children.

Funding for children is being squeezed out and shortchanged by other rapidly growing sections of the budget. Under President Trump’s FY 2027 budget proposal, total federal spending would grow by more than $400 billion over FY 2026. In sharp contrast, spending on children would decline by $5.7 billion. While the federal budget would grow by hundreds of billions of dollars, children (who already start with a small percentage of funding) would be slashed.

On the discretionary side of the budget, defense spending claims 52% compared to just 7.26% for all children’s programs combined. Moreover, interest on the debt, which is a burden that our children will bear in the future, is one of the fastest growing line items in the federal budget and crowds out investments children need today.

Meanwhile, spending on children internationally — fighting childhood HIV, tuberculosis, and malaria, and protecting children from trafficking — fell from 0.09 cents to 0.06 cents of every dollar in federal spending. The Trump Administration’s FY 2027 proposal would cut it to 0.03 cents – a cut of two-thirds from FY 2025 levels.

What follows largely follows my message opening this year’s report.

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On the Wrong Path: Why the Federal Budget Keeps Failing Our Children

A few years ago, in these pages, I wrote that America’s children stood at a crossroads. That was generous. A crossroads implies a choice not yet made. Children’s Budget 2026 makes clear that the choice has been made, repeatedly, year after year — and it is the wrong path.

In fiscal year (FY) 2026, the federal government invested just 8.43 cents in children out of every dollar it spent. That is a drop of more than 30% from the FY 2022 peak of more than 12 cents, or 12%, when pandemic-era investments briefly gave children something a bit closer to their fair share.

Since then, lawmakers have let that support lapse, and the retreat has continued nearly every year since. If the Trump Administration’s FY 2027 budget proposal were enacted, the share would fall further still, to just 7.90%: the lowest level since the first Trump Administration, and a level not seen in years before that.

Children make up more than one-fifth of the U.S. population. Yet just about 1-in-12 dollars of federal spending is devoted to them. That gap is not an accident of arithmetic. It is a design.

A Budget Process Built to Forget Kids

Every year, I explain the same data points, and every year I’m asked the same question: why does this keep happening? The honest answer is that the federal budget process itself is stacked against children, in ways that have nothing to do with how much lawmakers say they care.

In contrast, most spending that benefits older Americans — Social Security and Medicare — is mandatory, grows automatically with need, is protected by law, and is insulated from the annual scramble of appropriations. Spending on children runs almost entirely the opposite way.

Spending on children is disproportionately discretionary, meaning it must be re-justified, re-appropriated, and re-fought every single year. It is capped where adult programs are not. It expires where adult programs renew.

As the Committee for a Responsible Federal Budget (CRFB) has documented for nearly a decade now, this isn’t a partisan tilt — it’s structural, and it produces the same result year after year: children’s programs erode while programs that don’t require annual permission slips keep growing.

You can see the mechanism in this year’s numbers. Mandatory spending on children — Medicaid chief among it — rose slightly in FY 2026, not because Congress chose to prioritize kids, but because demographic and economic need pushed enrollment up automatically.

Discretionary spending on children, the part that actually reflects a proactive choice by lawmakers, fell again. In FY 2026, children received just 7.26% of all discretionary spending, while defense claimed 52%.

The problem was never a lack of money. It was, and remains, a lack of will and a budget architecture that makes that lack of will almost automatic without anyone ever having to cast a vote against kids by name.

The Evidence Was Never the Problem

If the case for investing in children needed more proof, we have it. The strongest of it comes from economists who spent decades focused on what we would argue was the wrong question.

Instead of focusing on children themselves, for much of the last half-century, economic research focused on adults and on the narrow question of “does helping poor families discourage work?” It rarely asked what that help did for the children inside those families. That has changed.

As researchers Anna Aizer, Hilary Hoynes, and Adriana Lleras-Muney have found, by using better data and longer time horizons, research is increasingly finding that investments in children have a high rate of return and should reorder how Congress thinks about every dollar it puts into, or takes out of, children’s programs.1

As they write:

A new focus on the benefits of safety net programs on children — the intended beneficiaries of these programs — that incorporates evidence on their many long-term benefits can contribute to the design of better policies going forward.

For example, take Medicaid. Children who had access to coverage went on to enroll in college at higher rates, delay having children, and live longer as adults. They also paid enough in additional taxes over their lifetimes that the government recouped 58 cents of every dollar spent on their childhood eligibility, without even counting the other benefits. A separate study of the program’s earliest years reached an even starker conclusion: childhood Medicaid coverage saved more than twice its own cost.2

Take food assistance. Children with early access to food stamps went on to complete more education, earn more, live in better neighborhoods, and experience less poverty, less illness, and less incarceration as adults. Economists measure a program’s return using something called the “marginal value of public funds” — essentially, what a dollar of public spending is worth relative to what it costs. Counting only the program’s effects on the adults who received it, that figure is 54 cents on the dollar: a loss. Counting what it did for the children in those households, it rises to 56 dollars of value for every dollar spent.3

Take the Mothers’ Pension programs, an early form of public cash assistance that begin in 1911. Judged only by its short-term cost and its effect on the mothers who received it, the return looks weak — 84 cents on the dollar. Judged by what happened decades later to the children who grew up in those households — more schooling, more years of life, higher earnings — the return climbs above $5 for every dollar spent.4

The pattern holds across nearly every safety net program economists have studied closely enough to trace into adulthood: investments in children pay for themselves, in a way that investments aimed at adults typically do not.5

That is not a coincidence of the programs chosen for study. It is what happens when you measure the right thing over the right amount of time. Unfortunately, it is precisely what a 10-year congressional budget window is built not to see.

None of this required 2021 to prove that investments in children matter. But 2021 offered the clearest live demonstration: the temporary expansions of the Child Tax Credit, nutrition assistance, and child care support that year cut the child supplemental poverty measure (SPM) nearly in half, to a historic low of 5.1%. Then Congress let it all expire, and child poverty more than doubled to 13.4% in 2025.

Americans understand what happened, even if Washington has chosen to ignore it. In polling conducted by Lake Research Partners, voters have consistently expressed — by margins as lopsided as 12-to-1 — that they want more federal investment in children’s health, safety, and economic security, not less.6

The American people get it.

The Retreat Doesn’t Stop at Our Borders

The same wrong path shows up, even more starkly, in what the United States spends on children beyond its borders. In FY 2026, the share of federal spending devoted to children internationally fell by one-third, from an already meager 0.09% to just 0.06% of total federal spending. The Trump Administration’s FY 2027 budget would cut that in half again, to 0.03% — or 3 cents for every $100 the federal government spends.

These are not abstract numbers. The dismantling of the U.S. Agency for International Development (USAID) eliminated much of the infrastructure that delivered life-saving nutrition, malaria and tuberculosis treatment, and maternal and child health care to some of the world’s most vulnerable children. Public health researchers estimate 200,000-to-300,000 children have already died as a result,7 and a Lancet-published analysis projects that toll could reach 4.5 million children under 5 by 2030 if these cuts are not reversed.8

The justification offered for these cuts — that foreign aid was a meaningful driver of federal deficits — never held up. Foreign assistance made up roughly 1% of the federal budget before these cuts began. Eliminating it saved almost nothing and cost almost everything for the children who depended on it most.

A budget process stacked against children at home is stacked doubly against children who have no domestic constituency to speak for them at all.

What This Report Is For

Children’s Budget 2026 exists because someone has to keep counting. For more than 250 federal programs, across nearly every agency, we track what the government actually spends on kids — not what it says, not what it intends, but what shows up in the ledger.

Prior to our starting this project in 2008, presidents used to release their budget and declare they were doing right by children by pointing to a line-item or two for kids that were being increased even if other areas were being cut. Children’s Budget and its companion piece, Babies in the Budget, have told the real story – both good and bad – for nearly two decades now.

This year’s ledger tells a clear story: the country is no longer at a crossroads. Federal policymakers have chosen a path and have been walking down it for five straight years, and it is one that is rapidly disinvesting in our children, our future. Our publications tell that story and give the Children’s Budget Coalition and others the data to hold lawmakers accountable for doing better by our children.

Our Ongoing Budget Work Is Being Threatened

Unfortunately, our continued work (an entire staff effort) on the budget is endangered. Funding for the Children’s Budget, our leadership of the Children’s Budget Coalition, and our related analysis of Babies in the Budget has declined sharply in the last two years. Without replacement support, our analysis of federal spending on children internationally will likely end after our funding for that work expires at the end of the year.

If you value an independent voice and analysis of how budget decisions affect children across the federal government, please consider supporting First Focus on Children. Your donation and support help us keep producing the evidence advocates need to hold policymakers accountable.

Donate to First Focus on Children

Choose a Different Path

In the U.S., children are not allowed to vote and do not have dedicated Political Action Committees (PACs), membership groups, or lobbyists demanding attention to their best interests and well-being. They rely on adults and child advocates like us to insist that their needs and best interests count.

To do so, we need to choose a better path. But that choice will not make itself. It will take the same thing it always has: people who refuse to let children be cast aside as an afterthought in our political system and budget process.

Congress and the President must reverse this trend now. Every one of these numbers that I have cited is a choice, and every one of them can be chosen differently in the next appropriations bill, the next budget, the next reconciliation package.

If we care about our kids and their future, we must demand that our politicians and policymakers do better.

Kids can’t wait.

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Endnotes

What I am referring to is the remarkable destruction of the Kennedy family legacy taking place across the Administration over the last 22 months.

As a child, my three favorite presidents in our history were Abraham Lincoln, Franklin Delano Roosevelt, and John F. Kennedy. In JFK’s case, it wasn’t so much the allure of Camelot but the ideas and belief that public service could be an expression of optimism – a “New Frontier”, as he put it, where government and citizens could accomplish important things together.

Today the Kennedy legacy is sometimes associated with places, such as the John F. Kennedy Presidential Library and Museum, the Kennedy Center, the White House Rose Garden, and the eternal flame at Arlington Cemetery. But the family’s greatest successes were not made of marble or stone, but of the programs, institutions, vision, and hope brought to the country and to people around the world.

There were institutions built around a particular idea of America: that government could summon people to serve something larger than themselves, that poverty should not determine a child’s future, that people with disabilities deserve dignity and opportunity, that health care is a fundamental right, that science should improve human lives, that justice should not depend on whether someone can afford a lawyer, and that America’s responsibility is global.

This legacy is one of family – belonging to JFK but also his brothers Robert F. Kennedy and Ted Kennedy, Eunice Kennedy Shriver and Sargent Shriver, Jacqueline Kennedy, and others who turned a famous family into institutions that have endured for generations.

This is one of the least discussed and most disturbing features of the Trump Administration: it seems to have targeted the Kennedy legacy directly. One by one, an extraordinary number of those institutions have been eliminated, cut, threatened, transformed, or diminished.

The Trump Administration’s first term targeted Special Olympics, a program founded by JFK’s sister Eunice. In the current term, the first target was the foreign aid agency President John F. Kennedy created: the U.S. Agency for International Development (USAID). Next came the memorial to JFK, now shuttered and under threat of demolition because a court won’t let Trump put his own name on it. Head Start, the program JFK’s brother-in-law launched, is being hollowed out by a rule written inside the very department Kennedy runs. Medicaid and CHIP, legacy items of JFK’s brother Ted, are being gutted with RFK Jr. at the helm. And even the MAHA movement RFK Jr. built has been turned into a corporate trade show.

Maybe it’s a coincidence. Maybe it’s just Trump being Trump. But taken together, it looks a lot like the President has gone out of his way to destroy the Kennedy legacy and even troll his Health Secretary.

Even Jackie Kennedy’s Rose Garden is gone.

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The Monuments We Can See

“I look forward to an America which will not be afraid of grace and beauty. . . .”
— President John F. Kennedy, Amherst College, October 26, 1963

Although the Rose Garden may seem trivial compared to some of the other issues I will raise here, for more than six decades, its central lawn provided the setting for presidential announcements, bill signings, ceremonies, diplomatic events, and moments of national celebration and mourning.

Throwing aside that history, the Trump Administration replaced the Rose Garden with a Mar-a-Lago style patio of cement and stone paving. While a garden and lawn can be replanted, what is lost will be much harder to restore.

Even worse is the destruction of the John F. Kennedy Center for the Performing Arts. Trump removed members of its board, appointed himself chairman, and presided over a fundamental change in the direction of the institution created by Congress as the nation’s living memorial to John F. Kennedy. Trump pushed to rename it the “Trump-Kennedy Center” and bolted his name onto the building.

U.S. District Judge Christopher Cooper ruled that only Congress can change its name. The Trump-appointed Board tried again with a “President Donald J. Trump Plaza” out front, which Judge Cooper blocked as well.

Today the Kennedy Center is closed, and the President is threatening its outright destruction.

Even the John F. Kennedy Presidential Library and Museum was not immune. Federal workforce reductions in February 2025 as part of Elon Musk’s DOGE eliminated most of visitor-services staff, which forced the Presidential Library to abruptly close and announce its indefinite shutdown.

After public outcry, the National Archives reversed course and reopened the library.

As for RFK Jr., it’s hard to imagine him serving contentedly under a boss who threatens to bulldoze a memorial to his family. Yet Kennedy serves on.

Abolishing President Kennedy’s Promise to the World’s Children

“To those peoples in the huts and villages of half the globe struggling to break the bonds of mass misery, we pledge our best efforts to help them help themselves, for whatever period is required.”
— President John F. Kennedy, Inaugural Address, January 20, 1961

President Kennedy turned that pledge into an institution. In 1961, he signed the Foreign Assistance Act and created the USAID by executive order. Over just the last two decades before its demise, USAID-funded programs helped prevent an estimated 91 million deaths worldwide, including 30 million children, according to a study in The Lancet.

USAID was one of the first things this administration tore down. Foreign aid was frozen within days of the January 2025 inauguration. By the end of March, 83% of USAID programs had been terminated, and what remained was folded into the State Department.

The toll falls hardest on children. The same Lancet research team projects more than 14 million additional deaths by 2030 if the cuts hold, including more than 4.5 million children under five. A tracker run by Boston University modeler Brooke Nichols estimates roughly 600,000 deaths in the first year alone, about two-thirds of them children. Secretary of State Marco Rubio nonetheless told Congress that “no one has died.”

Whatever one thinks about particular foreign assistance programs – the amount of funding dedicated to children internationally by the Trump Administration’s budget is just 0.03% of the entire federal budget – USAID represented the proposition that American power could be expressed not only through military strength, but through feeding people, responding to disasters, preventing disease, and helping children survive.

The Administration’s health secretary is a Kennedy. His uncle’s pledge to the world’s poorest children was dismantled in the first weeks of the administration that RFK Jr. serves.

The Programs Serving Americans

Also in his inaugural address, President Kennedy famously challenged Americans:

Ask not what your country can do for you — ask what you can do for your country.

In 1966, Robert F. Kennedy added:

This world demands the qualities of youth: not a time of life but a state of mind, a temper of the will, a quality of imagination, a predominance of courage over timidity, of the appetite for adventure over the life of ease. . . [I]t is the young people who must take the lead.

The Peace Corps was perhaps the purest expression of these two quotes.

Kennedy created it in 1961 and chose RFK Jr.’s uncle, Sargent Shriver, to build it. But Shriver did not stop there.

During the Johnson Administration’s War on Poverty, he helped create or build an extraordinary collection of institutions: Head Start, Job Corps, VISTA, Community Action, and federal Legal Services.

Under the Trump Administration, nearly every one of them has recently been threatened.

• The Administration attempted to suspend operations at 99 contractor-operated Job Corps centers around the country. A federal court intervened, and the administration eventually rescinded the termination notices.

• The Administration moved to dismantle large portions of AmeriCorps, threatening the infrastructure supporting VISTA, until states and others challenged those actions in court.

• President Trump’s budget proposed eliminating the Community Services Block Grant, the modern descendant of the Community Action Program.

• It proposed eliminating the Legal Services Corporation, providing only enough funding to wind it down.

Congress and the courts prevented some of these proposals from becoming reality.

However, the Administration continues to go after these programs, which again are part of the Kennedy family legacy.

Gutting Head Start, from Inside RFK Jr.’s Own House

“[A] comprehensive approach is what has made our Head Start program such a nation-wide success. We must never let that creation be destroyed! Sure, we can always improve on what we started, but the basic components which make Head Start unique should not be abandoned, reduced in size, or limited in any way!”

— Sargent Shriver, Speech to Members of National Health Start Association, May 18, 2005

And then there is Head Start.

Shriver ran President Johnson’s War on Poverty and was married to JFK’s sister, Eunice Kennedy Shriver. When experts urged a small pilot, he insisted on establishing Head Start across the whole country at once, so it could not be undone. It was enacted by Congress in 1964, and both Robert F. Kennedy (D-NY) and Ted Kennedy (D-MA) championed it in the Senate during their careers.

In fact, over the decades that followed, Sen. Ted Kennedy became Head Start’s most reliable champion in Congress, shepherding it through reauthorization after reauthorization. As a result, for more than 60 years, Head Start has embodied the proposition that children should not arrive at school already disadvantaged simply because they were born into poverty. Today it reaches more than half a million children, including children in deep poverty, children who are homeless, and children in foster care, with education, health, nutrition, developmental services, and family supports.

It is difficult to think of a program that better reflects the Kennedy-Shriver conception of public responsibility for the nation’s children.

Project 2025 called for Head Start’s elimination, and the Administration has repeatedly threatened the program with staff reductions, administrative disruption, and proposed changes to longstanding federal requirements governing the program.

In fact, now the administration has proposed cutting Head Start’s Program Performance Standards from more than 100 pages to about 10. The rewrite would scrap requirements on classroom ratios and group sizes, drop critically important health and developmental services for children and require English-only instruction.

Here is the part that should sting most: Head Start sits in the Administration for Children and Families, inside the Department of Health and Human Services. That is Kennedy’s department. The Kennedy family helped built Head Start, and the Kennedy in charge of it is presiding over its unraveling.

Shriver guarded against hostile Congresses and presidents. He never imagined the threat would run through a Kennedy’s own department.

Other Kennedy/Shriver Legacies Under Attack at HHS

“You are the stars and the world is watching you. By your presence you send a message to every village, every city, every nation. A message of hope. A message of victory. . . The days of segregation and separation are over!”
— Eunice Kennedy Shriver, Charge to the Athletes at the Opening Ceremonies of the International Summer Special Olympics Games, South Bend, Indiana, August 2, 1987

Perhaps no member of the Kennedy family demonstrates the difference between fame and legacy better than Eunice Kennedy Shriver, RFK Jr.’s aunt.

She changed the way America — and eventually much of the world — understood people with intellectual disabilities.

In 1962, she invited children with intellectual disabilities to a summer camp at her Maryland home. Camp Shriver eventually grew into Special Olympics, whose first international games were held in Chicago in 1968.

Today, millions of athletes participate in Special Olympics programs around the world.

During President Trump’s first administration, his Education Department repeatedly proposed eliminating all federal funding for Special Olympics education programs. In 2019, after widespread criticism, President Trump publicly reversed the proposed cut.

But the threats to Eunice Shriver’s legacy endure. Her advocacy helped spur the creation in 1962 of the National Institute of Child Health and Human Development at the National Institutes of Health, which bears her name: The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

NICHD supports research into pregnancy, child development, intellectual and developmental disabilities, reproductive health, rehabilitation, and many other issues affecting children and families.

The Trump Administration proposed eliminating NICHD as an independent institute and consolidating it with other NIH institutes into a new organization. Again, the Cabinet secretary overseeing HHS while the administration seeks to reorganize the institute bearing Eunice Kennedy Shriver’s name is her nephew, Robert F. Kennedy Jr.

Cutting the Children’s Health Programs That the Kennedy’s Built

As Sen. Ted Kennedy said at a 2002 speech at the John F. Kennedy Presidential Library:

Children should not be denied the opportunity for a healthy start in life because their parents cannot afford insurance.

My connection to this part of the story is more personal. Sen. Ted Kennedy spent nearly a half a century in the U.S. Senate, where health care became one of the defining causes of his career.

For four decades he was one of the Senate’s foremost defenders of Medicaid, the program that today covers more than half of all low-income children in America and pays for roughly two in five births. In 1997, I was working in the Senate when Sen. Kennedy led a bipartisan group with Sens. Orrin Hatch (R-UT), Jay Rockefeller (D-WV), and John Chafee (R-RI) to create the Children’s Health Insurance Program (CHIP), which insures kids whose families earned too much for Medicaid but too little for private coverage.

Since CHIP’s enactment, the share of American children without health insurance fell from 15% to less than 5% in 2016. That rate has been on the rise since Trump’s first term.

That safety net sits inside the department Robert F. Kennedy Jr. runs, and it is Medicaid and CHIP, above all, that the Trump Administration has moved to slash. On July 4, 2025, Trump signed the budget reconciliation law, the so-called One Big Beautiful Bill (OBBB), with Vice President JD Vance casting the tie-breaking Senate vote.

The Congressional Budget Office (CBO) estimates it cut federal Medicaid and CHIP spending by nearly $1 trillion over ten years, which is the largest cut in the programs’ history. CBO projects it will leave about 10 million more people uninsured by 2034. Children, who make up the largest share of Medicaid and CHIP enrollees, are squarely in the path.

Even before these cuts really start taking effect, Georgetown’s Center for Children and Families (CCF) has documented that more than 2 million fewer children have enrolled in Medicaid coverage since the beginning of the current Administration and RFK Jr.’s leadership.

On the matter of immunizations, RFK Jr.’s spreading of distrust and misinformation has helped contribute to the resurgence of measles and other vaccine preventable diseases. In sharp contrast, on February 27, 1962, President John F. Kennedy proposed the Vaccine Assistance Act to promote immunizations:

There is no longer any reason why American children should suffer from polio, diphtheria, whooping cough, or tetanus – diseases which can cause death or serious consequences throughout a lifetime, which can be prevented, but which still prevail in too many cases.

I am asking the American people to join in a nationwide vaccination program to stamp out these four diseases, encouraging all communities to immunize our children and adults, keep them immunized, and plan for the routine immunization of children yet to be born. . . This program would cover the full cost of vaccines for all children under five years of age.

There is no greater flight from the Kennedy family’s health care legacy than what we have witnessed from RFK Jr.

A MAHA Summit Without Much MAHA

“[The FDA] really became a sock puppet for the industry it was supposed to regulate.”
— Robert F. Kennedy Jr., on the FDA, in a speech to agency staff, April 2025

RFK Jr. came to HHS promising to challenge powerful interests that he argued had captured American health care policy. Whatever one’s views of his specific claims or policies (I, for example, strongly disagree with his positions on matters such as vaccines, Medicaid and CHIP cuts, and the proposed gutting of Head Start and children’s medical research), his critique of the relationship between government and concentrated corporate power has been central to his public identity and embraced by supporters of the Making America Healthy Again (MAHA) movement.

However, on September 29, the second annual MAHA Summit convened at the Waldorf Astoria in Washington. Kennedy closed the day in a “fireside chat” with Vice President JD Vance billed around MAHA’s accomplishments and its regulatory agenda. One afternoon panel was titled “Modernizing MAHA regulation.”

Look at who paid for the room. Sponsors reportedly offered packages of up to $300,000. They included Walmart, telehealth firms Hims & Hers and Noom (both sellers of GLP-1 weight-loss drugs), and AI companies OpenAI and Anthropic. Insurance executives, including from UnitedHealth, were on the speaker list. A food panel moderated by a Kennedy counselor featured executives from Walmart, Steak ‘n Shake, and Sweetgreen.

This was supposed to be the movement against corporate capture of health policy. Kennedy’s own 2025 MAHA report accused the food, chemical, and pharmaceutical industries of exactly that. Yet corporations dominated the most recent MAHA conference and deregulation was its focus. For a movement founded, in part, on opposition to regulatory capture, that is a remarkable evolution.

Kennedy’s own base noticed. Dr. Robert Malone, whom Kennedy put on the CDC’s vaccine advisory committee, called the sponsor list “sickening.” Texas physician Mary Talley Bowden said grassroots MAHA had become a “cesspool of corporate interests.”

Again, I strongly disagree with both of them on nearly everything about vaccines. But they are right about one thing: the event had Kennedy’s name on it and somebody else’s agenda inside it.

Inheritance Is Not Legacy

President John F. Kennedy said in a speech in July 1963:

Children are the world’s most valuable resource and its best hope for the future.

What does it mean to inherit a legacy? An inheritance is something you receive, but a legacy is something you leave behind.

Whether Trump is deliberately trolling RFK Jr. or simply doesn’t care, the message is clear that the Kennedy name was useful during the presidential campaign to this Administration as a brand, but not at all as a set of commitments.

Time and time again, when the agenda collides with Project 2025, Office of Management and Budget (OMB) Director Russ Vought’s agenda of dismantling government, the desires of wealthy donors, or the President’s ego, the Kennedy legacy loses every single time.

The Administration’s agenda has included:

• Dismantling USAID

• Threatening Head Start

• Targeting Job Corps for shutdown

• Proposing Legal Services for elimination

• Eliminating NICHD as an independent and child-focused institute

• Threatening Special Olympics (a first term agenda item)

• Slashing Medicaid and CHIP

• Shutting down the Kennedy Center for the Performing Arts

• Paving over the Rose Garden

An extraordinary portion of the architecture and legacy of the Kennedy-Shriver generation has been challenged and attacked in a remarkably short period of time.

Kennedy has a choice. He could defend the programs that his uncles, his father, and his aunt and uncle spent their careers creating. He could object to a summit that sold his movement to the industries he once railed against. He could say, plainly, that his uncle’s memorial should not be held hostage and closed. So far, he has chosen to do none of the above.

The Kennedys of an earlier generation understood that power is measured by what you protect. Robert F. Kennedy walked the Mississippi Delta and saw hungry children with his own eyes.

As RFK said in a March 1968 speech at the University of Kansas:

I have seen children in Mississippi starving, their bodies so crippled from hunger and their minds have been so destroyed for their whole life that they will have no future. . . I have seen children in the Delta area of Mississippi with distended stomachs, whose faces are covered with sores from starvation, and we haven’t developed a policy so we can get enough food so that they can live, so that their children, so that their lives are not destroyed, I don’t think that’s acceptable in the United States of America and I think we need a change.

His son now runs the department responsible for those children. By the standard his father articulated, the comparison is not even close.

A War on Children, with RFK Jr. at the Helm

President Kennedy said in a February 14, 1964, message to Congress:

To the extent that the Nation is called upon to promote and protect the interests of our younger citizens, it is an investment certain to bring a high return, not only in basic values but in social and economic terms.

When I was a child, I thought the Kennedy legacy was all about John F. Kennedy and his inspiration. I understand it much differently now.

It is a Head Start teacher welcoming a 4-year-old into a classroom, a Special Olympics athlete crossing a finish line, a scientist at NICHD working to address developmental disabilities, a child getting cancer treatment or an immunization with their Medicaid or CHIP insurance card, a young person getting another chance through Job Corps, or a Peace Corps volunteer leaving home to serve people half a world away.

Those are monuments too, but unlike marble or stone, they survive only if each generation decides they are worth keeping.

To me, the veneer of Camelot isn’t what is inspiring about the Kennedy family. It is the idea that government can ask something of us and do something for us and the next generation. It is the belief that public service matters. And it is the conviction that poverty, disability, illness, and the circumstances of a child’s birth should not dictate the boundaries of that child’s life.

Again, as President Kennedy said:

All Americans recognize that our children and youth are the most important asset and resource. . . If, for the sake of our nation as well as their own families, our children and young people are to grow into productive adult members of society and bear the responsibility of the legacy we leave them – that of the world’s most powerful and economically advanced nation – then all of them must have the fullest opportunity for moral, intellectual, and physical development to prepare adequately for this challenge.

In sharp contrast, ProPublica’s Eli Hager catalogued this Administration’s policies toward children under a blunt headline: “The Trump Administration’s War on Children.”

The piece documented cuts to child abuse investigations, child support enforcement, child care, and children’s health, all at once. It was not a list of coincidences, but a direction and roadmap.

I have spent the last two years chronicling that direction on this page, piece by piece: the slashing of children’s health coverage and immunizations, the attacks on birthright citizenship, the dismantling of the Department of Education and the attempt to shove special education back into a health bureaucracy, the erosion of the Child Tax Credit. USAID, Head Start, Medicaid, and CHIP are not just separate threats to children but part of an overall strategy of “organized abandonment” of the next generation.

At First Focus on Children, we hold every policymaker to one question: “Is it good for the children?” That is also a pretty good test of a legacy.

Robert F. Kennedy said in a 1968 interview with David Frost:

. . .perhaps this world is a world in which children suffer, but we can lessen the number of suffering children, and if you do not do this, then who will do this? I’d like to feel that I’d done something to lessen that suffering.

That is a Kennedy legacy worth protecting and aspiring toward. However, this Administration has demonstrated a commitment to tearing much of it down.

For the sake of our children, this must change.

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The nation is rightly outraged by what a young woman says happened to her inside a Cornell University fraternity house in October 2024. In a 101-page civil complaint filed September 16, the former student, identified as Jane Doe, alleges that seven members of the Chi Phi fraternity drugged and sexually assaulted her over several hours, and invited other members to join through a group chat.

She was 20 years old. She reported the assault to campus police in November 2024. No criminal charges followed, and she later left the university.

New reporting raises further questions about how authorities handled her account from the beginning. The district attorney told CBS News he never saw the transcript of her interview with campus police, in which she said she was confident she had been raped, before his office declined to bring charges. According to the Associated Press, he relied instead on a statement written by a campus officer and signed by her. Cornell says it shared all investigatory information with the DA’s office.

The lawsuit, first brought to light by the student journalists at The Cornell Daily Sun, has forced a reckoning and reevaluation of the events that evening. Tompkins County District Attorney Matthew Van Houten has reopened the case for grand jury review. Governor Kathy Hochul pressed Cornell to accept an independent outside investigation, and the university agreed. Cornell disputes claims that the accused faced minimal consequences, saying two were expelled and two suspended.

The accused have not been convicted of anything, and the legal process must run its course. But the questions this case raises about culture, institutional accountability, and our laws are already clear.

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The Calls for Action Are Right

Elected officials have responded quickly, and they deserve support. New York’s Assembly Speaker Carl Heastie has tasked lawmakers with drafting recommendations by year’s end. Speaker Heastie said:

The allegations being reported out of Cornell University are truly horrifying. We want to do everything we can to ensure victims of sexual assault see justice served.

Assemblyman Jeffrey Dinowitz and State Senator Nathalia Fernandez are pushing a bill to close a loophole in New York law. Today, a victim who voluntarily drank or used drugs is not considered legally incapacitated, which makes rape far harder to prosecute.

That loophole should close. So should the gaps in federal protection. As Time reported, Title IX protections have swung back and forth with each new administration, leaving colleges and survivors without stable rules. Congress should settle this in statute rather than leave students to the whims of whoever controls the Department of Education.

Sen. Elissa Slotkin (D-MI), a Cornell graduate, and Rep. Alexandria Ocasio-Cortez (D-NY) have both spoken out about institutions that fail women. They are right. Every student deserves a campus where a report of sexual assault is met with a serious investigation, real accountability, and genuine support for the survivor.

But the problem goes well beyond this one institution. We have a problem that, quite frankly, begins at the very top and is pervasive in our politics, our culture, our social media algorithms, and more. I would also raise that, as we focus on sexual assault on college campuses, we must also keep in view the sexual abuse of children, which is widespread, begins early, and too often goes unnoticed.

Sexual Assault Starts Before the Age of 18

Sen. Angela Alsobrooks (D-MD) reports that at least 1 in 4 girls and 1 in 20 boys in the United States experience child sexual abuse. If you add online sexual exploitation to that figure, the numbers are closer to 1 in 3 girls and 1 in 10 boys.

A Johns Hopkins study estimated that new substantiated cases of child sexual abuse in 2015 alone would impose at least $9.3 billion in lifetime economic costs, a figure that cannot capture the human cost.

Child sexual abuse happens in homes, schools, churches, youth sports, and increasingly online, where grooming, image-based abuse, and reports of child sexual abuse material are rising fast. Most will never make national news. Many will never tell anyone.

The two problems are connected. The scandals involving Jerry Sandusky at Penn State and Larry Nassar at Michigan State University and USA Gymnastics are prominent examples of universities failing both young people and children. Children who are sexually abused also face a higher risk of being victimized again as teenagers and young adults. Preventing abuse in childhood also helps interrupt patterns of violence and victimization that can continue into adolescence and adulthood.

When Institutions Fail Children

Cornell is not the first institution accused of putting its reputation ahead of the people in its care. When the victims are children, the pattern repeats itself: children speak up, adults look away, and the institution protects itself. As I wrote in support of legislation by Sen. Ed Markey (D-MA) and Rep. Morgan McGarvey (D-KY creating an independent Children’s Commissioner, that record is long.

• Jerry Sandusky and Penn State. An independent investigation found that university leaders repeatedly concealed a football coach’s abuse of boys to avoid bad publicity.

• Michigan State University, USA Gymnastics, and Larry Nassar. Young athletes reported abuse for years while the institutions failed to respond. Even the FBI, the Justice Department’s Inspector General found, failed to act quickly, giving Nassar more time to abuse girls.

• The Epstein files. Years of cover-up and limited access to the files have kept the focus on political damage control, as New York Times reporting on White House Situation Room meetings showed, instead of on the children who were trafficked and abused and on who enabled it.

• Religious institutions. Abuse and cover-ups in the Catholic Church, the story behind the Academy Award winning Spotlight, were documented again in a Pennsylvania grand jury report that identified more than 1,000 child victims. They were followed by scandals in the Southern Baptist Convention, the Mormon Church, and evangelical churches across the country.

• The Boy Scouts of America. More than 82,000 claims of childhood sexual abuse spanned decades before the organization was held to account.

• The troubled teen industry. Residential programs for struggling young people have faced repeated allegations of abuse. The GAO has warned and Sen. Ron Wyden (D-OR) has further documented the abuse of children in these institutions.

• Child trafficking. The crisis gets a great deal of public attention, yet the Administration is weakening federal protections. Last month, the Department of Health and Human Services (HHS) ordered care providers to stop reporting suspected trafficking of unaccompanied migrant children directly to the Office on Trafficking in Persons, the specialists Congress charged with protecting them. Those reports now go to the same office that holds the children in custody, which decides which cases the experts ever see. Sen. Wyden, who earlier raised alarms about a sharp decline in trafficking oversight, is now demanding the policy be reversed, warning that children could be deported before trafficking experts ever review their cases.

The list is endless.

Institutions and society repeatedly fail child victims of sexual abuse. Too often, official attention arrives only after years of harm.

Children deserve better, and there are many actions our nation should take. One solution, the establishment of an independent Children’s Commissioner, would create a dedicated person whose job is to see these patterns early and refuse to look away. Congress can and should pass legislation before both chambers of Congress, as noted below.

Washington Is Moving in the Wrong Direction

Unfortunately, instead of strengthening protections for children, the federal government has been pulling them apart. This is “organized abandonment,” and it is happening in plain sight.

In April 2025, the Justice Department abruptly terminated hundreds of grants, including funding for programs that support crime victims and abused and neglected children.

Among them were three awards worth more than $48 million to the National CASA/GAL Association, which trains court-appointed advocates for abused children. Reporting also documented withdrawn funding for task forces that investigate online exploitation and for programs where abused children are interviewed by police and mental health professionals together. Some grants, including those to Court Appointed Special Advocates (CASA), were later restored after appeals, but months of disruption weaken the organizations children depend on.

The President’s FY26 budget also proposed eliminating Centers for Disease Control and Prevention (CDC) funding for child sexual abuse research and for preventing Adverse Childhood Experiences, while threatening Community-Based Child Abuse Prevention grants. It also sought to cut the Office on Violence Against Women by nearly 30%, including sexual assault services.

Meanwhile, victim services funded through the Victims of Crime Act (VOCA) have endured deep reductions as deposits into the Crime Victims Fund have shrunk.

You cannot claim to stand with survivors while defunding the people who investigate their abuse, interview them, advocate for them in court, and work to prevent the next case.

Contrast Washington’s retreat with Scotland, where First Minister John Swinney has made ending violence against women and girls a personal priority, backed by legislation, a multi-year prevention campaign aimed at boys and young men, and sustained funding for services. Scotland also has an independent Commissioner for Children and Young People, something the U.S. still lacks.

What Congress Should Do for Children

Congress does not need to invent a new agenda. Concrete solutions, including bipartisan prevention legislation, are already on the table.

1. Create an independent voice for children. The Child Safety and Well-Being Act of 2026 (S. 4763/H.R. 9287), from Senator Ed Markey and Rep. Morgan McGarvey, would establish an independent Children’s Commissioner. It could investigate institutional failures, gather data from federal agencies, hold hearings, and report publicly, so we no longer have to wait for a lawsuit or a newspaper to raise the alarm. More than 85 countries and 45 states already have some form of children’s commissioner or ombudsman. The federal government does not.

2. Pass the PREVENT Act. Senators Angela Alsobrooks (D-MD) and Lisa Murkowski (R-AK) introduced the PREVENT Act in June. It would write CDC’s child sexual abuse prevention program into law, authorizing $6 million a year through 2030, so prevention research survives agency cuts. Congress must also appropriate the funds to make that authorization real.

3. Restore the investigators and advocates. Congress should guarantee full, stable funding for Internet Crimes Against Children task forces, Children’s Advocacy Centers, and CASA programs, so they are never again cut off without warning. The Invest in Child Safety Act by Sen. Wyden would double funding for the task forces and add agents and analysts to track exploitation online.

4. Fund prevention, not just response. Reject cuts to Community-Based Child Abuse Prevention grants, Child Abuse Prevention and Treatment Act (CAPTA), and CDC’s injury prevention work. Prevention is cheaper than the $9.3 billion we pay after the fact.

5. Stabilize victim services. Fix the Crime Victims Fund so VOCA grants stop shrinking and survivors of all ages can get help.

6. Put children’s safety in statute, not at the mercy of administrations. Title IX protections for K-12 students, like those for college students, should not change every four years.

From Outrage to Action

The Cornell case is a reminder that institutions too often protect themselves before they protect the people in their care. Leaders in Albany and Washington are right to demand better for college students.

That same commitment should also extend to the youngest survivors, who often have no platform and no one to tell. As Congress takes up campus sexual assault, it should also act on the sexual abuse of children and protect the programs that keep them safe. We can and must do both.

Outrage fades with the news cycle. Children need laws, funding, and accountability that last.

Kids can’t wait.

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Michael Marra, the newly elected leader of the Scottish Labour Party, used his first speech in the Scottish Parliament as party leader to challenge the Scottish National Party (SNP)-led government over child poverty. Marra said:

The first thing that I did on my election on Saturday was to write to the First Minister to seek his support for establishing a cross-party commission on meeting the child poverty targets that the Parliament wrote into law. . . We should recommit today to change the lives of children right across the country.

The timing mattered. This summer, the Scottish government said it would be “reviewing” its child poverty targets, amid warnings from the Joseph Rowntree Foundation and the Institute for Fiscal Studies that they were likely to be missed.

Scotland is not yet on track to meet those ambitious targets, Marra argued. So rather than abandon them, lower them, or explain them away, Marra called on Parliament to recommit to them and develop a process for getting there.

And Parliament did.

It adopted an amendment declaring that tackling child poverty “must be an immediate national priority,” calling on political parties to work together to reduce it, and reaffirming Scotland’s commitment to the statutory targets established under the Child Poverty (Scotland) Act 2017, including reducing relative child poverty to fewer than one in ten children by 2030.

What makes this particularly remarkable is that Marra was not challenging a government that considers child poverty unimportant.

Quite the opposite.

First Minister John Swinney’s Scottish National Party government calls eradicating child poverty its “defining mission.”

The SNP-led government’s new five-year Programme for Government puts eradicating child poverty first among its priorities and promises a concerted, cross-government effort to make further progress.

Think about the political debate taking place here.

Scotland’s SNP and Labour parties are not arguing over whether reducing child poverty should be a priority. They are arguing over whether government is doing enough to meet a child poverty target already written into law.

And Scotland has something to show for its efforts.

The latest figures show that 21% of children in Scotland live in relative poverty after housing costs, compared with 28% across the United Kingdom. Scottish Government modeling estimates that policies in its latest child poverty plan will keep about 100,000 children out of relative poverty this year.

As both parties agree, a 21% relative child poverty rate is still far too high. It is also more than twice Scotland’s statutory goal of getting below 10%.

But that is precisely the point.

Scotland is making progress. And instead of using that progress to declare victory, its political leaders are doubling down on their commitment to center children in the policy discussions and to do better by them.

That is what a target can do. It creates measurable accountability, which in this case, is focused on children.

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A Familiar Idea

Last week, I had the pleasure of being a part of an American delegation^[i] that traveled to Scotland to learn about their work to improve the lives of children. The child poverty target was of particular interest because, after collaborating with the Foundation for Child Development on a paper in 2010 by Jane Waldfogel entitled Tackling Child Poverty & Improving Child Well-Being: Lessons from Britain, First Focus on Children began our advocacy for:

• Adoption of a child poverty target based on Britain’s successful experience with it under the leadership of British Prime Minister Tony Blair in 1999 and the early 2000s.

• Enactment of a fully refundable Child Tax Credit, which was legislation sponsored by Rep. Rosa DeLauro (D-CT).

In 2015, Natalie Branosky and Jane Mansour wrote another report, A Look Back at the UK Child Poverty Target, for First Focus on Children about the United Kingdom’s experience. Their report itself built on a UK study visit and several years of comparative work that First Focus on Children had commissioned on the British approach to child poverty.

That same year, the UK Conservative UK government moved to scrap its income-based child poverty targets. The Scottish government objected and opted out, and in 2017, the Scottish Parliament wrote its own targets into law.

Branosky, fittingly enough, was also the organizer of a terrific U.S. delegation that traveled to Scotland this month to spend a week examining how Scotland approaches children, young people, children’s rights, child development, and democracy.

What we found was a reminder of what happens when improving children’s lives becomes a commitment and an expectation of government.

That distinction matters and the expanse of how radically different that approach is between what we have here in the United States and that of our friends across the pond is immense.

What Occurs When You Set an Accountable Goal?

A child poverty target does not magically eliminate child poverty. Scotland acknowledges that.

Its 2017 law established four ambitious targets for 2030:

• Fewer than 10% of children in relative poverty

• Fewer than 5% in absolute poverty

• Fewer than 5% experiencing both low income and material deprivation

• Fewer than 5% experiencing persistent poverty

It also requires government to develop plans and report on its progress.

The value of that structure becomes especially apparent when the country is not moving quickly enough. While the SNP and Labour may disagree about the specific policy details and pace of progress, they jointly reaffirmed their commitment to cutting child poverty.

The target is not simply a number in a government report. Instead, it produces something that is measurable and creates accountability. It asks:

• Are we making progress?

• Are we moving quickly enough?

• What is working?

• What isn’t?

• What does government need to do differently?

That is the debate Scotland is having right now. And in that debate, young people are engaging and making their concerns known directly.

And that makes what happened in the United States this month especially striking and disappointing.

Meanwhile, in the United States...

On September 15, the U.S. Census Bureau released its latest poverty statistics.

The Census Bureau reported that the Supplemental Poverty Measure (SPM), which measures the child poverty rate after taking into account government benefits and tax credits as well as taxes and certain expenses, remained at 13.4% for 2025.

This is in stark contrast to the rate in 2021, which was 5.1% (referencing Table 8 in the Census Bureau’s updated estimates), after temporary enactment of the fully refundable Child Tax Credit by Rep. DeLauro and Sens. Sherrod Brown (D-OH) and Michael Bennet (D-CO) as part of the American Rescue Plan Act (ARPA).

That means the child poverty rate under this measure is now more than two and a half times the record low achieved just four years earlier.

The comparison that matters isn’t between Scotland’s 21% and America’s 13.4% because the numbers are not directly comparable, as Scotland’s is a relative measure to median income and the U.S. measure is a threshold based on income and spending related to basic needs. If the U.S. used a relative poverty rate for children, it would also be above 20%.

The Peter G. Peterson Foundation, for example, cites more uniform data from the Organisation for Economic Co-Operation and Development (OECD) that shows the U.S. has the highest child poverty rate among OECD nations.

Consequently, what is most important to examine is what the two countries are doing in response to unacceptably high levels of child poverty.

Scotland is looking at its number and asking:

Are we on track toward the goal we established for our children?

And since the answer is no, political leaders are debating what more government should do and have reaffirmed the goal and their commitment.

In contrast, what is happening in the United States?

Without a national child poverty target against which the SPM child rate is measured and no requirement that the federal government explains why child poverty rose so dramatically from its 2021 low, there is near silence.

There is no national process triggered by the result. There is no centering of children in the policy debate. There is no requirement for a corrective plan.

There isn’t even an agreed upon national goal for where the number should be five or ten years from now.

Just last year, when Congress was passing H.R. 1, the so-called “One Big Beautiful Bill” (OBBB), changes to the Child Tax Credit left in place the current phase-in of the credit so that, as estimated by Columbia University’s Center on Poverty and Social Policy (CPSP), 19-20 million of our nation’s lowest income children still receive only partial or no credit.

Child poverty is a policy choice.

Rather than cutting child poverty, as the Scottish government is committed to doing, U.S. government officials have enacted policies, by design, that extend child poverty by giving the least to those children who need it the most. U.S. policy also often chooses to punish children for notions of “deservingness” or perceived shortcomings of their parents.

We Are Trying to Create a Child Poverty Target

There have been efforts to change how government orients itself toward children.

The Child Poverty Reduction Act, which sought to establish a child poverty target in the U.S., was first introduced in 2015 and had over 250 national organizations endorse it. The 2023 version of the bill (H.R. 5629 and S. 2906), which set the target to cut child poverty in half in five years, was introduced by Rep. Danny Davis (D-IL) and Sen. Bob Casey (D-PA).

Despite continued support for adoption of this approach in the U.S., the bill has not been reintroduced in the 119^th Congress (2025-2026).

The contrast between Scotland and the United States is stark. While Scotland’s SNP and Labour parties agree to reaffirm their commitment to the child poverty target and have made cutting child poverty their utmost priority, the U.S. Congress does not even have the concept of a child poverty target introduced and available for its consideration.

This lack of attention to the plight of children is not explained by public opinion. In 2020, when Lake Research Partners polled American voters whether the United States should establish a target to cut child poverty in half within 10 years, voters supported the idea by a wide 70-20% margin.

Support crossed party lines: 85–10% among Democrats, 67–22% among Independents, and 56–29% among Republicans.

In a subsequent 2022 poll by Lake Research Partners, voters said government spends “too little” (67%) rather than “too much” (10%) on “reducing child poverty.”

Yet, with the exception of action to temporarily slash child poverty in 2021, our political system has repeatedly failed to make the necessary commitment to cut child poverty. Public opinion and the needs of children be damned.

Two Very Different Political Conversations

We should not overstate what is happening here. Scotland has not eradicated child poverty. Far from it.

From what we saw and heard during our trip to Scotland and what was on clear display in the Scottish Parliament this week, they are making real progress. Scotland’s child poverty rate is substantially below the UK average. Their government estimates that current policies are keeping tens of thousands of children from falling into poverty.

And Scotland’s political leadership – both the Scottish National Party and Labour – have decided that progress has not been enough. Together, despite disagreement over the pathway to success, they just reaffirmed the commitment to cut relative child poverty below 10% by 2030.

The major political parties and their leaders are not arguing whether they even care about child poverty or whether child poverty should even be a government priority. Those are settled questions in Scotland.

Instead, they are arguing over how to do better. And remarkably, as we discovered on our visit, the Scottish government is doing so in consultation and collaboration with young people themselves.

Again, compare that with the United States.

We demonstrated in 2021 that dramatic reductions in child poverty are possible, as child poverty was cut to just 5.1%, but we have watched that progress disappear and have allowed child poverty to more than double to 13.4% in 2025.

Critically important legislation, the American Family Act (H.R. 2763/S. 1393), that would make the Child Tax Credit fully refundable and dramatically cut child poverty has been introduced by Rep. DeLauro and Sen. Bennet. However, no Republicans in Congress have cosponsored the legislation. It is promising that a few bipartisan bills that make incremental improvements to the Child Tax Credit have been introduced, but none of them are actively being considered for passage.^[ii]

Even worse, the child poverty target bill has not even been reintroduced by either Democrats or Republicans in this Congress, even though there is overwhelming support for establishing such a national goal among the American people.^[iii]

What We Choose to Measure and Expect

There is a larger lesson here.

Although a target does not guarantee success or agreement over what steps to take, it does establish responsibility, commitment, and accountability. It rejects the U.S. government’s current posture of organized abandonment, invisibility, and inaction that shrugs at children’s poor outcomes as misfortunes government merely observes from a distance.

A non-commitment allows the government to provide basic data on how much it spends (although that isn’t even clear with the current Administration), what the programs are, and how many people are enrolled (again, increasingly difficult with this Administration).

A target asks additional questions:

• Are fewer children living in poverty?

• What are we going to do differently?

That is accountability and focus that stand in sharp contrast to indifference.

A First Lesson from Scotland

After spending last week in Scotland along with others in the U.S. delegation, I came home after days of intense learning with pages of notes and many ideas about things we should reconsider or do differently at First Focus on Children.

Some reinforced things we have long advocated, including a renewed commitment to working toward the adoption of a national child poverty target, along with other ideas such as child impact statements and the creation of an independent Children’s Commissioner in the U.S.

Others pushed me toward questions I want to explore much more deeply:

• Scotland’s Getting It Right for Every Child approach

• Culture change that prioritizes the fundamental rights of children

• A political framework that engages children in decision-making

• Support for what Scotland calls “youth workers”

• How Scottish charities and civil society organizations sustain systems change work over the long term

Most importantly, the trip left me thinking about something bigger:

What would it mean to build a government that was genuinely child-friendly and an advocacy community organized not simply to defend individual programs for children, but to change the systems that shape their lives?

I would like to engage readers on these points in a series of posts in the weeks ahead and encourage a dialogue about them. In the end, it may fundamentally change the way we view our own work.

Child poverty seemed like the right place to begin because it touches every aspect of the lives of children and has been very much in the news in one place and not in the other.

While a child poverty target does not promise success, it does establish an expectation and commitment.

Scotland has decided that reducing child poverty is something government should be expected to accomplish. It measures itself against that expectation. It has made progress. And this week, rather than retreat from an ambitious goal it has not yet reached, its political leaders renewed their commitment to it.

The United States showed in 2021 that child poverty is not intractable, but is something that can be changed and driven to a historic low. But in 2026, news of an unacceptable child poverty rate in the U.S. barely registered.

This disparity underscores what is missing in the U.S.: we have never successfully built a promise, and an accountability structure, that expects us to make child poverty a priority.

This is why First Focus on Children urged Congress to commission the National Academies of Sciences, Engineering, and Medicine (NASEM) to develop an evidence-based plan that would achieve the goal of cutting child poverty in half within 10 years. Congress directed that study and the resulting 2019 report, A Roadmap to Reducing Child Poverty, gave us the blueprint.

What we still lack is the national commitment and accountability to follow it. Building that is the place to start, and the Scots are showing us the way.

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Further Reading, with links

• National Academies of Sciences, Engineering, and Medicine, A Roadmap to Reducing Child Poverty (2019): https://www.nap.edu/catalog/25246/a-roadmap-to-reducing-child-poverty

• Jane Waldfogel, Tackling Child Poverty & Improving Child Well-Being: Lessons from Britain, First Focus and Foundation for Child Development (2010): https://www.fcd-us.org/tackling-child-poverty-and-improving-child-well-being-lessons-from-britain/

• Natalie Branosky and Jane Mansour, A Look Back at the UK Child Poverty Target: Transferable Themes for the United States, First Focus (2015): https://firstfocus.org/resource/a-look-back-at-the-uk-child-poverty-target-transferable-themes-for-the-united-states/

• Scottish Government, Bringing Hope, Building Futures: Tackling Child Poverty Delivery Plan 2026–2031: https://www.gov.scot/bringinghope.

• Child Poverty Is a Choice, and So Is Ending It, Kids Can’t Wait: https://brucelesley.substack.com/p/child-poverty-is-a-choice-and-so

• Big Ideas for Kids: A Blueprint for Building Government That Works for Children, Kids Can’t Wait: https://brucelesley.substack.com/p/big-ideas-for-kids-a-blueprint-for

ENDNOTES

^[i] I was pleased to join a terrific U.S. delegation traveling to Scotland earlier this month that included: Natalie Branosky (Lead, The New Possible and international Knowledge Exchange); Jamie Baxter (Executive Director, Allies for Children); Danielle Goldberg (Managing Director, UNICEF USA); Wendy Lesko (Co-Founder, Youth Infusion); Jeannie Mansill (Founder, Project Unity); June Rose (Chief of Staff for the Providence City Council and Advisory Board Member for Vote16USA); and Kenneth Thompson, MD (Practicing Psychiatrist in Pittsburgh, PA).

^[ii] For example, Sen. Ron Wyden (D-OR) and Rep. Jason Smith (R-MO) push bipartisan legislation in the previous Congress to improve the Child Tax Credit in a manner that would cut child poverty, but it was blocked by Senate Republicans months before the 2024 election. Other bipartisan incremental bills have been introduced and would make some progress on reducing child poverty were introduced in this Congress, including:

• The Stronger Start for Working Families Act (S. 3596), led by Sens. Maggie Hassan (D-NH) and Todd Young (R-IN)

• The Working Families Disaster Tax Relief Act (S. 3432 / H.R. 6645), introduced by Sens. Amy Klobuchar (D-MN), Bill Cassidy (R-LA), and Rep. Sara Jacobs (D-CA)

• The Supporting Newborn Parents Act (H.R. 8806), introduced by David Valadao (R-CA), Thomas Suozzi (D-NY), Blake Moore (R-UT), and Debbie Dingell (D-MI)

There are further reasons for cautious optimism at the federal level.

^[iii] There are also important initiatives in the U.S. making a real difference at the state and local levels of government, such as the enactment of 15 state-level Child Tax Credits that cut child poverty (including 11 that are fully refundable), over 150 cash assistance programs, and the adoption of child poverty targets in states like New York, California, and Vermont.

Children and their families used to have similar focused attention in Congress, but that has been eliminated. Between 1983 and 1993, the House Select Committee on Children, Youth, and Families was dedicated to examining the best interests and well-being of children across the full range of their lives and circumstances, including health care, child care, child poverty, homelessness, and child abuse and neglect. The Select Committee conducted investigations and hearings on these topics and reported back to Congress and the country on what it found. Its work laid the groundwork for a bevy of laws and positive policy actions.

Select committees differ from standing committees in that they do not process legislation but rather take a deep dive into a given topic area. Chaired first by Rep. George Miller (D-CA) and then Rep. Patricia Schroeder (D-CO), who went on to become some of the most prominent voices in Congress on child and family policy, the Select Committee on Children, Youth, and Families did exactly what a select committee is supposed to do: it went places the standing committees, boxed in by narrow jurisdictions, couldn’t easily go.

Government is organized by agency, program, budget account, and committee jurisdiction. Children and families do not experience their lives that way. A child struggling with hunger may also lack health coverage, quality child care, stable housing, adequate family income, or a parent with a predictable job schedule. Yet Congress divides those needs among different committees, each looking at only one part of that child’s life and often too consumed by legislative business to consider a wider aperture. The Select Committee could provide that wider view and inform the Congress to see the whole child and the needs of their families.

Consider what the House Select Committee on Children, Youth, and Families produced in its short history. Its first hearing saw 10-, 11-, and 12-year-old children testify about the challenges their families were facing, leading to a Washington Post headline, “In Stark Terms, Children Lay Out the Plights of American Families.”

A 1984 hearing, “Child care: beginning a national initiative,” began to move child care from a legislative mire to what would eventually become the 1990 Child Care and Development Block Grant Act, which remains the nation’s primary child care law.

In 1987, while AIDS was still treated almost entirely as an adult crisis, it was the House Select Committee that issued a critical report on pediatric AIDS, A Generation in Jeopardy: Children and AIDS, followed by a sequel report the next year that shed light on the unique issues facing children with respect to the AIDS crisis.

That same March, at a joint hearing with the Senate Special Committee on Aging, Miller laid out a statistic that should sound familiar to anyone who’s followed the last four decades of health policy: of 35 million uninsured Americans, 11 million were children, many of them with working parents whose employer coverage simply didn’t include their kids. That’s the exact diagnosis that would eventually justify the creation of the Children’s Health Insurance Program (CHIP) a decade later.

Similarly, in 1985, the Committee published a technical report — Tax Policy: How Do Families Fare? — examining whether the tax code adequately accounted for child poverty and the costs associated with raising children. The hearings documented how federal tax policy affected families with children and raised questions that drew attention to problems with the Earned Income Tax Credit (EITC) and issues related to child poverty, child care, child abuse, and family leave.

The Select Committee did not merely publish reports and conduct hearings about children and families. Its work spawned widespread media coverage, fed into legislative efforts, and shaped the national conversation. In this respect, the Committee repeatedly found and spotlighted the children whom larger policy debates had rendered invisible. Pediatric AIDS was obscured by an adult-centered health crisis. Uninsured children were overlooked in debates about employer-based health coverage. Abused and neglected children disappeared inside disputes over federalism and budgets. The financial needs of children and families were submerged within broader arguments over the economy and tax policy. The Committee put the unique and holistic needs of children front and center. Importantly, this work was bipartisan and gave members of Congress a chance to hear from those closest to the issues and to debate the best path forward.

None of that work happened because the Committee had legislative jurisdiction to pass bills. By design, it didn’t. But it was able to conduct a more holistic examination of the problems facing children and families precisely because it was tasked with examining these issues from a “whole child” perspective, rather than as a side issue or a narrowly defined one tucked into somebody else’s committee agenda.

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Then It Was Gone for Reasons That Had Nothing to Do with Children

Despite its success, the Select Committee on Children, Youth, and Families was ended in 1993, but not because anyone actually reviewed its work and found it wanting. Instead, as is sadly often the case, children and families were collateral damage in a fight about something else entirely.

In January 1993, amid a fad of Congressional reform, the House rejected a resolution to reestablish the Select Committee on Narcotics Abuse and Control, but resolutions continuing the Select Committee on Children, Youth, and Families, the Select Committee on Aging, and the Select Committee on Hunger never received comparable votes. They were simply allowed to expire.

Congress never debated and voted on the proposition that children no longer deserved dedicated institutional attention. No member of Congress cast a recorded vote against a committee devoted to assessing the condition of America’s children. Kids and families did not lose their seat at the table because Congress examined the Committee’s record and decided that its work was no longer necessary. The Committee disappeared amid a broader retreat from select committees, in a dispute that had little to do with children or the conditions of their lives.

Thirty-three years later, the gap that decision left is still visible, and arguably getting worse. While there are Congressional subcommittees that focus on child and family issues, none has the same broad investigative charge as the former select committee.

In contrast, the Senate Special Committee on Aging (which Bruce staffed in 1997), the Senate’s form of select committee, has survived – likely owing to its politically powerful constituency – and is still going strong more than sixty years after its creation. Its continued work demonstrates that a committee without direct legislative authority can shape national debate, conduct meaningful oversight, develop expertise, and keep the needs of a population before Congress for the long haul. Congress has an institutional home charged with examining the conditions facing older Americans. It no longer has one, in either chamber, dedicated to looking out for children as children.

Congress, notably, hasn’t lost its appetite for using special or select committees. POLITICO reported recently that House Democrats are actively discussing standing up a new select committee on artificial intelligence (AI) if they retake the House in November, which is a sign that when lawmakers believe an issue needs special attention, they can create the institutional capacity to provide it.

AI is unquestionably consequential, and so are the lives and futures of the 73 million children in this country. Although there are certainly other important populations that face challenges and lack a dedicated Congressional structure – homeless adults, for instance – children and their families are the foundation of a healthy society, uniquely vital to the national interests, and have needs that cut across many policy arenas.

If Congress can contemplate a committee to understand how emerging technologies might reshape the country (and, indeed, we hope that if such a committee is formed an early hearing will focus on AI and kids), it can restore a committee charged with understanding how the country is shaping its children and families.

Flipping the Switch

The mechanism for reestablishing the House Select Committee on Children, Youth, and Families is simple: if the Democrats retake the House in the midterms they would just need to pass, via simple majority, a resolution to that effect. (It should be noted there is no reason for the existence or work of said committee to be partisan; we merely respond here to the most likely midterm scenario.) The Senate also has opportunities to take related actions, but we leave those recommendations for another day.

In making this proposal, we emphasize that we believe the problems facing children and families deserve Congressional action, not just talk. Reestablishing the House Select Committee on Children, Youth, and Families would not, by itself, create a national family policy or any new programs, impose a new mandate, or authorize new benefits. Yet it would create something more basic, enabling, and currently missing: a fact-finding body with staff, expertise, investigative capacity, and a public forum charged with telling Congress and the country what is happening to America’s children and their families. We know the value of what such a body can produce from its previous version.

Photo Credit: Dr. Brandi Slaughter, Clinical Professor and Program Director of the Karabelle Pizzigati Initiative in Advocacy for Children, Youth and Families at the University of Maryland School of Public Policy.

The restored committee should begin with an annual, public assessment of the condition of America’s children: not program by program or agency by agency, but across the full arc of childhood. They should examine the cumulative effects of federal budgets (including the onrushing fiscal challenges from a $40 trillion national debt and rapidly depleting social insurance trust funds) and major legislation on children, investigate problems that cross committee lines, identify gaps and conflicts among federal programs, hear directly from children and youth as well as parents and professionals, build out the framework for a unified approach to child and family policy, and recommend action to the standing committees with authority to advance legislation.

The select committee should also ask a question that Congress rarely considers systematically: What will this budget, bill, regulation, or government action mean for children and their families? Child- and family-impact assessments would not dictate the answer or prevent lawmakers from weighing competing considerations. They would simply ensure that the effects on children are visible before, not years after, Congress acts, much as most proposals on the Hill undergo an economic impact analysis.

Give children and their families desperately needed attention. Give lawmakers places to see the whole child. And give the country a regular accounting of whether its government is meeting its obligations to the next generation. Congress has committees devoted to people and interests powerful enough to demand attention.

Children deserve dedicated attention precisely because they cannot.

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Share Kids Can't Wait

As Dr. Ben Hoffman, a pediatrician at Doernbecher Children’s Hospital in Portland, OR, asks:

In what universe is it beneficial to anybody for a child not to have health insurance?

And it follows, as plainly as anything in public policy follows from anything, that no law, regulation, or administrative practice should increase the number of uninsured children in this country. If a policy leaves more children with less health coverage than they had before, that policy has failed, whatever else it may or may not have accomplished.

That was once a bipartisan standard. It produced the Children’s Health Insurance Program (CHIP), passed by a Newt Gingrich-led Congress with bipartisan support and signed into law by President Bill Clinton in 1997. Along with Medicaid, CHIP helped cut the uninsured rate among children from 15% in 1996 to below 5% in 2016.

CHIP has been a national success story. Cutting the uninsured rate for children by more than two-thirds was the product of a bipartisan, federal-state partnership that worked for an entire generation of children.

Sadly, that progress has been slipping away.

During the first Trump Administration, the uninsured rate for children began rising as administrative barriers made it more difficult for eligible children to enroll and remain enrolled.

Source: Georgetown Center for Children and Families analysis of the U.S. Census Bureau American Community Survey (ACS) Table HIC-5, Health Insurance Coverage Status and Type of Coverage by State - Children Under 19: 2008 to 2019, Health Insurance Historical Tables.

In the summer of 2017, the Administration also supported a catastrophic plan to arbitrarily cap and slash Medicaid and CHIP in a manner that would have disproportionately devastated children’s health coverage. In September, Sens. Lindsey Graham and Bill Cassidy proposed a similar measure that would have cut federal funding for children’s coverage by an astounding 31% by instituting per capita caps on Medicaid spending.

Fortunately, those efforts failed. In July, Sens. John McCain (R-AZ), Susan Collins (R-ME), and Lisa Murkowski (R-AK) joined all Senate Democrats to defeat the first repeal bill.

In September, Graham-Cassidy was abandoned after McCain, Collins, and Sen. Rand Paul (R-KY) announced their opposition.

Just months later, Congress allowed federal CHIP funding to expire for more than 100 days during the final months of 2017 and the beginning of 2018. Pediatrician Dipesh Navsaria sums up children's status at the time in an Op-Ed published on New Year’s Day in 2018. Dr. Navsaria wrote:

CHIP isn’t really what’s in question — it’s likely being used for negotiation on other, unrelated elements of policy. Children’s well-being should not be held hostage in this manner.

Dr. Navsaria was right to question “where our priorities lie when we proclaim our love and support for the well-being of children but then consider enacting budgets and policies that use them as pawns.”

After states began notifying families that their children’s coverage was in jeopardy, bipartisan agreements in January and February extended CHIP funding for ten years.

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Words Versus Actions and Outcomes

As we began President Trump’s second term in February 2025, Secretary Robert F. Kennedy Jr. posted the following message as part of his “Make America Healthy Again” campaign:

No stone will be left unturned in our effort to end chronic disease. The health of our children is a higher calling for all of us.

Let us take him at his word, and then examine the record.

First, Kennedy supported a reconciliation bill that passed Congress and was signed into law by President Trump. The Congressional Budget Office (CBO) estimated that the law would reduce federal Medicaid and CHIP spending by nearly $1 trillion over ten years and cause millions of people to lose health insurance.

“Higher calling”?

Kennedy has also spread misinformation about vaccines amid the return of measles, which stood at 2,632 cases as of mid-August — the most since 1991. He supported a budget that would have eliminated Healthy Start, a bipartisan initiative begun under President George H.W. Bush to combat high infant and maternal mortality rates in this country.

“No stone”?

His department has proposed a Head Start rule stripping federal requirements for developmental screenings, health and mental health services, and follow-up care for hundreds of thousands of low-income children. And he has implemented significant cuts to medical research, including pediatric research, at the National Institutes of Health (NIH).

“End chronic disease”?

And on his watch, Medicaid and CHIP enrollment has fallen by 2.3 million children.

A real initiative to “Make America Healthy Again” would look very different from this.

When Kennedy sat before congressional committees this spring, he had one answer, and he repeated it over and over, sometimes shouting it: There are no cuts to Medicaid.

But there are. Spending less than the government would have spent under prior law is a cut. The federal government will spend nearly $1 trillion less on Medicaid and CHIP than it would have without last year’s reconciliation law, and millions more people will become uninsured.

Even before most of those cuts take effect, disturbing enrollment numbers have started coming in.

The Warning Georgetown Documented

In May, Georgetown University’s Center for Children and Families (CCF) reported that two million fewer children were enrolled in Medicaid and CHIP than when President Trump took office for a second term in January 2025. The federal government’s own data showed a 4% decline of about 1.5 million children during the President’s first year. Georgetown’s tracker, which draws upon more current enrollment numbers reported directly by states, showed a larger decline.

Since then, the numbers have grown worse. The tracker now runs through July 2026, and the line has kept falling.

Source: Georgetown University Center for Children and Families analysis of state administrative enrollment data and CMS State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data. Updated August 2026.

By August 4, when Georgetown CCF’s Andy Schneider testified before the Senate Budget Committee, CCF’s tracking put the decline at 2.3 million children: a drop he told senators was occurring far faster than the comparable decline during President Trump’s first term.

Schneider offered the Committee a way to understand the magnitude. He explained that 2.3 million children exceed the entire population under age 18 in ten states – Alaska, Delaware, Maine, Montana, New Hampshire, North Dakota, Rhode Island, South Dakota, Vermont, and Wyoming – and the District of Columbia combined.

Every child in ten states and our nation’s capital: that is the scale of the decline.

We do not yet know that every one of those enrollment reductions represents a child who became uninsured. Some children may have obtained another source of coverage. Some records may have been duplicates. Some children may have moved between states or aged out of children’s eligibility categories.

But the decline itself is real. The unresolved question is what happened to the children, and that is a reason for investigation, not indifference.

Paragon’s False Claims

On June 1, Brian Blase and Liam Sigaud of the Paragon Health Institute published a piece accusing Georgetown CCF’s Executive Director Joan Alker of building a narrative on speculation rather than evidence. They argue that the enrollment decline may be explained by leftover pandemic cleanup, duplicate records, declining birth rates, teenagers aging out of children’s coverage, or families moving to private insurance.

Those possibilities deserve consideration, but do not deserve to be treated as findings that Paragon has proved.

The critique begins by mischaracterizing Alker’s point. Paragon claims that Georgetown attributed the enrollment decline to H.R. 1 even though the law’s central eligibility provisions have not yet taken effect.

But here is what Alker actually wrote:

Bear in mind that these enrollment declines are happening largely prior to the impacts of H.R. 1 kicking in — including historic cuts and more red tape that will cause coverage losses.

That is nearly the opposite of the claim Paragon attributes to her.

Alker did not write that H.R. 1’s work-reporting requirements had already directly terminated coverage for these children. She wrote that child enrollment was falling before most of the law took effect, that the trend was troubling, and that the increasingly hostile climate around Medicaid and immigration was likely contributing to at least some of the decline.

Those are warnings and hypotheses, not declarations that causation has already been proved.

Paragon is entitled to challenge those hypotheses, but not to rewrite them.

More fundamentally, Paragon makes the very error it accuses Alker of making. It offers a list of possible explanations and then treats those possibilities as though they resolve the mystery.

An explanation is not evidence merely because it is possible.

The Numbers Refute the Demographic Argument

The centerpiece of Paragon’s case is demography. Fewer babies are being born, it says, while larger cohorts of teenagers are aging out of children’s coverage categories. Therefore, Medicaid and CHIP enrollment should naturally decline. No big deal.

Paragon is right about one limited point: the child population is declining slowly, and that could place some very minor downward pressure on Medicaid and CHIP enrollment. But identifying a contributing factor is not the same as explaining the result.

Paragon notes that there are approximately one million fewer children in the United States than there were in 2020 (children being born offset by those aging into adulthood), but only a portion of the children represented in the population decline would otherwise have been enrolled in Medicaid and CHIP. Furthermore, Medicaid and CHIP enrollment has declined by approximately 2.3 million since January 2025 alone. Simple math tells you that 2.3 million greatly exceeds a fraction of one million.

Timing and variation among states matter as well. Falling fertility is a gradual national trend over the course of years. The decline CCF is documenting has occurred in a matter of months and varies enormously by state. Any serious explanation that Paragon is trying to make must account for its magnitude, speed, and uneven distribution.

Paragon’s own figures underscore why a general appeal to demography is insufficient. It reports that child Medicaid and CHIP enrollment stood at 42.2 million in both February 2020 and February 2026, despite the decline in the child population. That does not prove demographics had no effect: pandemic-era enrollment rose dramatically and then fell during the unwinding. But it does demonstrate that enrollment is driven by far more than births and birthdays.

As even Paragon would likely acknowledge, public policy and administrative practices matter enormously. And advancing policy that is very likely causing more uninsured children would be the opposite of RFK Jr.’s “higher calling for all of us.”

The Unwinding Cannot Be an Explanation Without an Expiration Date

Paragon’s other major explanation is that Medicaid enrollment remained inflated by the pandemic-era continuous coverage requirement and was still working its way downward in 2025 and 2026.

It is true that child enrollment in Medicaid and CHIP rose substantially during the pandemic, when states generally could not disenroll people from Medicaid as a result of federal law designed to bolster health coverage during the public health emergency. And, more than a year into the unwinding process, there were more children enrolled than had been enrolled pre-pandemic.

Source: Government Accountability Office (2025. Jun.). Medicaid and Children’s Health Insurance: Disenrollments After COVID-19 Varied Across States and Populations. GAO-25-107413.

However, the timeline doesn’t support Paragon’s claims.

Congress declared an end to the public health emergency in spring of 2023 and initially required states to complete redeterminations and disenrollments, as appropriate, within 14 months for nearly every single Medicaid beneficiary, including many on CHIP, enrolled during the pandemic pause.

As states rushed and fumbled through the process, at least 35 states had to reinstate coverage for individuals erroneously disenrolled. In other words, many states were overly stringent at first, only later reinstating coverage, and CMS granted flexibilities and extensions to states to complete the process properly. For example, North Carolina and Kentucky, received additional time specifically to protect children during renewals.

According to Schneider’s Senate testimony, this was largely concluded in 2024, which aligns with CMS statements that the majority of redeterminations had been completed by March 2025, according to a review by the U.S. Government Accountability Office.

With unwinding complete, the nonpartisan nonprofit KFF predicted in November 2025 that there would be flat (0.2%) enrollment growth in Medicaid in FY 2026 due to factors putting upward pressure on enrollment, such as children’s and postpartum continuous coverage changes.

Despite experts observing that aggressive unwinding efforts occurred in 2023-2024, officials stating that unwinding was substantially complete by March 2025, and despite nonpartisan predictions of a very slight uptick in enrollment in 2026, Paragon offers no evidence that the 2.3 million children dropped from Medicaid and CHIP in 2025 and 2026 could be explained by the long tail of unwinding. This timeline just doesn’t add up.

And the decline did not taper off as unwinding wound down. It accelerated. Georgetown's tracker shows children leaving the rolls faster in the first half of 2026 than in 2025, more than a year after even the last unwinding stragglers.

And again, “the unwinding” cannot function as an all-purpose explanation with no state-by-state accounting and no expiration date. Not even close. See, for example, the enormous difference between state experiences during that process, such as that between Oregon and Texas.

Paragon does not establish how many of the children leaving the rolls after January 2025 were delayed unwinding cases, in which states those cases occurred, or how much of the 2.3 million decline its explanation could plausibly account for.

A Correlation That Does Not Test the Claim

Paragon also attempts to disprove the possibility of an immigration-related chilling effect. It reports virtually no correlation between a state’s estimated share of unauthorized immigrants in 2023 and its change in child Medicaid enrollment between January 2025 and January 2026.

But that calculation does not meaningfully test Alker’s hypothesis.

The relevant population is not every unauthorized immigrant in a state. It is Medicaid-eligible children — many of them U.S. citizens — living in mixed-status families and encountering particular enrollment and renewal systems amid heightened enforcement fears.

A meaningful analysis would need to consider the number of Medicaid-eligible citizen children in mixed-status households, differences in state eligibility practices, language access, outreach, the timing and intensity of enforcement, baseline enrollment rates, and whether other state policies were simultaneously affecting enrollment.

A two-variable state correlation that controls for none of those factors cannot establish that fear played no role. At most, Paragon has shown that the unauthorized-immigrant share of a state’s population, standing alone, does not explain the overall variation in Medicaid enrollment. Alker never claimed that it did.

Again, a possibility has been presented as proof and a rudimentary calculation as a definitive answer. It is not.

Indiana Shows Why State Policy Cannot Be Ignored

The differences among states are among the strongest reasons to look beyond national demographic trends.

Indiana has lost nearly 20% of its child Medicaid and CHIP enrollment since January 2025 — more than 174,000 children. During this period, Indiana imposed additional reporting, verification, and paperwork requirements in its Medicaid program.

Indiana’s experience does not by itself prove a single national explanation. But it presents a serious problem for Paragon’s largely demographic account. Birth rates and aging cannot plausibly explain why enrollment fell so much more sharply in Indiana than in many other states.

Meanwhile, enrollment in states such as Colorado and Minnesota remained relatively stable. Birth rates do not vary among states in a way that could plausibly produce a nearly 20% decline in one state over such a short period while leaving others largely unchanged.

The precise contribution of each Indiana policy deserves additional study. But the state’s experience is powerful evidence that administrative choices and not merely population trends are driving substantial losses of coverage.

Texas, Florida, and Georgia reinforce that concern. These states have experienced some of the nation’s largest increases in uninsured children while maintaining restrictive coverage policies and difficult enrollment systems. Texas now has the highest child uninsured rate in the country—13.6%, or roughly 1.1 million children. Texas alone accounts for approximately one-quarter of all uninsured children in America.

The three states with the largest increases in uninsured children are Texas, Florida, and Georgia. Together, they account for more than half of the national increase in uninsured children under age six.

That pattern does not prove that any single administrative decision caused every coverage loss. It does show why a generic appeal to falling fertility is inadequate. Policy matters.

Nobody Said H.R. 1 Had Already Done This

Let me concede something that Paragon spends considerable energy establishing in response to a claim Alker did not make.

Most of H.R. 1’s major eligibility provisions had not taken effect during the period at issue. Work-reporting requirements for expansion adults begin nationwide on January 1, 2027. More frequent redeterminations for expansion adults begin then as well. No one—certainly not Alker, Schneider, or me—is claiming that those provisions directly produced all of the enrollment decline in 2025 and 2026.

But that does not make the point that Paragon thinks it does.

These losses show what child coverage looks like before the law’s largest administrative and fiscal pressures arrive. CBO estimates that H.R. 1 will reduce gross federal Medicaid and CHIP spending by nearly $1 trillion over ten years. It projects that the law’s Medicaid and CHIP provisions will increase the number of uninsured people by 7.5 million in 2034 relative to prior law, with additional coverage losses resulting from its Marketplace provisions.

CBO’s May 2026 slides estimate that the Medicaid and CHIP cuts will cause 3 million children to lose Medicaid and CHIP coverage from 2026 to 2036 “driving mainly by provisions in the 2025 reconciliation bill. . . .”

Children often lose coverage when their parents do. Not because every provision expressly changes children’s eligibility, but because families enroll and renew together. When a parent becomes tangled in a work-reporting system, misses a notice, cannot document an exemption, receives incorrect information, or gives up after hours on hold, eligible children can fall off the rolls with them.

Arkansas has already demonstrated the consequences of Medicaid work requirements: large numbers of people lost coverage, including people who remained eligible or were working but could not successfully navigate the reporting system. The savings did not come primarily from people finding jobs and leaving Medicaid. They came from people losing coverage. Georgia’s more recent program has demonstrated a related problem: complex reporting systems can keep enrollment far below projections even when potentially eligible adults are working.

H.R. 1 is about to apply similar bureaucracy on a vastly larger scale while simultaneously withdrawing hundreds of billions of dollars that states use to finance their Medicaid programs.

Paragon argues that the tremor should not concern us. Meanwhile, the earthquake is coming.

The Question the Administration Has Not Answered

Every alternative explanation Paragon offers – duplicates, fertility, aging out, unwinding cleanup, or movement to private insurance – is ultimately a claim about what lies behind Medicaid and CHIP enrollment counts.

But neither Paragon nor the Trump administration has shown what actually happened to the children.

Here it is important to be precise about what we can and cannot yet measure. Last week, the Census Bureau released its Current Population Survey (CPS) for 2025, and it showed the share of children uninsured for the entire year essentially unchanged — a slight dip that was not statistically significant.

As Georgetown CCF points out, CPS counts a child as uninsured only if the child lacked coverage for all twelve months, so a child disenrolled from Medicaid in June is not counted as uninsured at all. The share of children uninsured for part of the year rose.

The survey’s sample is a small fraction of the American Community Survey’s, and its response rates remain skewed toward higher-income households, the families least likely to rely on Medicaid. And the families most afraid to renew their children’s Medicaid may be equally unwilling to answer a federal survey, which may explain why the CPS shows the uninsured rate for non-citizen children implausibly falling.

Most importantly, the CPS covers only 2025. Roughly 900,000 of the 2.3 million-child decline has occurred in 2026, entirely outside the survey’s window.

As Alker and Aubrianna Osorio at Georgetown CCF add:

As of July 2026, CCF’s enrollment tracker is showing almost 2.5 million fewer children enrolled in Medicaid/CHIP as compared to January 2025 when President Trump took office. We have blogged before on why we think the number of children is declining so quickly, including anecdotal reports of children living in mixed-status families whose parents are too fearful to enroll or renew their citizen children in public coverage due to the Trump Administration’s aggressive deportation agenda and unprecedented decision to share Medicaid data with the Department of Homeland Security. Cuts to Medicaid at the state level have also started, though they will really get going in 2027 as many of the nearly $1 trillion in federal cuts to Medicaid start taking effect.

Unfortunately, the ACS — the far larger survey that provides state-by-state detail and would hopefully help answer some of these questions — has been delayed indefinitely this year following a Commerce Department order restricting how the Census Bureau reports data. The data that would tell us what happened to these children is being held up at exactly the moment we need it.

That is exactly why CCF tracks Medicaid and CHIP enrollment. It is the most timely national warning indicator available, and the historical relationship between declining public coverage and increasing child uninsurance is well established.

We also have evidence from the time period immediately preceding this one. Between 2022 and 2024, as the unwinding proceeded and Medicaid enrollment declined in the ACS, the child uninsured rate rose significantly. Public coverage fell without a corresponding increase in private coverage among the low-income children most likely to have been leaving Medicaid and CHIP.

That history does not prove that every recent disenrollment produced an uninsured child. It does make rising uninsurance a considerably more evidence-based concern than Paragon’s suggestion that families simply moved into private coverage.

If federal officials believe the story is different this time, they should provide the data, particularly after HHS Secretary Kennedy declared that “[t]he health of our children is a higher calling for all of us.”

How many children remained eligible? How many were terminated for procedural reasons? How many obtained employer-sponsored or Marketplace coverage? How many aged out? How many moved between states? How many records were duplicates? How many are now uninsured? Which states are driving the decline, and which policies distinguish them?

Those are empirical questions. Georgetown CCF is asking them. The Administration should be called on to answer them.

They Did Not Necessarily Move to Something “Better”

Paragon closes by suggesting that these children may have moved to employer-sponsored insurance and that a family moving from Medicaid to private coverage “has not suffered a loss.” In its telling, the family has probably obtained something better, with broader networks and greater access to specialists.

But Paragon provides no evidence that the children in question actually obtained employer coverage, that such coverage was affordable, or that it met their health needs.

The most recent period for which we have detailed coverage data points in the opposite direction. Private coverage among all children rose ever so slightly between 2023 and 2024. But among low-income children – the children most likely to be affected by Medicaid disenrollment – private coverage was statistically unchanged. Employer-sponsored coverage nationally was also essentially flat. Researchers at State Health Access Data Assistance Center (SHADAC) concluded that the loss of public coverage without a corresponding gain in private coverage was driving children’s uninsurance upward.

If private coverage did not absorb these children during the last period we can measure in detail, Paragon needs to explain why it assumes that it has started doing so now. There is no indication this is happening, and it is precisely the kind of speculation Paragon wrongly accused Alker of committing.

Private insurance is also not necessarily the safe harbor Paragon describes.

According to data from KFF, workers pay an average of $6,850 a year out of pocket to add a family to an employer plan, and $8,889 at small firms. Only about 60% of small firms offer coverage at all, and roughly 29% of those that do offer it provide no subsidy for dependents. A parent working a low-wage job is often not offered family coverage, and when thet are, the premium alone can exceed what the family has left after rent, food, child care, and transportation.

Schneider’s testimony puts it plainly: offers of affordable, comprehensive dependent coverage for low- and moderate-wage workers are scarce. This is the reason children fall through the cracks.

And for children enrolled in Medicaid, the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit guarantees access to medically necessary screening, diagnostic, and treatment services. Commercial plans do not replicate that pediatric entitlement. CHIP benefits are structured differently, but they too are designed around children’s needs and generally protect families from the deductibles and cost exposure common in employer plans.

Medicaid is the gold standard for children’s coverage, not a consolation prize.

Comparing a Medicaid card to an idealized employer plan that many low-wage parents are never offered is not an argument. It is a shiny brochure.

Retroactive Eligibility Is Not Continuous Coverage

Paragon also suggests that declining enrollment matters less because eligible children may be able to obtain retroactive Medicaid coverage after they need medical care.

Unfortunately, this does not account for the fact that H.R. 1 takes away states’ ability to extend retroactive coverage beyond 60 days for children and 30 days for expansion adults aged 19-64. According to analysis by Families USA, this will require 40 states and DC to scale back retroactive coverage when the provision goes into effect.

And the theoretical possibility of having a bill paid later does not help a parent find a pediatrician, fill an asthma prescription, schedule a behavioral health appointment, obtain preventive care, or know whether treatment can be afforded today. It does not guarantee that a provider will accept a child who appears uninsured at the time care is needed. And it still requires the family to complete the application and eligibility process afterward.

Insurance creates access and security before a crisis. Retroactive payment of some bills after a child becomes sick is no substitute for continuous coverage.

Four Arguments and Still No Answer

Look at what has been said about Medicaid and children by the Administration and Paragon over the past eighteen months.

First: “There are no cuts.” But there are. The nearly $1 trillion reduction in federal Medicaid and CHIP spending is the largest in history.

Then: “The cuts do not target children.” But children rely on the same state programs, providers, eligibility systems, and families that the law places under enormous financial and administrative pressure. Intent does not erase impact. CBO estimates that 3 million children will lose coverage.

Now: “Child Medicaid and CHIP enrollment is declining, but the numbers may be demographics, duplicates, or bookkeeping.” Some may be. The reality is that children are more likely than not to become uninsured.

And in reserve: “If children did leave Medicaid, perhaps they landed somewhere better.” Again, that is a possibility presented without evidence and private coverage with unaffordable premiums, deductibles, and weaker pediatric protections is not progress.

The disturbing facts are these: Medicaid and CHIP enrollment has fallen by 2.3 million children before most of H.R. 1’s central coverage provisions have taken effect. The most recent available state-level data from the ACS show that child uninsurance was already rising as public coverage declined. There was no corresponding increase in private coverage among low-income children. And CBO projects millions more people will become uninsured because of H.R. 1.

We should not claim to know precisely what happened to every child before the evidence arrives. But uncertainty about their destination is not evidence that they are fine.

It is an obligation to find them.

What cannot always be reversed is what happens to a child during a gap in coverage: a missed diagnosis, unmanaged asthma, an untreated behavioral health crisis, a prescription that goes unfilled, or an emergency room visit that should have been prevented by an ordinary checkup. Those children are not a rounding error in a fertility table, and they will not be made whole by a footnote about duplicate records.

Congress can and must choose differently. It can:

• Repeal the nearly $1 trillion in Medicaid and CHIP cuts that are coming.

• Restore the ACA’s enhanced premium tax credits.

• Pass the CHIPP Act, introduced by Rep. Nanette Barragán (D-CA), and guarantee that millions of children enrolled in CHIP do not face uncertainty when current federal funding expires after fiscal year 2029.

• Guarantee continuous eligibility for children from birth until age six.

• Take up Sen. Andy Kim’s MediKids bill and ensure that no child in this country goes uninsured.

Every one of those choices remains available.

What we cannot afford is to spend another two years debating whether a decline of 2.3 million children is worth investigating.

Alker’s conclusion was a request. Rather than holding press conferences about fraud in the name of protecting low-income children, she wrote, federal officials should be scrambling to determine the root cause of the coverage decline and what they can do to reverse “a disaster in the making.” She is right.

Schneider closed his testimony with the same observation, directed at the agency. While CMS leadership has focused its attention and energy on allegations of fraud in state Medicaid programs, it has failed to account for the 2.3 million children who have left the rolls since January 2025. Congress, he told the Committee, should direct CMS to use its resources to reverse that trend.

Decades of bipartisan progress on children’s coverage are being undone right now.

Paragon asks Georgetown to prove where every child went before expressing alarm. That has the burden backward. When 2.3 million children disappear from public coverage rolls, the government responsible for administering those programs should determine what happened to them.

We should strive to ensure that every child has health insurance and reject policies that erect bureaucratic barriers and increase the likelihood that eligible children become uninsured. No law, regulation, or administrative practice should leave more children uninsured than it found.

Sadly, whatever the explanation, 2.3 million children have lost Medicaid coverage, and the people responsible for their health are pretending all is fine.

The health of our children is a “higher calling.” RFK Jr. is right about that. But words are meaningless unless they are backed by policies that make progress for children rather than harm them.

Holding a position of public trust means more than insisting that children are the priority. It means accounting for them when they disappear from coverage, and changing course when government policy puts their health at risk.

Let’s get back to that former bipartisan commitment to children that has been the legacy of the adoption of the Children’s Health Insurance Program (CHIP), which was championed by somebody quite familiar to RFK Jr. – his uncle Sen. Edward M. Kennedy (D-MA), along with his partners, Sens. Orrin Hatch (R-UT), Jay Rockefeller (D-WV), and John Chafee (R-RI).

In the name of children, try it.

Kids can’t wait.

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Unfortunately, debates over Washington State’s November ballot Initiative 001 (IL26-001), which asks voters to roll back the State’s protections for children in its “parents’ bill of rights” laws, has mostly been framed as a contest between two forms of adult authority over children: parents versus government.

That’s the wrong frame entirely. Child protection laws are about the children. It’s a vote over whether Washington State keeps or discards a set of narrow, carefully crafted safeguards for the moment when a child’s safety and a parent’s access to information are genuinely in tension. Unfortunately, much of the current coverage doesn't explain what those safeguards actually are, or what changes if voters remove them.

Sometimes a child needs protection from government. Sometimes a child needs protection from a parent.

This piece is an attempt to explain, plainly, what changed in Washington State law over the last few years and what Initiative 001 would change again. Based on the simple standard – Is it good for the children? – voters should reject Initiative 001 and protect children from harm.

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How Washington State Got Here, and A Detail Few Are Explaining Correctly

In 2024, the Washington State Legislature enacted Initiative 2081, a “Parents’ Bill of Rights.” Washington’s constitution allows two kinds of citizen initiatives. An “initiative to the people” goes straight to the ballot. An “initiative to the Legislature,” which is what I-2081 was, works differently. In the latter case, proponents gather signatures, and then the Legislature itself gets to decide what happens next. It can adopt the measure directly, in which case it becomes law with no public vote. It can decline to act, in which case the measure automatically goes to the ballot. Or it can send its own alternative to the ballot alongside the original.

In 2024, the Legislature chose the first option. It adopted I-2081 itself. That’s why the law took effect immediately, and it’s also why the Legislature retained the ordinary authority to amend it later.

Problems arose quickly. The Office of Superintendent of Public Instruction (OSPI), Washington’s state education agency, issued legal guidance in 2024 and again in 2025, flagging that I-2081 conflicted with existing state and federal law, particularly around student health privacy. The law also landed in court. However, before the Washington Court of Appeals could rule, the Legislature clarified the challenged provisions through passage of House Bill 1296.

HB 1296 did three things worth naming specifically:

It protected the confidentiality of a child’s mental health counseling. A student’s medical, health, and mental health counseling records are not automatically inspectable by a parent the way ordinary education records are. This distinction exists because federal law (HIPAA) and Washington’s own health information privacy statute already treat health records differently than report cards and because Washington law already lets adolescents to consent to certain mental health and medical care on their own.

It preserved an existing safety valve for runaway and homeless youth. Washington has long had a separate law (part of what’s called the Family Reconciliation Act) governing what happens when a minor shows up at a licensed overnight youth shelter on their own, having left home without a parent’s permission. “Licensed” here means the shelter is certified by the state to legally house minors and meets state child-welfare standards for their care. It’s a formal facility, not an informal arrangement. A “host home” is a similar, state-approved private home that takes in a runaway or homeless youth under the same rules. These are not children placed by the government. They are young people who ran, or were taken in by someone after fleeing.

Under that existing law, the shelter or host home must notify the parent within 72 hours unless there’s a “compelling reason” not to, which the statute explicitly defines to include a circumstance suggesting the parent will respond with abuse or neglect.

In that case, the shelter notifies the Department of Children, Youth, and Families (DCYF), Washington’s child welfare agency. HB 1296 made clear that this long-standing safety valve wasn’t overridden by I-2081’s separate “immediate notification” language.

It consolidated scattered rights into one place. For the first time, HB 1296 gathered protections that had been spread across many different sections of Washington code -- including non-discrimination guarantees, special education due process rights, language access for non-English speaking families, bullying complaint rights, military family enrollment protections, notification of staff misconduct — into the single parental rights statute, so a parent looking for their rights could find them in one place instead of hunting through the code.

What Initiative 001 Actually Does

Initiative 001 is backed by a political action committee, Let’s Go Washington, and its founder Brian Heywood. It rewrites Washington’s core parental rights statute by repealing important safeguards for children included in HB 1296 and layering a few new provisions on top.

The measure is going to a public vote in November 2026. If it passes, the Legislature cannot fix problems with the language for two years unless it gets two-thirds vote of both chambers.

Initiative 001 makes several specific changes that matter for children in danger:

• Mental health counseling records become inspectable by any parent, with no exception unless an abuse investigation is already open, which means a child’s first disclosure to a counselor gets no protection at all.

• It strips Washington’s own guarantee of the “sole possession records” exception — the protection for a counselor’s private, never-shared notes that federal law has long treated as off-limits to disclosure.

• It narrows the exception protecting a child’s records when a parent is under abuse investigation, and eliminates entirely the separate protection that applies when a parent is criminally charged with a crime against the child.

• It reopens a conflict HB 1296 had resolved between a right to “immediate parental notification” when a child is taken to a shelter and the existing runaway youth law that lets a shelter notify child welfare authorities instead, when there’s reason to think the parent is the danger.

Why the Standard Framing Misses Broader Points Around the Safety and Health of Children

Governor Bob Ferguson’s press conference rightfully opposed Initiative 001 by calling it a rollback dressed up as a restoration. He stood alongside LGBTQ advocates making the outing risk argument, a real and serious risk that deserves exactly the attention it got.

What the press conference didn’t add, and what most coverage of it didn’t ask about, is the rest of the case: the sole possession records exception, the runaway shelter safety valve, the narrowed abuse investigation shield, and the weakened crime notification standard. Each of those protects LGBTQ kids too, along with every other child in danger, including abuse survivors, runaways, and other kids whose homes are not safe.

Most media coverage of this initiative — and most of the advocacy on both sides — treats it as a fight over LGBTQ students specifically. A child who is LGBTQ and not safe disclosing that at home faces a genuine, documented risk under this initiative’s expanded records access, and this is an important reason to oppose Initiative 001.

There are other reasons as well. The confidentiality and safety valve provisions that Initiative 001 strips out protect every child in danger, including children disclosing abuse for the first time before any investigation exists to shield them, the runaway who fled a violent home, the child whose parent is the reason they need a counselor at all.

As James Fineman-McKinney, a school counselor in Tacoma, WA, explains:

While purporting to be about parents’ “right to know,” I-001 will force schools to hand over sensitive information about child abuse victims to their parental abusers.

According to legal analysis, should this initiative pass, it would force schools to hand over sensitive information, including private social work and school counseling records to parents under criminal investigation or who have been charged with raping, assaulting or otherwise harming their own child. I-001 puts vulnerable children at even greater risk of harm.

Washington State Sen. John Lovick, a former state trooper and sheriff, adds:

School counselors, domestic violence prevention advocates, and law enforcement officers oppose Initiative 001 because it could put vulnerable children who’ve suffered abuse, violence, sexual assault, or neglect at risk of greater harm by their abusers.

It’s unclear who, if anyone, mega-millionaire Brian Heywood consulted when drafting this initiative. It’s one of the most complex, confusing, and poorly written measures I’ve ever seen. Parents already have strong rights when it comes to their children in school, and this initiative actually weakens some parents’ rights while also putting children in danger.

The ACLU of Washington made a related point in its challenge to the original law, noting that Black and Indigenous students disproportionately rely on school-based confidential health and counseling resources: meaning erosion of that confidentiality lands hardest on students already less likely to have alternative access to care.

So, we must ask the questions that the parent-versus-government framing that proponents of Initiative 001 leave out. They involve the children themselves:

• What happens to the child who walks into a counselor’s office because the danger is at home?

• What happens to the teenager who has already fled that home and arrives at a shelter asking for help?

• What happens when the parent demanding access to the child’s records is under investigation for abusing that child or is actually being prosecuted for a crime against them?

• What good is a right to seek help if asking for it automatically alerts the person a child is afraid of and was abused by?

Based on these questions and the overarching standard – “Is it good for the children?” – Initiative 001 fails children and should be rejected.

You can believe, as we do, that meaningful parental engagement in a child’s education and health is a good thing, but still recognize the reality that a law removing the narrow, carefully built exceptions for children will place them in active danger.

The League of Women Voters of Washington State, a nonpartisan civic institution, opposes Initiative 001. Their president, Karen Crowley writes:

Initiative 001 removes commonsense protections for victims of child abuse. In 2024 alone, Washington received 117,000 reports of child abuse or neglect. This initiative puts additional numbers of children at greater risk by allowing abusers under investigation or charges with sexual abuse, violence, or neglect to access their victims’ private records without a subpoena. That’s why law enforcement and the Washington Coalition Against Domestic Violence and Sexual Assault oppose the initiative.

Crowley adds:

School nurses and counselors say this measure discourages students who face domestic violence, sexual abuse, or bullying from seeking help from trusted teachers and other school professionals, who, under the provisions of the initiative would be required to release students’ confidential records.

[Initiative 001] would also force schools to “out” LGBTQ+ students, putting them at greater risk of potential abuse, and homelessness. In a 2011-2012 survey of agencies, 43% of the homeless LGBT youth being served were kicked out of their homes by unsupportive families. That’s why the Washington State Nurses Association, doctors, and school counselors oppose this measure.

The language in Initiative 001 is so broad and sweeping that it even threatens basic health care services for children. For example, it requires “prior notification when medical services are being offered to their child, except where emergency medical treatment is required.” There are no exceptions cited in Initiative 001.

Although this is branded as a notification requirement, the experience in neighboring Idaho and other states like Texas, Tennessee, and Florida demonstrates that it results in the delay or denial of important services, from basic first aid and concussion care to mental health services.

The State of Washington should not follow those states down that road, which has also resulted in the delay and denial of health care services to pregnant teenagers, including those who must obtain parental consent from a parent who may have sexually abused them.

Idaho, in particular, shows what the sweeping parental rights laws look like: a religious exemption treating parental authority as near-absolute has been linked to preventable child deaths, according to a ProPublica investigation.

The State of Washington should take great care to protect the health and well-being of its children by voting NO on Initiative 001.

What a “NO” Vote Means

A “NO” vote on Initiative 001 does not reject parental rights. Instead, it leaves Washington’s current parental rights law in place: the version the Legislature refined in 2025 after the state’s education agency identified problems with implementing the original law.

A NO vote keeps mental-health-counseling confidentiality intact for children who haven’t yet had an investigation opened on their behalf. It keeps the existing safety valve available for a child who has fled a dangerous home to a shelter. It keeps the broader notification standard for crimes committed against a child at school. It keeps the consolidated rights statute Washington families asked for.

A “yes” vote undoes all of those protections for children.

Children don’t get to vote on this. Yet, they are the ones who will live with the consequences of laws determining whether they can safely seek help when they are in danger, harmed, or abused.

These are the children missing from a debate framed simply as parents versus government.

On Initiative 001, put them back into the picture. Vote NO.

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Children desperately need people and organizations that enable their voices to be heard and to advocate for their fundamental rights and best interests, as they are almost always excluded from the rooms where decisions are made about their lives and futures.

At First Focus on Children, our job is to make sure they are no longer invisible and ignored by our policymakers. We are proud to work alongside advocates across the country who share that commitment. Together, we seek to ensure that children are seen, heard, and treated as a national priority.

We find that almost every major policy issue is also a children’s issue. Our job is to show up — at our nation’s Capitol, before the Supreme Court, in state legislatures, and at federal agencies most people have never heard of — to make the case for your kids and mine. We ask policymakers to answer one simple question: ”Is it good for the children?”

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Overcoming the Invisibility of Children

For kids, they often are an afterthought in these debates because they don’t vote, they don’t hire lobbyists, they don’t have political action committees (PACs), and they rarely get invited to testify. Yet decisions about their lives are made in the backrooms of the nation’s Capitol, in statehouse corridors, and by school boards every day. Therefore, where we can, we seek to be present and to ensure children’s concerns and best interests are seen, understood, and heard.

Friends, neighbors, family members, and Substack readers sometimes ask a deceptively simple question: “What does it mean to be a child advocate?”

I could go into all that we do, including policy analysis, education, organizing, coalition building, partner engagement, meeting with policymakers and their staff, talking to the media, and writing reports. But that can make people’s eyes glaze over.

So, the most honest and simple answer is this: if you are a child or care about the lives of children, we are your advocates.

Why I Do This Work

I was born in the Texas Panhandle to parents who grew up in small farming communities – places portrayed in John Steinbeck’s The Grapes of Wrath and Kristen Hannah’s The Four Winds – where weather, grinding poverty, difficult work, and churches, schools, and main street stores shape everyday life.

Both of my parents became educators, as did other members of my family, so education, health, nutrition, economic, and child safety issues were always central to conversations at our dinner table and family reunions.

At an early age, we moved to El Paso, Texas, and literally lived on the far western edge of Texas – just a mile from both the New Mexico and Mexico borders. Growing up on the U.S.-Mexico border taught me that Washington, D.C. may be far away, but the decisions made there don't stay there. They shape whether a kid gets to grow up safe, healthy, and hopeful.

During my childhood, nearly 40% of El Paso’s children lacked health insurance, and I remember how wrong it was when I lost a classmate to cancer because they lacked access to care due to the lack of health coverage. Later, when I took a job doing government relations for University Hospital in El Paso, the head of pediatrics took me on a tour of the child-focused areas of the hospital, including the neonatal intensive care unit (NICU), and spoke to me about the reasons why all children deserve to have health coverage.

Years later, I was pleased to work on Capitol Hill and here at First Focus on Children to expand the Medicaid program to more children, to protect it from repeated attempts to slash it, and to help establish the Children’s Health Insurance Program (CHIP), which, in tandem with Medicaid, helped cut the uninsured rate for children from 15% in 1997 to less than 5% in 2016.

Unfortunately, that fight continues. While we strive to cover all kids and ensure their health improves, policymakers sometimes put our children on the wrong path. Last year, Congress passed and President Trump signed into law a bill, the so-called “One Big Beautiful Bill,” that slashed Medicaid and CHIP by nearly $1 trillion over a decade. At First Focus on Children and our sister organization, First Focus Campaign for Children, we are urging policymakers to do better by our kids.

As a kid, I also remember what the Supreme Court’s decision in Plyler v. Doe meant to us in El Paso. The Court held that states could not deny children a free public education because of their immigration status. That decision ensured that some of my classmates and friends could receive an education.

Because the principle established in Plyler is still being challenged today, child advocates must continue to show up and defend every child’s access to education. This includes defending the federal commitment to education, even as the Administration seeks to abolish the Department of Education and eliminate or reduce much of its funding.

The belief that our society and our government should do what’s best for children is something that we will always champion. That’s the thread that runs through everything we do at First Focus on Children and why I do this work, which is to ensure that someone is making decisions on issues of importance to children, that their needs, rights, and futures are part of the discussion.

What That Looks Like in Practice

Through the Kids Can’t Wait and First Focus on Children newsletters, we examine the policies being considered by the Administration, Congress, state legislatures, and at the Supreme Court that will impact children – for better or worse.

Whether that means writing an issue brief, issuing a report like our Children’s Budget or Babies in the Budget publications, educating Members of Congress or their staff, working in coalition with other federal and state partners, filing a brief before the Supreme Court, speaking to the media, posting on social media, or asking people all across this country to weigh in with their policymakers about these issues, our end goal is to make the best and most visible case to decision-makers about the need to do a better job of keeping our promises to our children and grandchildren.

This work can be painstaking, including combing through the entire federal budget to identify the individual line items of importance to children both in the U.S. and abroad. Although laborious and technical, when we complete the process each year, our budget reports provide the Administration, Congress, other advocates, and the media with the only comprehensive look at the share of federal spending actually dedicated to children. If budgets tell us what we value, this work allows the nation to see, in dollars and cents, whether we are valuing and investing in the next generation or not.

As one of the nation’s leading groups fighting for children and families, our work also means paying attention to all the little things that don’t make headlines: the quiet rule change at an agency, the fine print in a bill that guts a program nobody’s watching, the moment when a court case that will affect millions of kids gets almost no coverage.

That’s where a lot of the damage and a lot of the fight actually happens.

What Real Advocacy Requires

Being an advocate also means being willing to express plainly and clearly what it is that children need. At First Focus on Children, we call balls-and-strikes.

If a policy would improve children’s lives, we will support it and say so, regardless of which party proposed it. If it would harm children, neglect their needs, or diminish their rights, we will oppose it and say so, regardless of who is responsible.

That is what it means to be nonpartisan. It does not mean engaging in “both-sidesism,” pretending that competing proposals are equally good for children when the evidence says otherwise, or settling for the lowest common denominator simply because it is the most that everyone can accept. Children need advocates who can honestly describe the circumstances that children face and who fight for the better world children deserve.

Calling balls-and-strikes can make people uncomfortable, but it is honest. Although it can create political and financial blowback, our responsibility is not to make institutions, political parties, or even our own allies comfortable. Our responsibility is to children.

That does not mean rejecting incremental progress. An incremental gain that meaningfully improve children’s lives can be an important step forward. Progress is progress. The challenge is to secure improvements that help children now without allowing today’s political limitations define what children ultimately deserve.

We can accept a step forward and not allow the perfect to be the enemy of the good. On the other hand, we should not pretend that incremental progress means that we have reached the ultimate goal or destination. We must always strive for better.

What You Can Expect from This Newsletter

That same commitment guides what I write about here. Kids Can’t Wait provides a close, evidence-driven look at the policy fights affecting children, especially those receiving far less attention than they deserve.

Sometimes policymakers target children for outright harm or abandonment. Sometimes they change laws in ways that can have unintended consequences for children. Sometimes they treat kids as an afterthought and leave their needs ignored or dismissed. And sometimes policymakers genuinely prioritize children and get it right.

When these debates are happening, I will continue to share how both policies and the politics are uniquely impacting children. I will also call them as I see them: supporting good proposals for children and opposing harmful ones, regardless of party.

On multiple indicators of child well-being, our children are struggling and fairing poorly. This create real urgency and kids can’t wait for us to get this right.

But I also want this to be a place where you know something simpler: that children and families have advocates in Washington, D.C., whether or not you ever read a single line of legislative testimony. My colleagues at First Focus on Children and I are striving to be that voice – for your child, your grandchild, your family, and children whose interests might otherwise go unheard.

Both here and on First Focus on Children’s own Substack, we will be doing more to make it clear what all of this means for real families and children in the months ahead, including more short videos by our team or from guests.

If that’s something you want to be part of — as a reader, as an ambassador who helps spread the word, or as a supporter who helps fund the fight — we need your help.

• Stay informed. Subscribe to Kids Can’t Wait and First Focus on Children.

• Help children be heard. Become an Ambassador for Children and share these issues with your community and elected officials.

• Sustain the work. If you are able, make a charitable donation to support the advocacy that makes this work possible.

Our kids can’t wait, because too many politicians have put children's lives and futures on the wrong path. The overall share of federal investments on children has dropped from around 12% in 2021 to just 8.57% in 2025. Consequently, federal interest payments now far exceed all federal spending on children combined (a debt the next generation will eventually be asked to carry). This is one of many indicators as to how our policymakers are failing the next generation.

At First Focus on Children, we will continue to analyze the budgets, read the fine print, challenge harmful decisions, support good ones, and make the case that children must be treated as a national priority rather than as an afterthought.

While we cannot guarantee success, we can promise that we will show up: for your children and grandchildren, for children you may never meet, and for a country whose future depends on whether they are safe, healthy, educated, and hopeful.

In this moment when many people, including kids themselves, are losing hope that those in power are thinking about them, children need someone paying attention, speaking up, and demanding accountability. That’s what we do. Please join us.

Kids can’t wait.

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Thanks to my friend and fellow child advocate Stephanie Malia Krauss, who encouraged me to step back for a moment and write about the importance of child advocacy, how we do it at First Focus on Children, and why it is so desperately needed.

After I published my newsletter yesterday, a federal judge issued a temporary injunction against the most recent Trump Executive Order on birthright citizenship later that afternoon. However, the Administration will undoubtedly appeal the decision, so this debate will continue.

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The Trump Administration is, according to Reuters, drafting new passport guidance that would require parents to prove their own citizenship or immigration status before their U.S.-born child can receive a passport. This is intended to open a new opportunity for the Administration to question the citizenship status of children.

Right now, a child applying for a passport must provide evidence of the child’s own citizenship. For most children born in the United States, a certified birth certificate does the job. Parents must establish their relationship to the child, present photo identification, and indicate whether they are U.S. citizens, but they generally do not have to submit documents proving their own citizenship or immigration status.

Under the draft guidance, that would change. State Department adjudicators would collect “parental information and evidence of parental citizenship or immigration status” to determine whether a child is covered by President Trump’s August 6 Executive Order targeting so-called “birth tourism” and attempting to create new exceptions to birthright citizenship.

This is the latest salvo in the Administration’s relentless assault on the citizenship status of children. The Administration’s latest Executive Order attempts to condition a U.S.-born child’s constitutional citizenship on some sort of audit of their parents’ paperwork. Once again, this is at odds with the Citizenship Clause in the Constitution, as the Supreme Court recently reaffirmed in Trump v. Barbara. It is yet another example of the Administration’s endless policy proposals that negatively impact children.

Reuters reports that the proposed guidance would apply to every child seeking a passport in this country and not merely to families suspected of fraud or other wrongdoing. Parents and guardians would be required to produce documents such as a valid U.S. passport, birth certificate, I-94 immigration record, or permanent resident card so the State Department could investigate whether the child qualifies for a passport under the new order.

That is a remarkable inversion of the current process, the Supreme Court’s recent decision affirming birthright citizenship, and over 100 years of federal law, administrative rule and practice.

The child’s birth on U.S. soil would no longer necessarily settle the question of citizenship for the Administration. The government would look behind the child’s own evidence of citizenship and investigate the adults responsible for submitting the application. The Administration’s goal is to create a loophole in which a child’s birth does not automatically convey citizenship under the guise of trying to stop “birth tourism” or “fraud”.

However, if the goal were simply to investigate specific evidence of “birth tourism,” fraud, or determine whether a parent possessed diplomatic immunity, the State Department could examine those cases individually. Instead, the Administration is seeking to require every child seeking a passport in America to go through a brand-new parental-status checkpoint. This would place each and every child’s citizenship documentation under potential suspicion and question.

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The Constitution Doesn’t Have a Parental-Paperwork Clause

Despite the Administration’s repeated attacks on birthright citizenship, the Constitution’s Citizenship Clause explicitly confers birthright citizenship on all children born in this country and who are subject to its laws.

That alone should have ended the Administration’s effort to make a child’s citizenship depend on a parent’s immigration status.

Instead, the Administration has returned with a narrower Executive Order in one respect but with a far different and broader documentation system at the State Department. The proposed passport guidance would require every family applying for a child to produce evidence about the parents, so that the government can decide whether the child falls within one of the new exceptions the President has attempted to create.

This new order is also broader in another way: unlike the original order, which applied only to children born after a specific date going forward, this one seems to be retroactive — which is why advocates have already asked a federal court to block the Administration from applying it to children who were born before the order was signed.

Furthermore, the Administration is trying to invent new conditions of citizenship for children that the Constitution does not contain. Although the Supreme Court has recognized a narrow historical exception for the U.S.-born children of foreign diplomats who possess immunity from American law, the new Executive Order goes considerably further. It expands the exception to include any parent who works at a foreign consulate or embassy, not just ambassadors and people with diplomatic immunity. It attempts to exclude children based on a parent’s alleged involvement in a surrogacy arrangement, another “commercial transaction,” or fraud.

The Constitution does not hold a child responsible for the status, circumstances, political views, or actions of their parents. It grants children birthright citizenship. Full stop.

Who Actually Gets Hurt

On paper, the proposed documentation requirement would apply to every family seeking a passport for a child. In practice, it would not burden every family equally. This is the quiet cruelty of the design.

A parent with a valid U.S. passport can make another photocopy and move on.

A naturalized citizen might have to locate documents issued years or decades ago. A parent whose lawful immigration status is being extended, reviewed, or corrected could face delays and uncertainty. A parent without legal status may reasonably fear that submitting immigration information to a federal agency will expose the entire family to enforcement.

The government knows this.

A parent without legal status may be unwilling to walk into a passport office and hand over information about their immigration history, even to obtain a passport that their citizen child is legally entitled to receive.

Whether that chilling effect is the policy’s formal purpose or merely its entirely foreseeable result, the consequence will be the same: some citizen children will never receive passports because their parents are afraid that applying will expose their families to immigration enforcement.

Denial by decision and denial by deterrence arrive through different doors. The child is left outside either way.

A formally universal paperwork requirement can therefore produce profoundly unequal results. The government would make every child pass through a parental-status checkpoint while knowing which children are most likely to be stopped there.

Children do not choose their parents’ immigration status. They do not choose where they are born. Birthright citizenship exists precisely so that a child’s legal standing in this country is not held hostage to a parent’s nationality, status, or circumstances. Birthright citizenship exists to protect children from statelessness, exclusion, exploitation, and the creation of a hereditary caste system.

A Status Check Only Children Will Ever Face

There is another inequality at the center of the proposal.

Adults born in the United States do not have to prove their parents’ citizenship or immigration status when they apply for or renew their passports. They establish their own citizenship through their own birth certificates, previous passports, or other accepted records. In effect, adults will not be affected.

Instead, the proposed guidance would only target children.

This burden is especially consequential for children because they cannot apply on their own. They cannot retrieve their parents’ records, explain discrepancies in immigration databases, challenge an official’s suspicion, or decide whether the family can safely disclose information to the federal government.

By definition, children depend on adults to exercise a right that belongs to the children themselves. That dependency becomes the mechanism through which the government is threatening the status of babies and children.

The Administration is purposefully exploiting the legal dependency of childhood to make a child’s access to citizenship documentation contingent on information about their parents. No adult citizen born in America will ever be required to prove that their parents were legally present when they were born, but every child would have to do so if the Administration has its way.

The Impossible Paperwork Problem for Some Children

Even setting aside the constitutional questions, consider how children would be expected to comply with this new system.

A child in foster care is more likely to have birth parents who are absent, unreachable, incarcerated, or the reason the child was removed from the home. The existing passport process permits foster-care agencies and legal guardians to use court orders and other records to establish their authority to apply. But would those documents also relieve the agency of an obligation to establish the absent birth parents’ citizenship or immigration status?

The reported guidance does not yet give the public an answer.

A child fleeing a violent household, or living with one parent who has cut off contact with an abusive partner, may have no safe means of obtaining the other parent’s immigration documents. A protective order may exist precisely to prevent the contact that the passport process could effectively require.

A child with a parent in jail or prison may have no practical way to retrieve records controlled by that parent.

A child being raised by a grandparent or another relative may have little or no contact with either biological parent, much less access to their passports, naturalization certificates, immigration forms, or records of their legal status at the time of the child’s birth.

The existing passport system contains alternatives for families in which both parents cannot appear. Depending on the circumstances, families can submit custody orders, death certificates, foster-care guardianship documents, incarceration records, restraining orders, or statements describing special family circumstances.

But those procedures were designed primarily to establish parental consent and protect against international child abduction. They were not designed to reconstruct the citizenship and immigration history of every absent parent.

These circumstances describe millions of American children living in ordinary, completely legal family arrangements, yet their citizenship status could be threatened by the Administration’s new policies.

Babies Do Not Sign Surrogacy Contracts

The Executive Order’s treatment of surrogacy is particularly troubling, as it targets certain children born through surrogacy, potentially making a child’s citizenship depend on how adults arranged and financed the pregnancy.

That raises questions extending far beyond immigration enforcement.

Which parent’s citizenship or intent controls? How would the State Department treat an American surrogate carrying a child for intended parents from another country? What happens when a state court has entered a pre-birth or post-birth order recognizing the intended parents? Can the executive branch create a disfavored constitutional category of children based on a lawful reproductive arrangement entered into before they were born?

Most important, why should any of those adult decisions diminish the status of the child?

A baby does not negotiate a surrogacy agreement. A baby does not select the adults involved, determine how they are compensated, or choose the jurisdiction in which a contract is signed.

Yet the Executive Order proposes to attach constitutional consequences to the baby because of it. Again, it defies the Constitution’s very clear birthright citizenship clause, which is a fundamental child right.

A Passport Is Not a Citizenship Permission Slip, but Is Important

A passport does not create citizenship. Instead, a passport provides proof of citizenship. The Constitution’s birthright citizenship clause and federal law are what decide citizenship.

A passport is important because it allows people to travel and is, like a birth certificate, one of the clearest and most durable pieces of evidence or documentation of their citizenship.

That is why placing an unconstitutional condition inside the passport process can do enormous harm even if the government stops short of formally “revoking” a child’s citizenship.

What Happens Next

The proposed State Department guidance has not been finalized, and the Administration’s latest Executive Order is already headed toward another court fight.

Lawyers representing babies who would have been deprived of citizenship under Trump’s original order have asked federal judges to prevent the August 6 order from taking effect. In Maryland, U.S. District Judge Deborah Boardman declined to block it immediately because the plaintiffs’ existing complaint did not yet challenge the new order. But she allowed them to amend their case and established an expedited schedule.

She also reportedly questioned where the Supreme Court’s ruling recognized an exception to birthright citizenship for “birth tourism.”

The Justice Department has so far relied in part on a procedural shield. It argues that judicial intervention is premature because federal agencies have not finished explaining how the new order will be implemented.

The Administration cannot have it both ways. It cannot order agencies to stop recognizing some children as citizens while asking courts to look away until the administrative machinery is fully assembled.

The State Department should release the complete proposed guidance. Congress should demand answers about how this process would even work. The Administration should have to explain why it is, once again, targeting children for harm.

Hopefully the courts will reject it, once again.

Citizenship Is Not Provisional

The proposed passport policy reveals a recurring form of governmental blindness to childhood. It treats children not as citizens possessing rights of their own, but as extensions of adults whose status, conduct, employment, and paperwork can be imputed to them.

Children do not choose their parents’ immigration status. They do not negotiate surrogacy agreements, take foreign-government jobs, arrange where they will be born, or maintain the family filing cabinet.

Yet it is their citizenship documentation that the government proposes to withhold.

The Administration seems to lack the understanding that a birth certificate merely documents citizenship, and a passport simply confirms it. For children born on U.S. soil and subject to U.S. jurisdiction, citizenship arises at birth under the Constitution.

On that point, the Fourteenth Amendment rejected the idea that American citizenship should descend only through favored bloodlines or parents whom the government considers worthy. After the Supreme Court reaffirmed that principle in Trump v. Barbara, the executive branch should be implementing the decision and not searching for administrative detours around it.

A U.S.-born child’s citizenship is not provisional. It is constitutional. It does not await an audit of the parents. And the government, in the form of a passport-office counter bureaucrat, should not deny a child the documents proving their citizenship because a parent cannot, or is afraid to, produce the new paperwork the government demands.

The Trump Administration needs to stop targeting children for harm. Enough already.

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• An inadequate benefit (the prescription drug bill’s bizarre “donut hole” took over 20 years to eliminate).

• Inadequately financed.

• Imposed billions of dollars in cost shifting to the states by commandeering state Medicaid funding to help partially pay for the legislation (otherwise known as the “clawback”).

In a blog I wrote 15 years ago, I revisited the Medicare Part D clawback, which operates as a rather strange and largely invisible piece of federal policy forcing states to send billions of dollars a year to the federal government to help pay for a federal prescription drug benefit for seniors.

At the time, it seemed like a policy that would eventually force a reckoning. Since the Supreme Court found it “coercion” for Congress to provide 100% federal financing to states for an expansion to low-income adults as part of the Affordable Care Act (ACA), how can the Court justify a policy which requires states to write checks to Washington, D.C. to help finance a Medicare drug benefit that states don’t run, don’t control, can’t appeal, and have no meaningful say in designing?

Today, nothing has changed, except the size of the clawback. What started as a $5.5 billion program in 2006 has more than quadrupled in size.

According to Federal Funds Information for States (FFIS), the clawback is projected to cost states $23.2 billion in calendar year 2027 — a 13.7% jump from 2026, which is the largest year-over-year increase since the program began and more than 4 times the overall amount of $5.5 billion in 2006.

Month after month, since the clawback began in 2006, states have been required to make monthly payments to the federal government. And this year, the clawback is becoming part of something even more dangerous: a fiscal vise closing around state budgets in combination with the more than $900 billion in cuts to Medicaid and nearly $200 billion in cuts to SNAP that the federal government imposed as part of H.R. 1, the so-called “One Big Beautiful Bill” (OBBB).

Less money is coming in for programs that states actually administer, while more money is being taken from states for a program they do not control.

It is rather surprising that the governors from both political parties aren’t up in arms about the clawback. Part of the answer is that almost nobody is paying attention to what is likely to cost the states $300 billion or more over the next 10 years.

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What the Clawback Is

When Congress created the Medicare Part D drug benefit in 2003, it shifted responsibility for people covered by both Medicare and Medicaid – known as “dual eligibles” – from state Medicaid programs and onto Medicare for the new prescription drug benefit.

To help partially finance the legislation, Congress required states to pay the federal government a percentage of what they would have spent on those beneficiaries’ drugs under Medicaid, monthly and indefinitely. Miss a payment, and the amount is clawed back from the state’s Medicaid funding automatically.

This State Issue Is Also a Problem for Children

If anyone talks about the clawback, they almost exclusively describe it as a state budget or federalism issue. Although it is that, it is also — quietly and mechanically — a children’s issue, for three structural reasons:

• Children are the largest population in Medicaid. They make up roughly 4 in 10 Medicaid enrollees nationwide, more than any other group. When a state’s Medicaid obligations grow or federal funding is withheld, the health coverage of children is threatened.

• Children have among the lowest federal matching rates in Medicaid. The federal government picks up a smaller share of the cost of covering kids than it does for many other populations, which means state general funds carry a disproportionate share of children’s coverage — the same general funds the clawback draws down every month.

• Roughly two-thirds of all public funding for children in this country comes from the state and local level, not the federal government. Unlike Social Security, Medicare, or federal tax credits, most of what government spends on kids is a state or local choice, funded by state dollars. The clawback isn’t just squeezing “state budgets” in the abstract — it is competing directly, dollar for dollar, with the funding base that kids depend on for an array of programs and services at the state level.

The clawback doesn’t have to result in a budget line labeled “cut to children” for it to harm them. State budgets are fungible. A dollar that must be sent to Washington is a dollar unavailable for Medicaid, schools, child care, behavioral health, foster care, housing, or any of the other responsibilities that states have to children.

An Autopilot Formula, Unmoored from What States Can Afford

There’s a deeper problem that disproportionately punishes states for having offered more generous drug coverage more than two decades ago. Every state’s clawback funding formula is calculated based on what it spent on drugs for “dual eligibles” in 2003 — 24 years ago — reduced by that state’s unique 2003 manufacturer rebate percentage. This net figure is trended forward every year since by a federally calculated national inflation rate, but never recalculated against what any state actually spends today.

To see how absurd this compounding “historical lock-in” is in practice, look at the actual audited base figures that CMS locked into the permanent formula for New Jersey and Arizona:

Note: These baseline amounts isolate the per capita calculation from 2003 before the cummulative inflation adjustments and the final FMAP state-matching modifcation is applied.

There is zero chance that the actual drug utilization costs for low-income dual eligibles in New Jersey are structurally more than double those of Arizona’s dual eligibles today. These base rates were locked in before Facebook even existed, and nothing in the formula ever updates them.

Because federal inflation (the Annual Percentage Increase) is applied as a percentage multiplier, New Jersey is hit with an exponential penalty in its clawback calculation. A state with a high baseline absorbs a vastly higher raw dollar amount of inflation every single year. Even if New Jersey completely overhauled its state pharmacy systems over the last two decades to become the most efficient, cost-saving state in the country, its clawback bill would not drop by a single penny. The state is legally trapped by its 2003 snapshot.

Consequently, even though New Jersey and Arizona enroll a comparable volume of dual eligibles in their Medicaid programs today, New Jersey’s clawback will be an estimated $832 million in 2027, or more than three times the $267 million for Arizona. Due to the compounding nature of the inflation factor, New Jersey was paying about $110 more per due eligible enrollee than Arizona in 2006 but that gap has grown to $231 per enrollee in 2027.

Ultimately, the Medicare Part D clawback, which is estimated to be $23.2 billion in total for 2027, operates less like a dynamic federal-state partnership and more like an unyielding historical tax on states.

Furthermore, a dual-eligible beneficiary in Newark, NJ costs New Jersey taxpayers thousands of dollars more than an identical beneficiary in Tucson, AZ — not because of the medicine they take today, but because of a spreadsheet locked into place nearly a quarter-century ago.

What $23.2 Billion Actually Buys

Numbers this size are hard to feel until you put them next to something concrete. First Focus on Children’s Children’s Budget 2025 tracks federal spending on the programs kids actually rely on:

• CHIP, the program that covers roughly 7 million children whose families earn too much for Medicaid but can’t afford private coverage, receives $21.3 billion a year in federal funding. The clawback alone now exceeds the cost of health care coverage for over 7 million children.

• Head Start, the flagship federal early childhood program, receives $12.3 billion. States are sending nearly two times that amount to Washington for the clawback.

• Healthy Start, the country’s primary federal program fighting infant and maternal mortality, receives $145 million. The clawback is roughly 160 times that size. The clawback’s single-year increase alone — $2.8 billion — is nearly 20 times the entire Healthy Start budget.

Meanwhile, the clawback is permanent, but CHIP is temporary. The clawback is permanent (and adjusted automatically for inflation), but Head Start funding and the program continue to be threatened. The clawback is permanent, but the Administration has threatened to abolish Healthy Start in its budget.

States are not just losing a rapidly increasing level of funding due to the clawback. They are losing the equivalent of multiples of entire federal children’s programs, year after year, to a Medicare drug bill they didn’t write and can’t control.

The Next Decade: A $300 Billion Question

A single year’s number, however striking, understates the real stakes. Using FFIS’s own figures and nothing more exotic than a straightforward extrapolation: if you take the average annual growth rate of two of the three most recent years for which we have real numbers — 6.1% (2024 to 2025) and 5.4% (2025 to 2026) and throw out this year’s record 13.7% (2026 to 2027) increase – the estimated conservative ten-year total still coming in at roughly $300 billion.

If the faster growth associated with the 13.7% increase in the coming year’s clawback persists, the total would be considerably higher.

Again, this is hundreds of billions of dollars flowing from states to finance the federal Medicare program that states have no ability to negotiate, cap, or opt out of. How are the nation’s governors and attorneys general not screaming about this from the domes of their capitol buildings?

The Politics Are Bipartisan, Which Is Exactly the Opening

The clawback is also a bipartisan problem, with some of the states facing the steepest hikes being represented by the very leaders who control whether Congress ever touches it.

• Louisiana — Speaker Mike Johnson’s home state — is facing a $27.5 million, or 12.7%, increase in its clawback payment for 2027 alone for a total 2027 clawback of $244 million.

• Idaho — Sen. Finance Committee Chairman Mike Crapo’s home state faces a 12.4% increase, pushing its total 2027 clawback to $66.3 million.

• Missouri — The home state of Rep. Jason Smith, who chairs the House Ways and Means Committee, faces a $50.4 million increase, pushing its total 2027 bill to $428 million, up 13.4%.

Lawmakers with the most direct power to fix this problem can and should take action to stop their states from having to absorb a bigger clawback every single year. The National Governors’ Association (NGA) and National Association of Attorneys General (NAAG) should be, on a bipartisan basis, talking to their lawmakers about this.

The squeeze is just as real in states already cutting programs to close budget gaps — and in some cases, the federal government is squeezing from both ends at once:

• California, facing a projected $4.3 billion deficit and already cutting Medi-Cal, will see its clawback bill rise by $562 million in 2027 alone, to a total of $4.68 billion. At the same time, the Trump administration has withheld more than $2 billion in California’s own Medicaid reimbursements this year — a $1.3 billion freeze announced in May over fraud concerns, followed by another $867.5 million deferred in July.

• Minnesota tells a similar story at smaller scale: the federal government withheld more than $259 million in Minnesota Medicaid funds in February 2026, then deferred another $199 million in July, while Minnesota’s own clawback amount is still projected to climb 12.1% in 2027, to $414 million.

In both states, the federal government is simultaneously freezing money owed to the state and demanding an ever-larger sum from the state — with no comparable off-ramp, appeal, or negotiation available on the clawback side. Meanwhile:

• Colorado, which just cut Medicaid provider rates and capped caregiver compensation to close a $1.5 billion shortfall while trying to protect K-12 education, will see its own clawback bill rise by $35.3 million, to $294 million.

These are states making real, painful trade-offs between children’s programs and other priorities, while simultaneously being required to send more money to Washington than ever before, for a program serving someone else’s constituents.

A Vise Closing from Both Directions

The clawback would be a serious problem in isolation. But, it isn’t happening in isolation.

Under OBBB, states are also absorbing the largest Medicaid cuts in the program’s history, alongside a fundamental restructuring of SNAP that ends 50 years of the federal government fully funding food benefits and evenly splitting administrative costs.

Starting in October 2026, federal reimbursement for states’ SNAP administrative costs drops from 50% to 25% — an estimated $17 billion shift to states over five years. Starting in October 2027, most states will owe a share of SNAP benefit costs themselves for the first time ever, tied to their payment error rates; collectively, states are projected to owe roughly $9 billion in the first year alone, with nearly half of states on the hook for $100 million or more.

Arizona has already seen SNAP participation drop by 47% since July as it scrambled to cut administrative costs and avoid the new bill — a preview of what other states are bracing for.

Meanwhile, the combined Medicaid and SNAP cuts to states were estimated at more than $1 trillion over 10 years.

Virginia’s Gov. Abigail Spanberger, has been blunt about what this means: her administration estimates $2 billion to $6 billion a year in lost revenue starting in 2028 from the combined Medicaid and SNAP changes, and she’s said plainly that Virginia “will not be able to make up the difference in a loss of federal funds” and won’t be able to close the gap the cuts have created. She’s not alone. Other states have signaled they may not be able to sustain SNAP administration at all under the new cost-sharing rules.

This is the context the clawback lands in. States are being asked to backfill historic federal Medicaid and SNAP funding with their own money while simultaneously being asked, through the clawback, to send more money than ever to Washington for a program that they have had no connection to for over two decades.

It’s a vise closing from two directions at once: less coming in from the federal government for the programs states actually run for kids, and more going out to the federal government for a program states don’t run at all.

States are being caught in the middle, and because children depend heavily on the programs states finance, children are caught there with them.

When a state has to choose between its own SNAP administration costs, its Medicaid program, its schools, child welfare, and child care programs, and a clawback bill it has no ability to negotiate, children are exposed on every side of the ledger.

Governors Have Sued Before, but Maybe They Should Try Again

In 2006, five states — Texas, Kentucky, Maine, Missouri, and New Jersey — went to the Supreme Court and asked the Court to take original jurisdiction over a constitutional challenge before the first payments came due. Ten more states filed in support. The states argued the clawback amounted to an unconstitutional tax on state sovereignty, an impermissible commandeering of state legislatures, and a violation of the Constitution’s Guarantee Clause.

As Susan Adler Channick documents, the rhetoric at the time was loud, and notably bipartisan.

• Texas Republican Gov. Rick Perry vetoed a $444 million appropriation covering the state’s clawback payment, warning that states were for the first time being asked to directly finance a federal Medicare benefit with their own tax dollars.

• New Hampshire’s Republican state Senate majority leader refused to pay at all, arguing the federal government couldn’t constitutionally “commandeer our revenue.”

• Connecticut’s Democratic lieutenant governor asked his attorney general to examine the provision’s constitutionality, calling it simply “a hidden tax.”

Today’s it is more than four times the size in was in 2006, but the political reaction has all but disappeared.

For one, the Supreme Court declined to hear the case in 2006. That’s a discretionary denial and not a ruling on the merits. Therefore, the constitutional questions were never actually resolved, but states dropped their legal cases.

Some states didn’t pursue it further, partly because other priorities took over and partly because the first year’s costs came in lower than feared. Nobody has seriously revisited the legal theory since, even as the dollar figures have more than quadrupled.

What States Should Actually Do

States should consider:

1. Filing new lawsuits to overturn the clawback policy. Every year demonstrates, with compounding effects, how unfair and egregious this policy enacted in 2003 is to states and how it undermines basic tenets of federalism in our constitutional system.

2. Creating a bipartisan governors’ coalition, built to fight the clawback. The states facing the steepest increases in 2027 — Hawaii, Florida, Montana, Vermont, Nebraska, Texas — span the political spectrum. That cross-partisan pain is the leverage a single state’s complaint will never have.

3. Pointing to the IRA’s Medicare drug price negotiation savings and billions in Medicare Advantage overpayments as offsets. If Congress were to pursue a legislative solution, the Inflation Reduction Act’s Medicare drug price negotiation program is already reducing federal Part D outlays, and an expanded program could be a natural, ready-made offset for clawback relief, rather than asking Congress to find new money elsewhere. So would be the elimination of the tens of billions of dollars in Medicare Advantage overpayments that I have written about before.

4. Reviving the policy behind the Fair Drug Prices for Kids Act — bipartisan legislation carried in past Congresses by Reps. Brian Fitzpatrick (R-PA) and Susan Wild (D-PA), with a Senate companion from Sens. Mark Warner (D-VA) and Cory Booker (D-NJ) – that would let states extend Medicaid’s “best price” drug rebates to their standalone CHIP programs. The underlying mechanism has a track record: the Medicaid Drug Rebate Program reduced gross federal and state Medicaid drug spending by nearly 53% — $42.5 billion — in fiscal year 2021 alone. Extending that same mechanism to CHIP isn’t untested policy; it’s applying a program that already works to the population left out of it. A Department of Health and Human Services Office of Inspector General analysis found that states with separate CHIP programs could have collected an estimated $641 million annually in additional drug rebates ($125.5 million for states and $515.7 million for the federal government) if CHIP were subject to the same rebate requirements as Medicaid, based on 2020 data alone.

5. Demanding an independent accounting of the child-specific harm. A Government Accountability Office (GAO) or Medicaid and CHIP Payment Advisory Commission (MACPAC) analysis quantifying how much clawback growth displaces children’s coverage and services would give this argument credibility with members who won’t take an advocacy group’s word for it alone.

Neither Medicare price negotiations nor CHIP drug rebates eliminate the clawback by itself, but they embody a much better principle: if prescription drugs are costing the government too much, seek savings from the price of prescription drugs and not from state budgets that children rely upon for the health, education, early childhood, child care, foster care, and child welfare.

Fixing a 24-Year-Old Problem

When it was enacted in 2003, it seemed like a problem that would eventually force its own resolution. It hasn’t.

The dollar figures have simply gotten larger, the disparities have worsened, and the squeeze on state Medicaid budgets has been made much worse by recent federal policy (i.e., the so-called “One Big Beautiful Bill”).

One side of the vise reduces the resources states receive. The other takes away resources they already have.

And squeezed between them are the programs states actually operate: health coverage, public schools, child care, early childhood, nutrition, foster care, behavioral health, and other services of great importance to children.

For decades, Congress should have fixed the clawback because it was bad policy. Today, Congress should fix it because states – and the children who depend on them – can no longer absorb the costs in silence.

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The ProPublica investigation and follow-up piece lay out just how this legal reality was created. Reporter Audrey Dutton obtained coroner and law-enforcement records from five Idaho counties and shared them with more than a dozen pediatricians, birthing specialists, cardiologists, and epilepsy experts, asking a simple question about each death: could this have been prevented with medical care? At least three professionals reviewed every case. The near-consensus answer, again and again, was yes.

Despite child advocates repeatedly asking the State of Idaho to close this loophole over the years, lawmakers have taken actions that widen it.

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A Decade of Choosing the Loophole Over the Child

Idaho does have child abuse and neglect laws, and a parent can be charged with manslaughter if a child dies as a result of their actions or decisions, except when the neglect is claimed to be religious. Since 2014, Idaho lawmakers have rejected repeated efforts to narrow the faith-healing exemption to child neglect statutes.

Source: Wilson, J. (2016, Apr. 13). Letting them die: parents refuse medical help for children in the name of Christ. The Guardian.

In February 2018, protesters marched to the Idaho Capitol and stacked 183 symbolic child-sized coffins on the Statehouse steps — representing what Protect Idaho Kids estimated at the time was the number of Idaho infants, children, and teens who had died because of withheld medical treatment since the exemptions were enacted.

“These coffins may be symbolic, but the children whose lives were cut short are not,” the group’s founder, Bruce Wingate, said at the time. “This is not a religious issue. This is a child protection issue.”

Even a Canyon County sheriff told lawmakers that year that he’d had three children die under the exemption in four months alone, calling it “an embarrassment to our state.”

Idaho lawmakers heard it all and left the exemption in place. Even worse, they have gone the other direction: codifying “parental rights,” banning vaccine requirements in schools and childcare centers, and — in 2024 — passing Senate Bill 1329, which made parental consent a prerequisite for nearly all medical care provided to minors.

SB 1329 was framed as a narrow, common-sense assertion that “parents have the fundamental right and duty to make decisions concerning the furnishing of health care services to the minor child.” In practice, it was so sweeping that it created chaos far beyond its intended target.

Within a year, the 988 Suicide and Crisis Hotline reported that the law limited operators’ ability to follow up with callers under 18. Schools and emergency rooms reported confusion over first aid. A nine-month-pregnant 13-year-old showed up in an Idaho ER in active labor; because the law required parental consent for care, doctors had to track down a guardian before treating her, even though that same 13-year-old can dictate medical care for her baby. Parental consent was required so a child could obtain a Band-Aid from school nurses to even treating child victims of sexual assualt, even if the offender is potentially the parent.

Lawmakers introduced “clean-up” legislation this year to patch some of the most obvious harms: allowing First-Aid treatment to kids and care in situations of “serious bodily harm” or when evidence collection is “time-sensitive” after reported abuse. These are real, if belated, fixes.

But notice what they concede and the problems that other parental rights bills have created for children, which is that these laws are often so sweeping that they block Band-Aids, access to a suicide hotline, sexual assault exams, or care for a laboring 13-year-old and that it took more than a year of documented harm before anyone moved to narrow it.

That is the pattern. Idaho enacts sweeping parental-rights protections, watches conflicts emerge between those protections and children’s health and safety, and then patches some of the most obvious harms. But the underlying problem remains largely untouched, and new problems are being created because lawmakers begin by seeing the parent as the only rights-holder and too often treat the child as the object of those rights rather than as a person with fundamental rights of their own.

The faith-healing deaths expose what happens when a legal system recognizes the rights of parents without equally recognizing the fundamental rights of children. Children are not merely the objects of parental rights. They are fundamental rights-holders, including the right to life.

However, Idaho began ignoring the fundamental rights of children when it enacted faith-healing exemptions in the 1970s. Although these laws have been defended as deeply rooted protections of parental or religious liberty, Dutton’s historical review found that claim is difficult to square with Idaho’s own history.

From at least the 1880s through the early 1970s, parents in Idaho could be held legally responsible for withholding necessary medical care from a child. What is now defended as a traditional parental right is actually a recent historical exception Idaho created to its traditional obligation to protect children.

This has been a policy and legal choice with devastating consequences to children. In contrast to Idaho’s law, ProPublica shows how neighboring Oregon has taken a much different approach after it faced deaths among the same religious community.

In fact, nearly three decades ago, Oregon removed legal protections for faith healing in cases involving children. ProPublica reports that Oregon prosecutors and detectives saw more Followers of Christ parents seek medical care for their children after the law changed. The state did not abolish religious freedom or parental rights. It recognized that the child has rights, too – including the most fundamental right of all: the right to live.

The Supreme Court made this very point in Prince v. Massachusetts, 321 U.S. 158 (1944) with Justice Rutledge writing the majority opinion:

The right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death. . . . Parents may be free to become martyrs themselves. But it does not follow they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion when they can make that choice for themselves.

Why Delete the One Safeguard That Protected a Child’s Life?

This is not a uniquely Idaho problem.

In September 2025, Rep. Mary Miller (R-IL) introduced H.J. Res. 127, a proposed constitutional amendment to enshrine parental rights nationally. It carries forward the sweeping language of earlier versions — a “fundamental right” for parents to direct their children’s upbringing, education, and care, subject to strict scrutiny, the highest bar in constitutional law, before government can intervene. I’ve written before about the dangers baked into that framework.

But the 2025 version of the proposed constitutional amendment did something its predecessors did not: it dropped the language that had clarified the amendment would still apply to “a parental action or decision that would end life.”

Earlier versions of the Parental Rights Constitutional Amendment have always contained this fundamental limitation:

H.J. Res. 127 omits this language. The safeguard is gone. And unlike Idaho’s exemption, this is not limited to decisions based on religious belief. The deleted protection would apply to any parental action or decision that would end life. Unfortunately, Reps. Sheri Biggs (R-SC), Ashley Hinson (R-IA), Mike Collins (R-GA), Addison McDowell (R-NC), Ben Cline (R-VA), Greg Steube (R-FL), Mike Handopolos (R-FL), Ralph Norman (R-SC), Randy Fine (R-FL), John Rutherford (R-FL), Glenn Grothman (R-WI), Pat Harrigan (R-NC), and Barry Loudermilk (R-GA) have all cosponsored this bill.

Furthermore, the amendment’s backers include the Alliance Defending Freedom, Family Research Council, Eagle Forum, and Moms for Liberty, which describe themselves, loudly and often, as pro-life. That omission, therefore, deserves particular scrutiny. Whatever one’s views on other issues, Idaho poses a straightforward question: Why would a parental-rights amendment remove language expressly stating that parental authority does not extend to a decision that ends a child’s life?

This was a choice, and the burden should be on the amendment’s authors and supporters to answer why that decision was made.

Fundamentally, as with Idaho’s laws, it reflects a legal framework that embraces sweeping fundamental rights for parents while failing to give comparable recognition to children as independent rights-holders. Children are not simply objects to be controlled.

The Declaration of Independence held it self-evident that all people are endowed with unalienable rights to life, liberty, and the pursuit of happiness. Children are not exempted from that premise merely because they are young, or because their guardians hold religious or ideological convictions that place a higher value on parental authority than on the child’s life.

As Supreme Court Justice William Brennan wrote in his opinion concurring in part and dissenting in part in Parham v. J.R., 442 U.S. 584 (1979), children do not somehow acquire constitutional rights on their eighteenth birthday:

Constitutional rights do not mature and come into being magically only when one attains the state-defined age of majority. Minors, as well as adults, are protected by the Constitution, and possess constitutional rights.

Citing a line of Supreme Court decisions — among them Breed v. Jones, 421 U. S. 519 (1975); Goss v. Lopez, 419 U. S. 565 (1975); Tinker v. Des Moines School Dist., 393 U. S. 503 (1969); In re Gault, 387 U. S. 1 (1967); and Planned Parenthood of Central Missouri v. Danforth, 428 U. S. 52, 428 U. S. 74 (1976) — Brennan added:

Indeed, it may well be argued that children are entitled to more protection than are adults. The consequences of an erroneous. . .decision are more tragic where children are involved.

The principle could hardly be more relevant here: childhood creates greater vulnerability and not lesser humanity.

A parental rights framework that cannot guarantee a child’s right to live is not protecting liberty. It is subordinating a child’s most basic unalienable right, as if they are merely the property of an adult.

This is precisely why the parental-rights debate cannot be reduced to “parents versus government.” That framing leaves out the very people whose life, health, education, safety, and future are actually being decided: children.

Parents have rights, children have rights, and the government has obligations to both.

Sometimes parents need protection from government. Sometimes children need protection from government. Sometimes children need government protection when the threat comes from a parent’s decision. And sometimes parents and children together need protection from the state.

A legal doctrine that recognizes only “parent versus government” cannot adequately protect all of those interests or all of those rights.

Two Different Laws, One Shared Blind Spot

Line up Idaho’s medical-consent statute and Miller’s federal amendment and the shared architecture becomes clear. Both start from a premise that sounds reasonable – parents should generally direct their children’s care – but both reveal the danger of constructing parental rights as though children have no independent rights of their own.

As legal scholar Samantha Godwin has written:

When evaluating the extent of parents’ legal rights, we should not merely consider how ideal parents exercise their power to provide the effective care and guidance children need. The extent of what the law enables imperfect parents to do to their children must also be taken into account... Thinking only in terms of how the best parents conduct themselves is a mistake; it is also necessary to account for what the worst parents can get away with.

Idaho’s laws epitomize the danger Godwin identifies, and H.J. Res. 127 risks constitutionalizing it. ProPublica’s investigative report shows why getting their wrong can have life-and-death consequences for children.

That is why children’s rights cannot merely be treated as implied exceptions to parental rights. They must be part of the legal framework itself. Parents have rights. Children have rights. Government has obligations to both. A serious legal framework has to recognize all three.

Ask the One Question

At First Focus on Children, we argue that every piece of legislation, rule, or regulation affecting kids should be measured against one question: “Is it good for children?”

Idaho’s faith-based exemption fails that test. And Idaho’s more recent parental rights law, SB 1329 also failed that test so badly it took a hotline crisis and a 13-year-old in active labor to get lawmakers to admit it and to propose changes.

H.J. Res. 127 fails it more quietly, by subtraction — by removing, without comment, the words that would have kept a “parental rights” amendment from being read as a license for parents to make decisions and take actions that cause a child to die.

The deeper question is whether we are willing to see children themselves as rights-holders. A serious legal framework has to recognize that both parents and children have rights and that the government has obligations to both.

Parental rights are not, and should not be, in conflict with children’s rights to survive their own childhood. Most of the time, parental rights and children’s rights reinforce rather than contradict one another. Parents are ordinarily their children’s strongest advocates, protectors, and champions. But when those rights do come into conflict, the answer cannot be to pretend that only the parent’s rights are fundamental.

Children are not mere extensions of their parents. They are not property. They are not merely the objects of someone else’s constitutional liberty. They are people — and rights-holders — in their own right.

Any legislation that cannot say that plainly — or that used to say it and now doesn’t — has told us something important about whose rights it has forgotten.

The children in Idaho should not have to die to remind us to protect them.

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Kids Can't Wait

Parental Rights Bills Forgot Children Have Rights, Too

Three Houston mothers just handed us a model that those of us who believe in both parental and children’s rights should adopt…

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2 months ago · 10 likes · 2 comments · Bruce Lesley

In the case of health care policy, children are not little adults, and they often have unique health care and developmental needs. We have pediatricians and children’s hospitals that specialize in child health for a reason.

As a result, children should never be an afterthought in someone else’s coverage, and a health system that ignores their special needs has a long, documented history of failing them.

That’s the standard I bring to Paul Krugman’s and Paul Waldman’s recent case for a Medicare buy-in. Krugman made the case this month for a Medicare buy-in as the pragmatic next step toward universal coverage: a soft, opt-in transition that lets individuals and employers pay actuarially fair premiums into a system Americans already trust.

Krugman writes that Medicare for All is better but may be politically infeasible. Instead, he argues for:

…this is an alternative. A public option, better described as Medicare Buy-In. Allow individuals, and possibly more important, employers, to sign up for Medicare benefits, paying actuarially fair premiums to Medicare reflecting the health status of their workers.

Waldman then picked up the argument, warning Democrats not to repeat the 2020 mistake of drowning voters in competing wonky health plans, and urging them to “simplify, simplify, simplify”: just let people buy into Medicare.

I often agree with both of them on their analysis of public policy problems and solutions in this country. I also agree with them on their diagnoses of the desperate need for health reform. However, in this case, I disagree with them on the prescription.

And there are two major reasons:

• First, children are not little adults. You don’t treat a child by simply giving them a smaller dose of adult medicine because sometimes the adult medicine is the wrong medicine altogether.

• Second, health reform should follow medicine’s most basic principle: do no harm.

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Where I Agree

Waldman’s starting point is his own family getting shifted into an Individual Coverage Health Reimbursement Arrangement (ICHRA), which was created via regulations the Trump administration issued in 2019 and that took effect in 2020. ICHRA hands employees a token stipend and tells them to go find their own coverage on the Affordable Care Act’s (ACA) Marketplace Exchange.

Waldman’s absolutely right that this is a bigger deal than most people realize, and I’d underscore his warning that this is about to collide with extremely negative consequences of Medicaid work requirements. Waldman correctly points out:

I’ve written at length about how work requirements are actually paperwork requirements whose purpose is not to promote work (the vast majority of Medicaid recipients who can work are already working) but to take health coverage from as many people as possible by forcing them to navigate a bureaucratic obstacle course and then punishing them when they slip up.

Waldman adds, the Center on Budget and Policy Priorities estimates 10 to 15 million people could lose coverage once Medicaid paperwork requirements kick in.

Children are, in theory, not impacted by the new Medicaid “work requirements” but there are other added coverage barriers and paperwork requirements that have already contributed heavily to the loss of coverage for more than 2 million children.

Source: Burak, E.W. & Osorio, A. (2026. Jun. 1). Uninsurance Among Youngest Children on the Rise as Families Face Growing Economic Pressure. Georgetown Center for Children and Families.

These problems, compounded with the loss of enhanced ACA subsidies, are likely to produce a genuinely ugly health care situation and “political moment” heading into the 2028 election.

As for the fraying employer coverage, the group who is disproportionately losing out are dependents. KFF’s 2025 Employer Health Benefits Survey found that workers already pay an average of $1,440 out of pocket a year just to add themselves to a plan, and $6,850 to cover their whole family, a figure that jumps to $8,889 at small firms with 10 to 199 workers.

A growing number of employers don’t subsidize dependent coverage at all, and even when children are technically covered, research on both ACA marketplace and employer-sponsored plans has repeatedly found narrower networks for pediatric specialists than for adult ones. Add the rising use of ICHRAs to that trend and you get more parents facing a system that leaves their children uncovered or underinsured.

For example, Sen. Andy Kim (D-NJ) estimates that nearly one-third of America’s children are underinsured.

So, Waldman and Krugman are onto something important and real. Employer-based coverage is eroding and both Medicaid and ACA cuts are going to add millions more to the ranks of the uninsured and underinsured.

Where a Medicare Buy-In Actually Could Make Sense

First, there’s a real population for whom a Medicare buy-in, as advocated by Krugman and Waldman, could be a sensible bridge. For example, it makes sense to allow near-elderly Americans in their late 50s and early 60s who aren’t yet eligible for Medicare but whose age, health risk, and care needs already look a lot like the population Medicare was built for.

That’s a coherent match between program design and population. It’s the same actuarial logic Krugman describes, applied to people Medicare already knows how to serve. As long as there are not terrible risk selection issues that could arise, this could even help make Medicare plans more affordable, as risk could be shared with a slightly younger and healthier population.

Where It Falls Apart

However, there is one group the Medicare buy-in proposal doesn’t address: children.

Kids need pediatric networks, not the physician panels built around the needs of an older population. They need the AAP immunization schedule, not the adult vaccine schedule. They need age-appropriate preventive care, like developmental screenings that won’t be addressed through Medicare’s parts A, B, C, and D architectural structure around a 65-and-over population’s chronic and acute care patterns.

Instead of Medicare, for kids we already have insurance programs that are built around their needs: Medicaid and the Children’s Health Insurance Program (CHIP). Medicaid and CHIP have pediatric benefits, pediatric provider networks, and affordability protections developed specifically with children in mind.

Kids also need coverage built around growth, not diagnosis. For example, Medicare’s replacement rule treats a wheelchair as good for five years. In sharp contrast, Medicaid’s EPSDT benefit instead requires a case-by-case necessity review for anyone under 21 because a child’s body doesn’t wait five years to change, and an insurance system built around adults who’ve stopped growing isn’t built to ask that question.

This distinction for children goes beyond any particular benefit.

In a blog written seven years ago, Bryan Sperry and I wrote about this very problem in Principles of Health Reform for Children. We urged that policymakers considering health reform should start with a basic set of standards for children:

• Medically necessary, age-appropriate benefits that promote healthy development.

• Affordable coverage.

• Timely access to pediatric and perinatal specialists, subspecialists, and facilities.

• Pediatric-specific quality measures.

• Continuous coverage without gaps.

These principles should apply whether the proposal is called Medicare for All, a Medicare buy-in, a public option, Medicaid expansion, a Medicaid or CHIP buy-in, or something nobody has named yet.

I understand why Waldman and Krugman are trying to help Democrats by reaching for a familiar, popular brand name and assuming it can be stretched to cover a need it was never built for. Medicare’s popularity is real. For example, Krugman cites Medicare’s 82% favorability, but popularity is not the same as fitness for purpose.

Waldman’s political advice is “simplify, simplify, simplify.” However, when it comes to children’s health coverage, simple isn’t necessarily good or best.

We’ve Made This Mistake Before

Washington has tried something similar before. During debate over the Affordable Care Act in 2009 and 2010, at the behest of the insurance and hospital industries, the House proposed eliminating CHIP and moving millions of children into the new ACA Marketplace Exchange plans. Their goal was to help make the Exchanges more affordable, as children are cheaper to insure.

Children’s advocates asked a different question: Would kids actually be better off?

The Robert Wood Johnson Foundation commissioned an actuarial analysis compared CHIP with the proposed Marketplace coverage. The analysis found that the 8 million children then covered by CHIP would have been worse off in terms of both benefits and affordability.

Sens. Jay Rockefeller (D-WV) and Orrin Hatch (R-UT) successfully offered an amendment that ultimately protected children from being left worse off under the ACA.

They argued a broader system change can be a major advance for adults without inadvertently leaving children worse off. Their protection of CHIP has stood the test of time.

In 2016, the Medicaid and CHIP Payment Advisory Commission (MACPAC) did a follow-up analysis comparing CHIP to employer-sponsored insurance and ACA Marketplace Exchange plans. MACPAC found:

That’s why “more people covered” cannot be the only test of health care reform. We have to also ask what kind of coverage children actually receive.

Children Aren’t Little Adults

Pediatric medicine has a name for this mistake, and a famous cautionary tale attached to it.

For years, aspirin was routinely used as a safe remedy for adults and children. That was until physicians discovered an association between aspirin use in children with certain viral illnesses and Reye’s syndrome, a rare but potentially fatal condition affecting the brain and liver. The lesson wasn’t simply to give children less aspirin. Sometimes they need different medicine entirely.

As a result, general hospital emergency departments sometimes fail to have the right-sized equipment to take care of children in all their developmental stages and sizes from infants, to toddlers, and up to adolescents. Children also need more intensive and specialized pediatric nursing care, as they cannot be given self-care instructions or left unattended in the same way adults are. Hospitals that care for kids must have expertise in child abuse and maltreatment. Children who have certain medical procedures, such as orthopedic and cardiology, sometimes have to repeat them as they grow and develop.

Even among children, there is an enormous array of different services and care needed. Babies are different from toddlers, and their special needs, including services, equipment, and training required, are vastly different from those for adolescent medicine. As Dr. Kurt Newman, former president and CEO of Children’s National Hospital and author of Healing Children: A Surgeon’s Stories from the Frontiers of Pediatric Medicine, explains:

Babies are that different from children, as different biologically and anatomically as children are from adults. Medical intervention on infants, from surgical strategy to the calibration of anesthesia, from pain management to pain control, is completely different.

Health policymakers must understand this in order to recognize why a Medicare buy-in is not a children’s health solution. It isn’t that Medicare is too strong, too generous, or too complicated for kids. It’s that Medicare’s entire architecture — its physician networks, its benefit design, its rules and regulations — was built around a very different population with very different health care needs.

There is no doubt that Medicare could be redesigned to meet children’s needs. However, a buy-in does not assume such an overhaul, but policymakers would have to deliberately design such protections for children into the system rather than assuming that changing the eligibility rules solves the problem.

A program can be excellent medicine for the population it was designed for and still be the wrong prescription for a nine-year-old with asthma who needs a pediatric pulmonologist, not a geriatrician’s idea of a specialist network.

Before We Buy In, Answer the Questions

Edwin Park, a longtime health care expert at Georgetown University’s Center for Children and Families, developed nine questions back in 2019 that policymakers should ask about health reform. They remain relevant to this debate and were:

1. How would the coverage expansion proposal affect Medicaid and CHIP coverage of children?

2. Would the new coverage expansion’s benefit package be tailored to children’s unique needs?

3. What would be the premium and cost-sharing requirements under the new coverage expansion?

4. How would the coverage expansion measure and ensure quality of care?

5. What would be the health care delivery system under the coverage expansion and how would health care providers be reimbursed?

6. What are the beneficiary access protections under the coverage expansion?

7. How will the coverage expansion be administered?

8. What is the implementation timeline for the coverage and is there a transition period?

9. How will children’s needs specifically be addressed in any new coverage expansion?

These are questions that should be answered before anyone declares any health reform proposal, including a Medicare buy-in, is the solution to America’s health coverage problems.

A Word About “Medicare for All” (M4A)

This distinction also matters because “Medicare for All” can mean dramatically different things to different people.

Some proposals actually expand Medicare to additional populations. Others create an optional Medicare buy-in. Still others use the Medicare name for an entirely new single-payer system that would replace Medicare, Medicaid, CHIP, and much or all private insurance.

And as Rachel Cohen Booth points out, many people do not think it means changing your private health plan.

From a children’s perspective, these are all fundamentally different proposals that could have very different ramifications for their coverage.

In 2020, Vox’s Matthew Yglesias and the American Prospect’s Joel Dodge each made the case for a fourth variant: a standalone “Medicare for Kids” program. Again, I appreciated the goal because they made children a direct focus rather than an afterthought. Yglesias and Dodge were right about the objective: automatic, universal coverage for kids.

Like them, my objective has always been to achieve universal health coverage for every man, woman, and child. But the vehicle matters, and the fact is that Medicare today only covers a few children (e.g., only those with end-stage renal diease (ESRD)), has no pediatric network or benefit design, and would have to be rebuilt entirely for it to work for kids. At that point, you’ve simply torn down Medicaid and CHIP and rebuilt them under a different name.

Calling something “Medicare for All” doesn’t answer the questions children need answered. What pediatric benefits are guaranteed? What will families pay? Will children have access to pediatricians, pediatric specialists, children’s hospitals, and other appropriate providers? How will pediatric quality be measured? And what happens to protections children already have under Medicaid and CHIP?

If a universal or single-payer proposal can answer those questions favorably to children, then that is meeting the conditions for getting universal coverage right for children.

Universal coverage should not mean uniform coverage. A newborn, a nine-year-old with cerebral palsy, a 45-year-old with diabetes, and a 78-year-old with congestive heart failure all deserve excellent health care. But that often means they need very different benefits, provider networks, and delivery systems.

What Kids Actually Need Instead

For children, the vehicles already exists, and they’re not Medicare — they’re Medicaid and the Children’s Health Insurance Plan (CHIP).

This is why Sen. Andy Kim (D-NJ), who carefully examined the best options for covering all kids, created MediKids. Instead of beginning with an elderly health program and asking how far down the age ladder we can extend it, MediKids begins with what is best for children.

Sen. Kim estimates that nearly 4.5 million children remain uninsured and another 23 million (about 1-in-3 kids) are underinsured. MediKids would automatically enroll children at birth and provide continuous eligibility through age 26 regardless of income or health condition.

His proposal would build upon a child-focused plan with pediatricians, children’s hospitals, the American Academy of Pediatrics (AAP) vaccination and prevention schedules, and its comprehensive EPSDT benefit.

That’s what health reform for children should do. As Sperry and I wrote, policymakers “must fully understand that children are not little adults and one-size-fits-all policies often fail our kids.”

The Wrong Solution for Children and Political Parties

Krugman and Waldman are both making a Democratic-strategy argument. However, is it even best for Democrats?

According to NBC exit polling, Democrats won parents in the 2020 presidential election by 6 percentage points and lost parents in the 2024 election by 8 percentage points: a 14-point swing, including a 20-point swing among fathers alone.

Failing to address the unique needs of children doesn’t help solve this problem for parents or the Democratic Party – it compounds it. Progressives should not respond to a health care crisis by offering parents a solution without being able to explain what that solution means for their children.

Again, the buy-in idea is right for some populations, like older Americans – just not kids. Good child policy asks whether whatever is proposed actually fits the people it is meant to serve.

The details matter for children.

Unfortunately, every major health care coverage and reform debate in Washington tends to default to adult frames – employer coverage, Medicare, and even Marketplace Exchanges – with children’s needs assumed to just come along for the ride. They don’t.

Kids have never been little adults. Universal health coverage is a worthy goal. But in health reform, as in much of public policy, children cannot simply be assumed to come along for the ride. We have to design a system that works for them, too.

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Emily Roth, Audrey Rosa Nath, and Sanjam Kaur Sohal sued Texas over the Ten Commandments posters state law now requires in every public classroom, and they didn’t reach for a First Amendment claim that’s already lost twice in the Fifth Circuit. They sued under the Texas Religious Freedom Restoration Act and, more pointedly, under Proposition 15, the “Parental Rights Amendment” Texas voters approved last year, which guarantees parents “the fundamental right to exercise care, custody, and control” of their own children, including “the right to make decisions concerning the child’s upbringing.”

Although a judge declined to block the posters before school started, a hearing on a longer injunction is set for today, August 17. Win or lose, the lawsuit makes a point that should outlive the case: the same language conservative legislatures wrote to give parents veto power over vaccines, books, and health care also gives parents standing to say no to actions that states take, such as a state-mandated religious display that imposes one religious belief on all children.

In a matter of a few years, state laws are being proposed and cases are being taken to the Supreme Court built on the premise that “parental rights” are sacrosanct, non-negotiable, and immune from anything short of strict scrutiny.

As a child advocate, I don’t accept that premise. Children are rights-bearing people, not appendages of whatever their parents or the state decides for them, and their own interests shouldn’t disappear into an absolutist veto held by either one.

However, if legislators and this Supreme Court are going to build law on that premise and to treat children with legislative and judicial “blindness,” it doesn’t get to apply parental rights selectively. If it’s a foundational tenet, then the rule should apply to all parents. Otherwise, parental rights are nothing more than what legislators want them to be.

A useful principle should be simple: parental rights do not give one group of parents authority over everybody else’s children, and parental authority cannot mean that children themselves have no rights at all.

To protect all parents and children themselves, the Houston parents have hit upon a strategy that we should consider.

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The Clause the Parental Rights Crowd Has Decided to Suddenly Drop

Here's what is most stunning about the "close to absolute" and sweeping nature of some of the “parental rights” bills being introduced.

For over a decade, the federal Parental Rights Constitutional Amendment carried, at the very least, an explicit protection of children’s lives. Rep. Trent Franks’s (R-AZ) 2012 version, H.J.Res. 110, and Rep. Debbie Lesko’s (R-AZ) 2022 version, H.J.Res. 99 each closed with the same line:

That would seem to be the bare minimum, but at least it was included in these filed constitutional amendments.

Then, in September 2025, Rep. Mary Miller (R-IL) introduced the latest version, H.J. Res. 127. It kept the sweeping parental rights language, the school-choice section, and the strict scrutiny standard – all problematic for reasons I have highlighted in previous blogs.

However, even worse is what is now missing. Miller’s bill dropped the language protecting children from parental actions or decisions that would end their lives.

So much for the parental movement claiming to be “pro-life.”

The amendment’s supporters include stalwarts of the parental rights movement, such as the Alliance Defending Freedom, Family Research Council, and Moms for Liberty. These groups apparently also support a deliberate decision to no longer even protect the lives of children.

Legal scholar Samantha Godwin explained exactly why absolutist parental rights frameworks are so dangerous — not because parents do not matter, but because law cannot be built around idealized parents:

When evaluating the extent of parents’ legal rights, we should not merely consider how ideal parents exercise their power to provide the effective care and guidance children need. The extent of what the law enables imperfect parents to do to their children must also be taken into account... Thinking only in terms of how the best parents conduct themselves is a mistake; it is also necessary to account for what the worst parents can get away with.

The Fight Is Also Over the Default

Every one of these fights must also address the underlying design questions: how sweeping is the language? When the state builds in an accommodation, does it default to inclusion with an opt-out, or exclusion with an opt-in? That choice determines who actually gets hurt, and it is a fundamental decision that often goes unnoticed.

When Texas’s SB 12 took effect this past September, the statute made clear that health care services for a child require parental consent, with an exception only when “necessary to further a compelling state interest, such as providing life-saving care.” School nurses across the state’s more than 1,200 districts didn’t know if that covered a Band-Aid, since that isn’t “life-saving care.”

The Texas Education Agency had to issue emergency guidance about a week later clarifying that general caretaking — Band-Aids, ice packs, checking a forehead for fever — doesn’t require a signed form. That guidance still didn’t touch other circumstances: for example, a broken bone or a serious injury isn’t “general caretaking,” and it isn’t obviously “life-saving” either — at least not until it’s too late for that distinction to matter.

Idaho’s own version of the law produced the same story, with a face attached to it.

“We ended up with a young man whose femur had been broken, and they couldn’t get ahold of the young man’s parents, so they didn’t treat him,” Idaho Republican State Rep. Barbara Ehardt — the law’s original sponsor — told reporters this spring, describing exactly the kind of case her own bill was never supposed to create.

Idaho’s law also meant that counselors on suicide hotlines could not serve teenagers without parental consent — until this spring, when Idaho passed an emergency patch (more on that, and its limits, below).

Without exceptions to sweeping parental rights laws, a parent who sexually or physically abuses their child can retain the right to make medical decisions and access the medical records of that child. That’s the sharpest version of the default problem this whole piece is about: institutions built to defer to parents first and verify only later.

In April 2025, Dr. Eithan Haim — a pediatrician who worked at Texas Children’s Hospital, testifying as a majority witness at a House Judiciary Subcommittee hearing on parental rights — told the committee that in his trauma experience, he treated dozens of children who’d suffered intentional starvation, cigarette burns, and finger amputations, and would find their abusers in the child’s hospital room the very next day.

Dr. Haim said he stopped reporting those cases to Child Protective Services (CPS} because he never saw evidence it actually protected children. Although Haim went to that hearing to defend parental authority, what he actually described was what a default of deference to parental rights costs the children who need protection from their parents the most.

As for other defaults, in Montgomery County, Maryland – the school district at the center of the Supreme Court’s decision in Mahmoud and where my children attended school – the district was ordered to notify parents before using specific storybooks and let them excuse their kids on request. This decision has had a chilling effect on teaching kids about acceptance and inclusion.

But, after the decision, the district reported in October that out of roughly 160,000 students, 43 families had filed 58 opt-out requests. That’s under 0.03%.

The lesson isn’t just that the sky didn’t fall. It’s that an inclusive default matters and serves almost everyone, while still “protecting” the handful of families who demanded something different. The default is a real win for kids — the curriculum stayed intact for the 99.97% of children who wanted the books, and the families who desired an accommodation got one without a fight over every book, every kid, every year.

As Harvard professor Cass Sunstein, pointed out in his book, Nudge, defaults aren’t neutral. Most people stick with whatever the system hands them, which means whoever sets the default is effectively guiding the choice for most people. These parental rights bills understand that lesson perfectly. They repeatedly apply it selectively, and in a manner that leads to restrictions on children’s access to things like books or health care services.

What these parental rights bills also get repeatedly wrong is that parental disagreement is normal, but they fail to take that disagreement seriously. Legislatures often treat parental rights as grounds to tear down a shared institution for every other family’s kid, instead of building an accommodation for the one family that wants something different.

Rather than banning books, closing libraries, gutting curriculum, abolishing school-based health services, denying teenagers access to suicide hotlines, reducing immunization rates, and defaulting to no services, legislatures should take a different approach.

Use Mahmoud to Take Down the Ten Commandments, Not Just State RFRAs

The point is not that inclusion is automatically the right default. It’s that a default only counts as fair if a real opt-out exists for a family and a child that wants or needs something different. A library book can be declined by one family or student while everyone else keeps access – that’s what makes Montgomery County’s 0.03% work.

In contrast, even if you completely ignore the fact that this violates the Constitution’s separation of church and state and the forcing of one religion on all children, the requirement that the Ten Commandments poster be in every Texas classroom cannot be declined by families and children. There’s no mechanism to exempt children from classrooms for an entire school year.

It’s the same failure mode Idaho’s original 2024 parental rights law produced, before its legislature was forced to spend two years patching it — denying kids access to the suicide hotline and other barriers to health care with no genuine way to protect kids from harm.

Here’s the application nobody’s tested yet. Mahmoud didn’t establish a blanket rule that any unavoidable exposure to objectionable content triggers strict scrutiny — the case turned on young children, an explicit curriculum, and a district that didn’t offer an opt-out.

But that same fact pattern should be applied to a permanent classroom display. There’s no notice, no workaround, and no opt-out at all, for an entire school year, for the parents of children who can’t opt-out of having their children subjected to the Ten Commandments in all classrooms.

Every state that copied Texas’s SB 10, which mandated the Ten Commandments posting in every classroom, creates a situation in which every parent whose faith doesn’t match the King James numbering on that poster can make a Mahmoud argument, even though no court has ruled on it yet.

Somebody should file it.

Mahmoud is the tool that’s most available because this Court chose to build the doctrine on parental authority rather than on the student’s own rights (something I have argued is “judicial blindness” to children).

But it’s worth saying plainly: the kids sitting under that poster have a stake in it that’s theirs as well, and not just their parents’. Tinker v. Des Moines held decades ago that students don’t “shed their constitutional rights at the schoolhouse gate”: a recognition this Court has been quietly writing out of the law even as it expands what parents can claim on a child’s behalf. Using Mahmoud to win doesn’t mean forgetting that a child’s own dignity is what’s actually on the line.

That distinction is central. Sometimes parents need protection from government. Sometimes children need protection from government. Sometimes children need government protection when the threat comes from a parent’s decision. And sometimes parents and children together need protection from the state. A legal doctrine that recognizes only “parent versus government” cannot adequately address all four in the best interests of children.

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If “Parents Direct Their Child’s Health Care,” Let Parents Keep School-Based Health

Moms for Liberty and allied groups have also spent this year trying to shut down school-based health centers, the on-campus clinics that provide vaccinations, mental health counseling, vision and dental screening, and basic care to kids whose families can’t easily leave work for a doctor’s appointment.

That’s their choice to lobby for. But notice what they’re actually doing: using state power to take an option away from every other parent who wants it.

Turn it around. A parent’s decision to sign a blanket consent form at back-to-school registration, keeping their kid enrolled in the on-campus clinic, is an exercise of their fundamental right to support their child’s access to health care. A district or state that closes the clinic anyway is overriding the choice of every parent who made one.

Restore parental control cuts both ways, or it isn’t really about parents. It is really just about ideology.

Books: Demand Access, Not Just the Right to Remove One

Curriculum transparency portals exist in a growing number of districts specifically so parents can flag and remove books. That same infrastructure could and should carry a parent’s request to add a book back, with the identical notice-and-review process.

And the legal argument underneath outright book bans is weaker than it looks: a full removal isn’t narrowly tailored if a permission-slip opt-out protects an objecting family’s rights while preserving access for every other parent’s child who do not object to the book.

If the parental rights movement wants to apply a “least restrictive means” test to government, then it should not burden the vast majority of parents and children with book bans. Instead, the practice should mirror Montgomery County’s opt-out rate under Mahmoud, which was under 0.03%.

An inclusion default doesn’t produce chaos. A removal default just extends one family’s objection to every other family’s kid.

This isn’t only a parents’ fight, either. The Supreme Court held decades ago in Board of Education v. Pico that students have their own First Amendment interest in access to ideas in a school library: a right that belongs to the kid, not a delegation from the parent. A ban erases that interest for every student in the building, not just the objecting family’s.

That is the distinction the current parental rights debate repeatedly misses. There are rights parents exercise on behalf of their children, and there are rights that belong to children themselves. They are related, but they are not interchangeable.

It also means parents whose own families look like the Houston plaintiffs’ — multi-faith, LGBTQ-headed, disability-affected, blended — have a live parental rights claim to books that reflect their kid’s actual life, on the same “diversity within the family” theory conservative litigants have used to challenge what they call ideological gag orders.

The Affirmative Side: Undue Burden Cuts Both Ways

None of this has to stay defensive — and it doesn’t need a courtroom to work. To be clear about what kind of claim this is: Troxel-style parental rights doctrine generally protects against state interference, and nobody is suing their way to a bigger Child Tax Credit under the Fourteenth Amendment. But as political and statutory advocacy, the state’s own logic holds: if a state won’t infringe on a parent’s “fundamental right to exercise care, custody, and control” of a child — including decisions about that child’s upbringing — lawmakers should be held to that standard when their own paperwork, funding cuts, and structural gaps do exactly that.

What good is a “fundamental right to direct your child’s upbringing” if public policy systematically abandons families and deprives parents of the practical ability to exercise it?

A Head Start proposal that weakens quality standards burdens a parent’s ability to direct their child’s early education.

A Child Tax Credit that leaves an estimated 19 to 20 million of the lowest-income kids behind burdens a parent’s ability to provide for their child.

Red tape in WIC, Medicaid, and child care subsidy enrollment can prevent parents from obtaining services they have already decided are best for their children.

None of these are new demands — paid family leave, sick leave, and simplified benefits access have been on the table since I first made this argument against Florida’s HB 241 back in 2021. They’re just more urgent now, and there are more openings to make them.

If policymakers genuinely want to empower parents, it must include parents’ ability to say “yes”: yes to health care, yes to books and education, yes to child care, yes to nutrition, and yes to other supports their children need to thrive.

Fix the “Mother May I” Problem Before It Takes Two Years and a Broken Femur

Idaho’s SB 1329 required affirmative parental consent for nearly any “health care service” a minor received, with an emergency exception so narrow — death or imminent, irreparable injury — that a 988 hotline counselor was legally required to hang up on kids who called in serious distress but weren’t mid-crisis. More than 1,500 Idaho kids contacted the hotline in the year after the law took effect. That wasn’t parental empowerment. It was a state-designed default of denial dressed up as parental rights — and the one actually harmed by it wasn’t the parent, who never had to make a decision at all.

It was the kid on the other end of the line, whose own interest in reaching help didn’t depend on anyone’s permission slip.

Don’t mistake what happened next for a success story. It took nearly two years — and a parade of Idaho teenagers testifying about what the law had actually done — before lawmakers acted and problems remain.

Jace Woods told the committee he knew a girl who’d been hung up on twelve separate times in twelve separate crises. Dakota Baker described being hospitalized after a suicide attempt and said he often thinks about how differently that night might have gone if someone had simply stayed on the line. “I think we were all in shock of what a mess it turned out to be,” one lawmaker admitted at the hearing.

HB 860 — introduced by Ehardt, the original law’s own sponsor — passed the Idaho Senate 34 to 0 this spring. It carved general first aid out of the consent requirement entirely, widened the injury exception, addressed abuse-related exams and records, and let the 988 hotline serve any minor who calls without a parent’s sign-off first.

However, a statute that needs a year-two rescue bill, passed only after actual kids had to travel to Boise and testify about what it cost them, isn’t evidence this approach works. It’s evidence the approach was broken from the first line of the bill, and that no amount of carve-outs turns a law built backward into a law built right. In fact, long-standing Idaho parental rights laws remain problematic for children in numerous ways.

Children’s own interests also become stronger as they mature. States have long recognized circumstances in which adolescents may consent to sensitive services — including STI testing and treatment, mental health care, and substance-use treatment — without prior parental permission. Those laws recognize something the absolutist parental-rights framework misses: minors have interests in bodily autonomy, privacy, safety, and access to care that cannot always be collapsed into the wishes of an adult.

That doesn’t make parents irrelevant. It means the law must recognize what Tinker, Pico, Parham, and other cases have recognized in different contexts: childhood does not mean constitutional nonexistence.

Be the Next Houston Lawsuit

To the authors of all of these parental rights bills, I would say what I said to Florida’s legislature in 2021: be careful what you wish for.

These bills are drafted to say a parent, any parent, has the right to direct their child’s upbringing, education, health care, and religious life — and courts are now taking that language at its word.

So child advocates should “flip the script” of these bills. Advocates for children should consider:

• Filing the Mahmoud-style challenge to Ten Commandments postings in your state.

• Demanding the blanket consent form for education, books, and child health.

• Asking your district why the health clinic is closing when you signed the form keeping your kid in it.

• Asking your state’s congressional delegation why “parental rights” stops at detention centers that

We should share ideas like the Houston lawsuit and support one another in their filings. We should “flip the script” and support parents who want the book, the vaccine, the school clinic, the religious accommodation, and their child returned from government custody. And wherever parental authority collides with a child’s safety, liberty, dignity, and developing autonomy, insist that the child has rights too.

Parental rights cannot mean that some parents get to make decisions for everyone else’s children. And they certainly cannot mean that children have no rights at all.

The far-right is engaged in a very deliberate campaign to promote parental rights and undermine children’s access to health care and education.

Is it good for the children? That’s still the only question that matters, but the question far too many of these laws forgot to ask.

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Vaccinations work because they’re collective. A single child’s shot protects that child, but the reason measles stayed off American soil for two decades isn’t any one family’s choice — it’s that enough families, in enough communities, kept the disease from ever finding a foothold.

This is why this policy debate has never simply been about individual choice. It has always been about whether every child has the opportunity to grow up protected from diseases that society already knows how to prevent.

That’s the frame that matters here, and it’s the one this Administration is determined to erase.

Every child’s immune system is capable of learning to recognize and disarm a virus before that virus ever makes them sick. A vaccine gives that child’s immune system the information it needs to do what immune systems are built to do — prepare to fight disease. That is what’s actually happening at the pediatrician’s office.

It is not an “explosion,” as the President said in the Oval Office announcing his Executive Order. Nor is it a “soda bottle poured into a toddler,” which was another bizarre claim by the President.

This latest anti-vaccine effort by the Administration is part of a disturbing trend attacking policies of importance to our nation’s babies and children. In just the last week, the Administration has sought to overturn the Constitution’s guarantee of birthright citizenship to babies, undercut Head Start quality standards and services for young children, and shred the vaccine schedule that protects our nation’s babies and children from preventable disease.

None of these actions stand alone. Together they reveal an Administration increasingly willing to shift risks, costs, and burdens to children while framing those decisions as expanded freedom. This is increasingly a defining feature of this Administration’s approach to children.

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A Sequel to a Fight That Was Already Decided

This week’s Executive Order attempts to overturn a loss in the courts this past spring when U.S. District Judge Brian Murphy’s ruling in American Academy of Pediatrics v. Kennedy blocked the Department of Health and Human Services’ (HHS) January 2026 memo cutting the recommended childhood schedule from 17 diseases to 11. The court found that HHS Secretary Robert F. Kennedy Jr. had reconstituted the Advisory Committee on Immunization Practices (ACIP) unlawfully and bypassed it entirely to gut the schedule, in violation of the Administrative Procedure Act (APA). Federal recommendations from before June 2025 were restored, at least temporarily.

Having lost their argument that the Centers for Disease Control and Prevention (CDC) and a hand-picked ACIP could gut the schedule administratively, the Administration is now trying to accomplish the same result by presidential fiat.

The presidential order seeks to cut the federally recommended list down to 11 diseases, reclassifies the rest as “shared clinical decision-making,” calls for splitting the combined MMR vaccine into three separate shots at three separate visits (for immunization products that don’t currently exist in the U.S.), and directs the Department of Justice to investigate whether states are honoring exemptions to school vaccine mandates. It also comes on the heels of a measles epidemic that is plaguing the country.

The legal mechanism may have changed, from an agency memorandum to an Executive Order, but the objective is the same. After losing in court, the Administration is attempting to achieve, through a presidential directive, what it could not lawfully accomplish through the administrative process.

Why The Frame Matters as Much as the Facts

The Administration’s claims are important to rebut. But the larger problem is the story being told. This Executive Order asks Americans to think almost exclusively about adult preferences, while paying remarkably little attention to the children who will bear the consequences of those choices.

But on the merits of their arguments:

• No, there’s no credible link between vaccines and autism.

• No, splitting MMR into three shots isn’t supported by any clinical evidence (and it also triples the number of vaccines needing to be administered, visits to a doctor’s office, and insurance claims).

• No, this isn’t what pediatricians recommend.

• No, a vaccine is NOT anything like a bottle of soda.

As American Academy of Pediatrics (AAP) President Dr. Andrew Racine said in their statement:

As measles cases reach a 35-year high in the U.S. and with cold and flu season quickly approaching, today’s executive order on vaccines is not only disheartening but dangerous. Instead of ensuring every family can access life-saving vaccines for measles, influenza, RSV and more, federal leaders are once again spreading misleading claims.

To protect children from vaccine-preventable illnesses, their interests deserve independent consideration – not simply as an extension of government and adult preferences, but as interests in their own right. This includes ensuring they have health insurance coverage, access to vaccines, and high rates of vaccine completion. The Executive Order does none of this.

The Access Story that the New Order Threatens

Proponents of the President’s new policy argue that it is about risk stratification and not restriction. They claim no vaccine is banned, but are reclassified into tiers based on individual risk. That framing skips over what reclassification actually does in practice: a vaccine moved out of the universal category is a vaccine fewer children end up getting, because “shared clinical decision-making” means the default has shifted from on to off.

The most concrete harm in this order is logistical. Splitting one MMR visit into three doesn’t reduce risk to a child. Instead, it triples the number of appointments a family has to make for that child to be protected at all. Even those defending the order acknowledge that more visits means more opportunities for a dose to be missed or delayed. They simply argue the tradeoff is worth testing.

That’s a remarkable admission to build a national policy on: an unproven experiment, run on children, in the middle of an active outbreak, justified by a study that hasn’t been done yet. We already know that delays in the early vaccine series strongly predict that a child will never complete the MMR series by age 2.

The families who will pay for that are the ones with the least flexibility and resources to begin with: hourly workers who can’t take three days off instead of one, families without reliable transportation to a clinic three separate times, households already stretched thin by this year’s cuts to Medicaid, the Children’s Health Insurance Program (CHIP), and SNAP.

Children and families do not experience health policy in theory. They experience it through time off from work, transportation challenges, insurance paperwork, child care for siblings, and finding appointments that fit the schedules of already overburdened families and the health system. Policy that multiplies those burdens by three inevitably reduces access to care, even if vaccines are not formally prohibited.

Framing this order as being about “parental choice” obscures the reality that this is the definition of “organized abandonment.” Rather than supporting and improving access to vaccines for children and families, the Administration is raising doubt and suspicion about vaccines, creating vaccine hesitancy in parents, and then expressing surprise that we are seeing a resurgence of measles, pertussis, and other diseases in children.

The consequences of a system already moving this direction are not hypothetical. Kindergarten exemptions are up, and MMR vaccine rates have declined. Reported measles cases have reached nearly 2,500 already this year, and roughly 93% of this year’s confirmed measles cases are in people who were unvaccinated or had unknown status.

Beyond measles, a JAMA study of more than 5 million births found refusals of the newborn vitamin K shot nearly doubled between 2017 and 2024. Pediatricians in Idaho and Florida have reported infant deaths and ICU admissions from vitamin K deficiency bleeding and Hib meningitis: diseases medicine effectively solved a generation ago.

This is organized abandonment in practice:

• Raising doubts about vaccines.

• Making it harder for families to complete the recommended schedule.

• Expressing surprise when vaccination rates fall and preventable diseases return.

• Shifting blame to parents for the “decisions they made.”

Rather than strengthening the partnerships between parents, health care providers, and government to protect children, the Administration is weakening them and shifting the resulting risks onto families and ultimately onto children themselves.

However, it’s not what the public wants. The President’s own pollster, FabrizioWard, found last August that 86% of voters believe it’s important for people to get the MMR vaccine, 85% believe vaccines save lives, and 90% want vaccine policy based on scientific evidence rather than politics. This order isn’t responding to public demand. It’s responding to a court loss.

Freedom Cuts Both Ways

Supporters of this order describe its enforcement provisions as a victory for parental authority and religious liberty: freedom for adults to opt their children out. But freedom in this debate doesn’t run in only one direction.

Children have their own claim to it: the freedom to grow up protected from diseases that used to kill and disable American kids by the thousands before vaccines existed. Public policy exists precisely because children cannot protect themselves from every risk adults create.

For seventy years, that has been treated as one of the basic freedoms of American childhood: freedom from polio’s paralysis, from measles encephalitis, from the deafness, blindness, and heart defects rubella caused in infants before 1969.

Infants too young to be vaccinated, and the small number of children who can’t be for medical reasons, depend entirely on everyone else’s immunity for that freedom. The freedom of medically vulnerable children depends on the responsibility of the rest of us. One family’s decision can become another child’s fatal exposure. This is why vaccination policy has always been understood as both an individual benefit and a public responsibility.

Is It Good for the Children? Absolutely Not

Whose interests does this policy ultimately serve? Our standard for federal policy affecting children has always been simple: “Is it good for the children?”

A collective story about vaccination is good for children. An immune system that is equipped to fight off disease is good for children. On-time vaccines and protection during the worst measles outbreak in a generation is good for children. Health insurance coverage is good for children.

This order threatening vaccine coverage – like the $900+ billion in Medicaid and nearly $200 billion in SNAP cuts, attempts to eliminate birthright citizenship, and the proposed gutting of Head Start standards and protections – is part of the Administration’s ongoing attacks on children’s health, education, development, safety, and well-being.

This fight to protect children’s vaccines from another poorly constructed Executive Order, like the last one, will likely head back to court. In the meantime, states, pediatricians, and advocates will need to do what they did in the spring: hold the line while the litigation plays out, and keep telling the true story about what vaccines actually do – not just to children, but for them.

Our kids can’t wait.

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Things You Can Do

• Call Congress and urge members to defend ACIP’s independence and insist that vaccine policy stay grounded in science, not executive fiat.

• Consider donating to First Focus on Children to help us counter the well-funded forces spreading vaccine misinformation and push back on this order.

• Join us as an Ambassador for Children and add your voice to the fight to protect children’s health at the federal, state, and local level.

Instead, child policy should begin with children.

Children do not choose whether they are born into a two-parent household, a single-parent household, a military family, a foster family, an immigrant family, a wealthy family, or a family struggling with disability, unemployment, or substance abuse. They should not receive less support because of circumstances beyond their control. That principle should guide every child policy we write.

The American people agree. In a study by Rebecca Kreitzer and Candis Watts Smith that sought to assess which groups Americans believe are most “deserving” of support and assistance, children ranked second only to veterans and ahead of all other groups, including favored populations like seniors, people with disabilities, mothers, and soldiers.1

However, when some think tanks or political commentators look at families, they impose judgment on adults, including single parents, that often ignores some fundamental truths and structural barriers that put those families and their children at a significant disadvantage:

• Income is significantly higher in two-earner households.

• Women, who are far more likely to be the caregiver in single-parent households, continue to face employment discrimination and salary disparities.

• The U.S. does not have a coherent and universal child care policy.

• The U.S. is one of the only high-income countries without guaranteed paid family and medical leave.

Compounding these structural problems is a Child Tax Credit that is built to better serve two-earner households, and leaves over 1-in-4 children, or 28%, behind with less than a full credit as a result. This policy punishes low-income families by denying them the credit or only allowing them a partial credit because their parent(s) earn “too little” to receive the full benefit.

Since single-parent households are more likely to be poor, their children are also far more likely to be excluded from the Child Tax Credit. This exclusion is by design.

If Congress truly wanted to help all children succeed, flourish, and thrive, the Child Tax Credit would be designed to compensate for underlying disadvantages rather than magnify them. Instead, current policy does the opposite.

Analysis from Columbia University’s Center on Poverty and Social Policy (CPSP), paired with a policy brief a team of graduating seniors at the University of Maryland School of Public Policy produced for First Focus on Children last semester, makes the mechanism visible.

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The Scale of the Problem

According to CPSP, 28% of children under 17 are “left behind” by the Child Tax Credit under the so-called “One Big Beautiful Bill” (OBBB) — either ineligible or only partially eligible because their family’s income is too low to qualify for and claim the full credit. This is up from 25% left behind before the passage of OBBB.2

That national number, however, hides enormous variation by family type. Children in single-mother households are left behind at more than four times the rate of children in dual-parent households: 60% and 14%, respectively.

That gap dwarfs every other disparity in the same dataset, which also documents disparities for babies and young children, children of color, rural children, and larger families — each reflecting serious equity problems in their own right.

CPSP also finds the harm to children is concentrated geographically.3

The design of the Child Tax Credit, in effect, punishes roughly 19 million children because of their household conditions. The kids most in need get the least under this policy.

In addition to the children from demographic groups, because the credit is pegged to a single tax year’s earned income, kids are punished for circumstances far outside their control, including:

• Having a mother who loses income during pregnancy, childbirth, and postpartum, so no longer qualifies for the full credit for their baby and the baby’s siblings.

• Living through a natural disaster with an accompanying loss of household income

• Experiencing the death of a parent.

• Suffering as a victim of violence or abuse and a related loss of household income.

• Dealing with a parent who suffers from an illness, such as cancer, or has a disability that reduces household income.

• Having a parent serve as a caregiver for a child, their other parent, or other family member.

• Living with a parent who loses a job and income, even on a temporary basis.

These points are often lost in family-structure debates that focus on parenting behavior as the reason for higher rates of child poverty, rather than on other factors, including government’s own policy design.

The Mechanism: A Phase-In That Favors Two-Earner Households, and Punishes Moms and Babies

Under current law, the Additional Child Tax Credit — the refundable portion of the credit — phases in at 15% of earnings above $2,500. A household needs substantial earned income before it can claim the full credit, and the income threshold rises steeply with each additional child.

According to CPSP, a head-of-household filer with one child now needs $28,700 in earnings to receive the full credit under OBBB — up from $25,500 under prior law. A filer with two children needs $33,700, up from $28,500. And a single parent with four children must now earn $45,800 to receive the full credit, up from $42,300.

Compounded with the fact that mothers lose income during pregnancy, childbirth, and the postpartum period, families with newborns are often subjected to a “double penalty”:

• The loss of income associated with the birth of a child.

• The higher earnings threshold required to qualify for the full credit.

This helps explain why younger children and children in larger families are disproportionately left behind by the Child Tax Credit, and why there are higher poverty rates among children in those families. The following chart by CPSP shows the impact on child poverty if there were no CTC (grey bar), the CTC before passage of OBBB (royal blue), the CTC after passage of OBBB (light blue), and if the CTC were expanded and made fully refundable, as through the American Family Act (navy blue).

This gap between eligibility and need doesn’t happen by necessity. Child poverty is a policy choice. It reflects a specific design choice, as the international comparison below shows — countries that don’t attach eligibility to earnings don’t produce this disparity at all.

For single-parent households, the credit’s phase-in creates a structural bind two-parent households don’t face: a married couple can split the labor needed to reach the income threshold across two adults — each working a manageable, caregiving-compatible number of hours while the other covers child care. A single parent has to clear the same bar entirely alone, with no second adult to add income and no second adult to care for the kids while they work.

That last point regarding child care compounds the problem. Single parents typically face higher child care costs relative to income than two-parent households, precisely because there’s no second adult available to cover care for free while the other works. The economies of scale a married household gets from splitting earning and caregiving between two people simply aren’t available in the same way to a household with one adult.

Extended family support (when available) can partly substitute for a second parent’s flexibility, but single parents are also less likely to have that backup nearby as well. The credit’s phase-in effectively assumes every household can flex a second adult’s hours to clear the threshold. Only two-parent households can do that.

The Paradox: Raising the Credit Amount Made This Worse

For those who assume a bigger credit is automatically a better credit, OBBB’s increase in the maximum Child Tax Credit per child from $2,000 to $2,200 failed to even keep pace with past levels of the CTC in 2004, 2017, and 2021.

Even worse, because the increase didn’t come with any change to the phase-in or refundability rules, raising the credit amount without fixing refundability increased the number of children left behind by three million children — again, from 25% under prior law to 28% under OBBB.4

Every dollar added to the credit’s ceiling^{, without mechanically addressing refundability, widens the gap} between “eligible” and “excluded.” This has been a design choice: a policy sold as an expansion that functioned, for the children in families with the least income, as a bigger gap.

What a Fix Looks Like

The American Family Act (AFA), reintroduced by Reps. Rosa DeLauro (D-CT), Suzan DelBene (D-WA), and Ritchie Torres (D-NY), and Sens. Michael Bennet (D-CO), Cory Booker (D-NJ), Raphael Warnock (D-GA), Catherine Cortez Masto (D-NV), Dick Durbin (D-IL), and Ron Wyden (D-OR) and included temporarily as part of the Child Tax Credit in 2021 after passage of the American Rescue Plan Act (ARPA), would make the credit fully refundable. Every eligible child receives the credit regardless of how much their parent earned, and the credit would be paid monthly rather than as an annual lump sum at tax time.

The differences are profound and highly important to millions of children.

The poverty-reduction difference is large. CPSP’s modeling puts child poverty at 13.3% under OBBB versus 8.8% under the AFA for all children under 185, and the gap is even larger for poor children under six, precisely the group where family income instability does the most developmental harm, and for children living in single-parent households.

Full refundability also changes who the benefit reaches. The Institute on Taxation and Economic Policy (ITEP) shows the average benefit for the bottom 20% of earners jumping from $200 under OBBBA to $4,900 under the AFA — a 24-fold increase concentrated exactly where the phase-in currently excludes families.6

Notably, families in the second through fourth income quintiles still see roughly $2,800–$3,000 average benefits under the AFA, meaning the reform is not a zero-sum shift. Instead, it reaches all kids, including those at the bottom, without hollowing out the middle.

A Different Way of Thinking About Support for Children

This past spring, First Focus on Children asked a team of University of Maryland School of Public Policy students to examine how best to reduce child poverty in single-parent households. They chose to compare U.S. policy to that of other countries.7

Their analysis found the following about the U.S. Child Tax Credit:

. . .the CTC’s effectiveness in alleviating poverty among single parents is limited by these policies, which undermine equity and create a complex set of rules that complicate the administrative feasibility of calculating the appropriate benefit.8

Their conclusion was that countries with much lower child poverty rates begin with a common premise: child benefits are designed to provide stable support for children rather than requiring parents to meet “deservingness” standards related to work, marriage, immigration status, disability, or earnings.

Their work shows the same underlying fix from the Nordic countries holds up across all three designs.

Norway: Supporting Families During the Earliest Years

The students highlighted Norway’s parental benefit system because it addresses one of the biggest weaknesses in the American Child Tax Credit: the period immediately following a child’s birth, when family income often falls even as expenses rise.

Under Norway’s model, eligible parents receive paid parental leave with income replacement after the birth of a child. Parents who qualify may take roughly a year of leave, much of it paid, with portions reserved for mothers, fathers or co-parents, and the remainder shared between them. Parents may also use portions of the leave flexibly before a child turns three. Those who do not qualify for paid leave receive a one-time benefit instead.

The students argued that this approach reduces one of the structural disadvantages facing single-parent households. Rather than conditioning support on reaching higher earnings after a child is born, as the U.S. Child Tax Credit effectively does through its refundability rules, Norway provides income support during precisely the period when caregiving responsibilities are greatest.

Sweden: Every Child Receives the Benefit

Of the three countries studied, Sweden offers perhaps the clearest contrast with the American Child Tax Credit.

The students focused on Sweden’s universal child allowance (Barnbidrag system), which provides a flat monthly benefit to families regardless of income or employment status. Single custodial parents receive the full benefit without a marriage penalty, and eligibility does not depend on earned income or tax liability. The benefit is paid automatically rather than requiring families to navigate a complicated refundability formula.

The students also examined research showing that directing the allowance by default to mothers increased the share of resources reaching separated and low-income mothers without reducing labor-force participation. Their broader conclusion was that predictable, universal benefits can strengthen the economic stability of single-parent households while avoiding many of the administrative barriers and penalties built into the U.S. Child Tax Credit.

Denmark: Making Work Possible

While Norway emphasizes parental leave and Sweden emphasizes universal cash benefits, Denmark combines income support with policies designed to help parents remain connected to the workforce.

The students highlighted Denmark’s “flexicurity” model, which pairs family benefits with subsidized childcare, active labor-market programs, and employment supports. Rather than treating cash assistance and work as competing goals, Denmark seeks to make employment feasible for parents by reducing child care costs and investing in workforce participation.

One finding particularly relevant to single-parent households was Denmark’s emphasis on affordable child care. The students noted evidence that Danish single parents face substantially lower childcare costs relative to income than families in countries with less comprehensive childcare systems, making it easier to maintain employment while raising children. They also pointed to Denmark’s strong labor-force participation among single mothers as evidence that universal family supports and employment need not be competing objectives.

What the Students Ultimately Recommended

Perhaps the most interesting conclusion from the students’ work was that they did not recommend importing any one country’s system wholesale.

Instead, they recommended combining elements of Sweden’s universal child allowance with Denmark’s investments in child care and employment supports. Their proposal recognized that reducing child poverty requires more than a single policy. Stable income support, affordable child care, and opportunities for parents to work reinforce one another.

The same lesson applies to the Child Tax Credit. Whether Congress adopts the broader vision the students proposed or simply reforms refundability through the American Family Act, the underlying principle is the same: eligibility should begin with the child and not with whether a parent earns enough to satisfy an arbitrary threshold.

They recommend:

• Provide guaranteed monthly financial support to all families with children, regardless of income or employment status, to reduce poverty and improve long-term economic stability for single-parent households.

• Reduce the administrative burden by implementing a universal parental benefit that begins at birth and ends at age 18.9

Their work is a reminder that some of the most valuable policy ideas come from asking fresh questions and from beginning with the needs and best-interests of children rather than ideology. They didn’t ask which families deserved help. They asked how public policy could better ensure that children in every family, regardless of composition or household status, had a fair chance to succeed.

The Bottom Line

When we think about child poverty, our priority should be to lift up every child to help them flourish and thrive rather than to punish them for the circumstances of their parents related to marriage, work, immigration status, disability, or earnings.

Unfortunately, as currently constructed, the Child Tax Credit amplifies disparities and actually pushes millions of children into poverty. Congress can change that.

Children in single-parent households don’t need judgment or blame and shame policies. They need structures and supports that recognize their inherent worth and invest in them.

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ENDNOTES

The first one attempts to, once again, deny citizenship to some babies born in the United States – not because of anything they did, but because of allegations about their parents’ conduct and intent in traveling to this country. The other targets so-called “birth tourism.”

At the signing, the President and Deputy Chief of Staff Stephen Miller took questions from reporters. As part of their statements and answers to questions, they made several claims that are demonstrably false, plus one so incoherent it barely qualifies as a claim at all.

Before we get to the made-up historical and legal references, let’s be clear about what the orders actually do because the mechanics are the real story, and the mechanics are, once again, bad for innocent children regardless of who is speaking in the Oval Office.

Whatever one thinks about immigration policy, this new executive order on birthright citizenship is not aimed at people crossing the border today. It is aimed at babies born tomorrow. The legal question isn’t simply what the government thinks about immigration. It’s whether an innocent child can lose fundamental rights grounded in the Constitution because of something government officials allege about a parent’s conduct and intent.

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The Fundamental Problem with Trump’s Latest Actions

Apply the One Question — “is it good for the children?” — and the first executive order fails immediately, on its own terms.

The order directs agencies to withhold citizenship recognition from a child, where neither parent is a citizen, if either parent falls into one of several categories, including someone who “engaged in a commercial transaction to purchase or access birthright citizenship for the person.”

First, the Supreme Court made clear that birthright citizenship is exactly what it says it is. As Supreme Court Justice Amy Coney Barrett said during oral arguments:

They don’t focus on the parents. It’s the child.

However, in this new executive order, the Administration is trying to condition an innocent newborn’s citizenship – the single most consequential legal status a child can hold – on an accusation about what a parent did. As a result, a child’s legal status would become conditional and questioned until a dispute about the parent’s conduct gets settled. It treats children as instruments of their parents’ immigration history rather than as people with independent rights of their own – the same error this Administration has used with respect to detention, Plyler, and nearly every other child-specific or child-adjacent immigration order of the last eighteen months.

The “commercial transaction” language, in particular, is a loophole factory. The order defines it to include when a parent “engage[s] in a commercial transaction to ensure that the person’s mother is present in the United States... to give birth.”

The phrase “commercial transaction” may sound narrow, but it isn’t. The order defines it broadly enough that ordinary expenses associated with travel – a plane ticket, hotel reservation, or a visit to a doctor – could become evidence in a future dispute over a baby’s citizenship. This goes well beyond the organized “birth tourism” operators the “birth tourism” second order describes.

Again, birthright citizenship has always been determined at birth. Instead, this order seeks to create a new system in which a newborn’s citizenship can remain in limbo while the government investigates a parent’s actions and intent. No baby crossed the border with intent, but it is that innocent child who would be punished by the government. The Administration is, once again, fundamentally trying to change whose conduct and action determine a child’s constitutional status and life chances.

The second order, Ending Birth Tourism, is narrower and uses visa authority under INA §215(a) to deny entry or revoke visas for people found to be traveling for the purpose of giving birth. There are already rules on this matter, but this places enforcement through a consular officers guessing at intent, with a “humanitarian grounds or national interest” exemption left entirely to the discretion of the Secretary of State or Secretary of Homeland Security. No court review. No defined standard. Just “as determined by.”

The two orders are not the same. The one about “birth tourism” is primarily concerned about visas policy and how the government decides who may or may not enter the country. The other one is much broader because it attempts to determine whether some babies born on American soil should or should not receive citizenship that the Constitution has guaranteed since 1868. Even if someone supports stricter visa enforcement, that does not justify imposing life-long punishment to an innocent child born here.

That would seem to present a permission structure for sweeping, unreviewable decisions about who gets to be American, applied retroactively to newborns who had no say in how their parents traveled.

The Nonsense They Said in the Oval Office

Then there was the press conference itself, where the administration didn’t just defend the policy — it misrepresented the history and the law behind birthright citizenship numerous times.

Here is the video of the White House event.

First, as background, United States v. Wong Kim Ark (1898) and Trump v. Barbara (2026) are the controlling Supreme Court precedents on birthright citizenship, and neither turned exclusively on race or on the aftermath of slavery. The man at the center of the Wong Kim Ark decision was born in San Francisco to Chinese immigrant parents who were legally barred from ever becoming citizens themselves under the Chinese Exclusion Act.

The Supreme Court ruled he was a citizen anyway, holding that the Fourteenth Amendment “was not intended to impose any new restrictions upon citizenship, or to prevent any persons from becoming citizens by the fact of birth within the United States.” In other words, the Supreme Court had the opportunity to exclusively limit birthright citizenship to formerly enslaved families and they have explicitly rejected doing so on numerous occasions, including five weeks ago.

Stephen Miller told reporters this history “had no other meaning and purpose” than covering the children of freed slaves. He’s blatantly wrong, and not in a debatable way — he’s contradicted by the actual text of the Court’s own 6-2 opinion.

The President’s claim that the U.S. is “just about the only country” with birthright citizenship is also false, and it isn’t new. Trump has made this claim repeatedly, which the press has repeatedly fact-checked. The reality is that roughly 30 countries offer unconditional birthright citizenship, including Canada, Mexico, and most of Central and South America.

The President also referenced a rather bizarre story about a family with 98 children. Even if that were to be true, it literally has no bearing on how birthright citizenship works.

Citizenship is determined child by child at birth, not accumulated through some made-up family-based accounting system. Birthright citizenship is about real babies born on U.S. soil, who are protected by the Constitution. Whatever the point the President was trying to get at, it wasn’t about birthright citizenship or even birth tourism.

Since the order attacking birthright citizenship is actually attacking innocent children, who have done nothing wrong, the goal is to demonize parents, even if doing so is through outlandish and irrelevant claims.

Here Is What’s Actually True

The part of this story that isn’t in dispute: the new order on birthright citizenship would attempt to condition a newborn’s citizenship status based on their parents’ conduct and intent, administered through vague language and unreviewable executive discretion. The latest effort to gut a fundamental constitutional operating principle since our nation’s founding, but has been written clearly in the Constitution since 1868, is being sold to the public with pathetic history and legal arguments the Supreme Court itself rejected 128 years ago and early this year.

Every administration has the authority to enforce immigration laws. However, none have the authority to rewrite the Constitution and statutory language by redefining which babies they deem are precious and which are pushed into the shadows of our society.

This is exactly what the Constitution’s Fourteenth Amendment sought to end.

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What almost never gets asked, plank by plank in party platforms, is how the best interests and well-being of children should apply to the policies adopted in those platforms, including that by the Texas Republican Party.

I read the newly approved 2026 Texas GOP 59-page platform (so you don’t have to) with that filter in mind.

In a few places, the platform takes positive positions that would improve child well-being. The last paragraph in Plank 107, for example, recognizes some “students’ rights.” It reads:

…Texas public schools shall provide age-appropriate education on students’ rights and safe reporting channels for forced marriage, female genital mutilation, honor violence, grooming, and trafficking. Schools shall ensure that no student faces retaliation for reporting coercive abuse.

I just wish there were far more passages like it. Instead, for the most part, the platform’s planks that impact children fail them and their future.

In its totality, the Texas Republican platform would leave many children abandoned, less healthy, less protected, less educated, and with fewer rights and protections than they have today. That is the wrong path forward.

I broke it into distinct areas so you can more easily find the sections of greatest interest in which Texas children would be most affected by the Texas Republican platform.

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Where Texas Kids Stand Today

Before getting into the platform itself, it’s worth establishing the baseline that this platform would be built on and why we should all be concerned.

First, Texas is home to roughly one in every ten children in America. When Texas succeeds and the State’s children thrive, the nation benefits. When Texas leaves children behind, it pulls down national progress on children’s health, education, nutrition, and economic security. The future of America’s children cannot be separated from the future of Texas’s children.

Unfortunately, Texas isn’t starting from a position of strength for children – it’s starting from close to the bottom on nearly every measure that matters.

Overall Well-being Is 44th in the Nation: The Annie E. Casey Foundation’s 2026 KIDS COUNT Data Book — the gold-standard annual assessment of child well-being, scoring states across economic security, education, health, and family/community indicators — ranks Texas 44th overall, tied with Oklahoma. Only Nevada, Alaska, Louisiana, New Mexico, and Mississippi rank lower.

Uninsured Children Rate Is Worst in the Nation: More than 1.1 million Texas children — nearly 14% of the state’s child population — lack health insurance coverage, the highest rate of any state in the country.

Child Poverty Is Well Above the National Average: The same 2026 report found Texas child poverty rates remain well above the national average, one of the core drivers of the state’s low overall ranking.

School Funding Is Among the Worst-Funded Systems in the Country: Per-pupil spending for Texas public schools was about $12,300 in 2023 — 26% below the national average and the 10th-lowest figure among all 50 states, according to a Federal Reserve Bank of Dallas analysis of Census Bureau data. Even after the Texas Legislature’s 2025 funding increase, per-pupil spending remains roughly $4,000 below the national average, leaving Texas in the bottom 10 nationally.

Hunger – Texas Is the Most Food-Insecure State in the Country: According to Feeding America’s 2026 Map the Meal Gap report, Texas has surpassed California for the third consecutive year as the state with the most people experiencing food insecurity, with an overall food insecurity rate of 19.4% — more than 6 million Texans. The child-specific numbers are worse: Texas’s child food insecurity rate is 26.1%, meaning nearly 2 million Texas children — roughly 1 in 4 — face hunger, up sharply from 22.2% just a year earlier.

Texas’s Child Protective Services Fails Children: Through extensive research by Texas Public Radio, the Pulitzer Center, and Story Reach U.S., they found:

Hundreds of children die in Texas each year from abuse and neglect. In an effort to preserve families, the state has employed several policies and laws intended to reduce the number of kids entering the system for various reasons — at times with grave results. Simultaneously — rather than bolster services to keep children safe — the state narrowed eligibility rules to access them, rejecting families in record numbers.

Texas has failed in protecting children from child abuse so badly that U.S. District Court Judge Janis Graham Jack had to reprimand Texas child welfare leaders in court: “There are children dying and being injured on your watch. You want to protect the providers and not the children. This is a pattern.”

These poor rankings and outcomes for Texas’s children are the context in which the platform’s provisions on health coverage, education, nutrition, and child poverty land.

One of my favorite Ben Sargent cartoons in the Texas Observer perfectly captures the status of children in Texas.

I. Children’s Health

Medicaid

This is the section of the platform I want to spend the most time on, because the stakes for Texas kids specifically are enormous.

Plank 136 calls for building a state health savings account “sufficient to exit the federal Medicaid program” altogether, and — until that happens — “we support Medicaid block grants to the states.”

Here’s the problem in plain numbers. Texas already has the worst rate of uninsured children in the entire country — more than 1.1 million kids or nearly 14% of the state’s child population lack coverage.

According to UnidosUS, 80% of uninsured Texas kids are already eligible for but unenrolled in Medicaid, the Children’s Health Insurance Program (CHIP), or ACA Marketplace coverage. Therefore, coverage should be simplified rather than made more bureaucratic and difficult to obtain.

Unfortunately, an arbitrary cap on federal Medicaid funding through a block grant would cut federal spending on children’s coverage by hundreds of billions of dollars nationally over a decade, forcing states to either raise their own spending substantially or ration care through tighter eligibility, reduced benefits, and longer waitlists.

A capped federal block grant would also likely disproportionately harm Texas because it:

• Permanently locks federal funding to Texas at lower levels of Medicaid spending per child than the nation as a whole.

• Fails to adjust for demographic changes, which would disproportionately harm Texas well into the future, as Texas is one of the fastest growing states in the country.

• Fails to adjust for economic downturns.

• Fails to adjust for any public health crisis, including the current measles crisis.

• Fails to adjust for medical breakthrough, such as a cure for pediatric cancer, cystic fibrosis, or an array of other health care conditions facing children.

• Fails to adjust for natural disasters, which would also negatively impact the state, as it is highly susceptible to hurricanes, tornadoes, wildfires, flooding, and other natural disasters.

Over three decades ago, Sen. Bob Graham (D-FL) explained why natural disasters are just one example as to why arbitrary Medicaid caps are unworkable:

Under block grants, a State that is knocked down to its knees by a flood, earthquake, hurricane, would not find a helping hand from the Federal Government at the time it needed help to get back on its feet. No, Mr. President, acts of God and block grants do not mix.

These words hold true today.

Furthermore, Medicaid and the Children’s Health Insurance Program (CHIP) together cover half of the nation’s children nationally, nearly 80% of children living in poverty, nearly half of the 13 million children with special health care needs, and almost all of the children in foster care. A funding cap arbitrary rations care for the kids who most need it.

Compounding the harm, the platform’s call for exiting Medicaid altogether would be a withdrawal from the primary financing structure that keeps Texas children covered at all, replaced with literally nothing other than some vague notion of a health savings account (HSA) that is not remotely comparable in scale or durability to the coverage children receive via Medicaid.

Texas children look to the State’s adults to protect their health and well-being, but this platform proposal is a complete abdication of such protection. As former Texas Governor Ann Richards used to say:

You can put lipstick on a pig and call it Matilda, but it’s still a pig.

The gutting of maternal and child health coverage: Plank 141, titled “Medicaid Reform,” opposes any Medicaid expansion and explicitly opposes “Medicaid for noncitizens,” while calling for funds to be redirected toward “genuine biological medical needs” tied to “good preconception care, good birth outcomes, and good maternal health in Texas.”

Texas has a real program built on this framework: It’s called CHIP Perinatal, which covers prenatal care for pregnant women, regardless of their immigration status, by acknowledging that both women and “unborn children” have improved health outcomes and reduced levels of maternal and infant mortality rates.

Texas’s pro-life community pushed for its adoption, and yet, the Texas Republican Party’s platform is effectively calling for its repeal in:

• Plank 7(e), which calls for eliminating birthright citizenship.

• Plank 272, “Aid to Illegal Aliens,” which calls for prohibiting any federal or state funding to “any entity or organization that provides material aid or benefit to illegal aliens.”

These two planks would effectively eliminate Texas’s own CHIP Perinatal care standard and maternal and child health coverage policies.

In addition, for the tens of thousands of children that would be newly deemed undocumented or stateless by eliminating birthright citizenship, those children in need of care for cancer, asthma, or care for preventable and communicable diseases would now be denied basic care and services, even for life-saving health care, if the platform were adopted.

Repealing the ACA, in the state with the worst coverage numbers in the country. Plank 143 demands the immediate repeal of the Affordable Care Act in favor of unspecified “free-market principles,” with only a passing nod to preserving preexisting-condition protections. It’s worth restating the baseline one more time: Texas already has the highest uninsured rate in the nation for both children and adults, and Texas is a non-expansion state, meaning it never took the ACA’s Medicaid expansion in the first place.

Repealing the ACA would exacerbate the State’s core uninsurance problem by also eliminating the Marketplace subsidies that are currently one of the only paths to coverage for many Texas families, who don’t qualify for Medicaid and don’t get insurance through work. This plank actively reducing the tools available to address Texas’s uninsured crisis for children.

Home and community-based services (HBCS) is a Medicaid program. Plank 144 calls for “full funding” of HCBS for people with disabilities, as an alternative to institutional care. Here is a positive goal, as HCBS keeps kids and adults with disabilities in their homes and communities instead of institutions. That’s a genuinely good policy.

However, HCBS is delivered almost entirely through Medicaid. Failing to even recognize the contradiction, the Texas GOP platform wants to shrink Medicaid to a block grant, cap its federal financing, and ultimately exit the program altogether. You cannot both starve the funding stream and fully fund the service it pays for.

Again, no state starts farther behind than Texas. That makes this platform’s call to cap and ultimately abandon Medicaid uniquely dangerous for Texas children.

Vaccines

Plank 130 specifically bars any entity — public, private, medical — from conditioning access to school, child care, or public benefits on vaccination status, “including in an emergency or in a pandemic.”

Combined with Plank 133’s mandate that all mRNA-containing medications and vaccines carry special warning labels, this is not neutral language. It’s advocacy solidly against immunizations, which are the biggest public health success story in reducing childhood mortality from preventable disease in generations.

This anti-vaccine plank is being proposed in the midst of a measles epidemic that is harming children all across the Lone Star State and the nation. For example, measles in an infant can result in permanent hearing loss, pneumonia, blindness, brain damage, and even death.

Consequently, even the nation’s biggest spreader of anti-vaccine misinformation, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., said to Dana Bash on CNN’s State of the Union:

Parents should get their children vaccinated for measles. A measles vaccine is effective, it stops measles in about 97% of the cases. People should get vaccinated.

In this instance, the Texas GOP should heed his words.

Children’s Mental Health

The platform’s opposition to school-based mental health access isn’t a single plank — it’s a theme, repeated three separate times in three separate sections:

• Plank 96 calls for eliminating “universal mental health surveys, screenings, and psychological assessments” and imposes opt-in consent requirements so sweeping they would functionally end school counseling access for many kids.

• Plank 137 goes further, calling for abolishing the Texas Child Mental Health Care Consortium and school-based mental health providers outright.

• And Plank 146, in the platform’s dedicated Mental Health section, restates it again, explicitly demanding the Legislature “ban all psychological or mental health questions, instruction, activities, surveys, and check-ins in any capacity in public schools.”

That’s not incidental repetition. It’s disturbing that its a priority of the Texas GOP to make mental health services to children far less accessible, and it’s happening in the middle of a well-documented youth mental health crisis.

Removing school-based access doesn’t reduce need — it just removes the one point of contact many children have with any mental health support at all.

Parental Control Over Child Health Up to Age 26

Plank 127 extends parental rights over medical information, grades, and records to dependent children up to age 26.

Plank 129 goes further still, demanding “informed parental consent for all medical care and counseling for all minors“ — full stop, no carve-outs for children seeking cancer treatment, mental health counseling, substance abuse treatment, treatment for physical or sexual abuse by a parent, first aid, broken bones, or immunizations. There is no exception structure.

Parental involvement in a child’s health care is a good and important thing. Treating a minor — or, functionally, a young adult approaching their late twenties — as having no independent standing to access basic care or counseling is a different thing entirely, and it inverts a principle that children are independent rights-holders and not solely the property of their parents.

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II. Education

The Texas GOP’s education planks (91–117) are numerous and have enormous implications for Texas’s 5.5 million students. Here are 10 of them:

• Abolishing Property Taxes – A Direct Hit to Public Schools: Planks 79 and 80 call for eliminating the property tax system entirely within five years. Local property taxes are the backbone of Texas public school funding. The platform offers no credible substitute mechanism at anywhere near the scale required — and explicitly rules out an income tax as an alternative. However this is dressed up, the practical effect on already-strained Texas school districts, and the children sitting in their classrooms, would be severe.

• “Nanny State” and the Assault on Pre-K Programs: Plank 98, styled “Nanny State,” argues children “should not be institutionalized at the age of 4 or 5” and calls for pushing pre-K and kindergarten out of public schools. This flies in the face of a large, long-standing, and growing evidence base on the value of quality pre-K for school readiness and long-term outcomes, particularly for lower-income kids who most need it.

• Opposing Social-Emotional Learning (SEL): Plank 103 opposes SEL programs in schools, running against research showing SEL supports academic achievement and reduces behavioral problems.

• Opposing STAAR Standardized Testing: That same plank also calls for replacing the STAAR standardized test, which I agree with, but with a broader assessment system. I’ve written critically about NAEP misuse and the perverse incentives of high-stakes standardized testing regimes.

• A Veiled Attack on Plyler v. Doe: Plank 104 asserts that “the role of the public education system is to educate American citizens” and opposes allowing undocumented children into public schools — a direct challenge to the Supreme Court’s 1982 holding in Plyler v. Doe that states cannot deny a free public education based on immigration status. Whatever one thinks of immigration policy generally, Plyler rests on the fundamental rights of all children to receive an education and a recognition that punishing a child for their parents’ immigration status, by denying them an education, harms both children and society. This plank would reopen that fight, with children as the casualties.

• A Disturbing Irony on Curriculum on Reproductive Health: Plank 107 mandates detailed instruction on the “concept that life begins at fertilization” and “witnessing a live ultrasound” while Plank 94 elsewhere bars nearly all instruction on “sec education, sexual health, or sexual choice or identify in any government school or any grade whatsoever.” A platform that wants schools teaching about pregnancy and fetal development in exacting detail, while banning nearly any instruction on the reproductive and sexual health topics that precede pregnancy, serves an ideological rather than a health purpose.

• A Surprising Acknowledgment of Student Rights: In contrast and as noted in the opening section of this newsletter, buried at the end of that same Plank 107 is a requirement for age-appropriate education on students’ rights and safe reporting channels for forced marriage, female genital mutilation, honor violence, grooming, and trafficking, with protection from retaliation for reporting. This is genuinely good, protective policy, and it deserves to be said plainly: children are safer where student rights are a part of public policy.

• Abolishing the Department of Education and Everything It Funds: Plank 108 calls for abolishing the U.S. Department of Education and explicitly bars the transfer of its functions elsewhere. Make no mistake about what “abolish, don’t transfer” actually means in practice: it means the end of Title I funding for low-income schools, the end of federal enforcement of IDEA for kids with disabilities, the end of federal civil rights enforcement in schools, and the end of Title IX protections for girls. This is the elimination of the primary federal levers protecting the most vulnerable kids in the system.

• Gagging the People Who Advocate for Children: Planks 114 and 115 restrict school districts and administrators from any lobbying or legislative advocacy without board pre-approval, effectively muzzling the institutional voices most likely to speak up for children in the legislative process. Children cannot vote, cannot lobby, and cannot organize a PAC. The adults and institutions around them — teachers, school boards, administrators, coaches, counselors, school nurses, etc. — are needed advocates for children have in the political process. Silencing those advocates doesn’t protect children. It isolates them further from lawmakers who are often indifferent to their interests.

• Abolishing School Health Programs: Plank 117 calls for defunding and abolishing the Texas Department of State Health Services School Health Program — on top of the mental-health-specific planks (96, 137, 146) already discussed above. Between all of these, the platform takes direct aim at nearly every institutional channel through which Texas kids currently access basic health and mental health support at school.

III. Social Services

The platform calls for the abolition of important programs for our nation’s children:

• Abolishing Federal Welfare Programs: Plank 138 calls for the “abolition of all federal welfare programs,” framing state and faith-based charity as the interim substitute. Combined with the minimum wage and family leave repeal above, this plank removes both the wage floor that keeps working families afloat and the safety net meant to catch them when work alone isn’t enough — a one-two punch that lands hardest on the children in those households, who have no say in either policy and no independent means to make up the difference. Child poverty, which negatively impacts every aspect of the lives of children, would rise exponentially.

• Eliminating Minimum Wage and Family Leave: Plank 28 calls for repealing federal minimum wage and prevailing wage laws and eliminating mandatory sick and family leave, at both the federal and state level. Child well-being researchers have spent decades establishing the link between family economic security and child outcomes — nutrition, housing stability, school readiness, and health care. A parent who can’t take paid leave when a child is sick, or whose wages are pushed below subsistence, isn’t gaining “freedom.” Their children are losing ground. This is organized abandonment of fundamental needs of children and families dressed up as deregulation.

Child poverty, hunger, and homelessness are policy choices. This platform makes the wrong choices for children.

IV. Immigration

The immigration sections of the platform would negatively impact the lives of a large number of Texas children – whether they are citizens, legal immigrants, or undocumented. Those provisions include:

• Stripping Citizenship from Babies: Plank 7(e) calls for amending the 14th Amendment of the Constitution so that citizenship is granted only to children with at least one parent who is already a U.S. citizen — eliminating birthright citizenship for everyone else. As noted above, this targets harm to innocent babies and would create a permanent class of American-born children who are, by design, stateless. A baby has no say in where or to whom she is born. Punishing a newborn for it — stripping them of the single legal status that determines their access to nearly everything else in life — is about as pure an example of organized abandonment as exists in American law.

• A Census That Would Undercount Texas Itself: Plank 16 calls for excluding “illegal aliens and noncitizens” from the census. This is flatly inconsistent with the constitutional text, which calls for an actual enumeration of persons — not citizens and not voters, but persons — every ten years. It’s also not operational. How, precisely, would Census workers verify the citizenship status of a household, including the children in it, door to door? There’s no mechanism. And the irony is that Texas would be shooting itself in the foot: an undercount shrinks the state’s congressional apportionment and its share of federal formula funding for years to come, hurting every Texan, child and adult, citizen and noncitizen alike.

• The Rest of the Immigration Section Targets Kids Too. Plank 7(e)’s attack on birthright citizenship isn’t isolated — the platform reinforces it twice more, and each time the target becomes more explicitly a child.

Plank 266(b), tucked into a list of measures meant to “eliminate illegal immigration magnets,” calls on the State of Texas to “refuse to grant a birth certificate to any child born to illegal alien parents on Texas soil.” This is a state-level attempt to accomplish, by administrative refusal, the fundamental right of citizenship to infants, despite the clear language of the Constitution’s Citizenship Clause. A newborn denied a birth certificate isn’t just denied citizenship paperwork. They are denied the single document that unlocks a passport, a Social Security number, health and nutrition services, and proof of identity for the rest of their lives. There is no version of this plank that doesn’t fall entirely on innocent children who had no part in the policy decisions of their parents or their government.

Then there’s Plank 272, “Aid to Illegal Aliens,” which calls for prohibiting any federal or state funding to “any entity or organization that provides material aid or benefit to illegal aliens,” with tax-exempt status and business licenses revoked for violators. Every Catholic Charities affiliate food pantry, legal clinic, mobile health van, or an immigration services desk would be targeted. Every pediatric clinic or public health department that vaccinates a child regardless of status. Every legal aid nonprofit that provides a lawyer to a child in immigration proceedings — including the unaccompanied minors who, under existing law, don’t automatically get appointed counsel and depend entirely on nonprofit legal aid to have any advocate in court at all. Every water utility and food bank that doesn’t check papers before it turns on the tap or hands over a box of groceries. As written, it puts all of it at risk, and the institutions most exposed — churches, charities, legal aid clinics — are disproportionately the ones serving children directly.

V. Children’s Rights

Despite the positive reference to student rights in Plank 107, the rest of the platform threatens children’s rights repeatedly:

• A “Single Age of Majority” That Erases Children’s Actual Rights: Plank 13 calls for “a single age of majority on which, when reached, all citizens will be guaranteed their rights, duties, and privileges.” However, children hold rights now – due process rights, free speech rights, rights under the 4^th Amendment, a right to education, rights as crime victims and as patients — that don’t spring into existence magically on a child’s 18^th birthday. Children are not future citizens. They are citizens now, with a developmentally appropriate but very real set of protections.

• Parental Rights Language That’s Already Redundant and Getting More Extreme: Texas has already passed a parental rights constitutional amendment but Plank 18 nonetheless calls for another one, and Plank 91 pairs it with sweeping language making parents “the primary educators and disciplinarians of their children, to which all other entities are inferior.” I’ve written before about the real Texas parental rights law and its problems. Parental involvement in a child’s life is a good and important thing. But this platform, read alongside the age-26 medical consent provisions discussed in the Children’s Health section above, consistently treats children as objects of parental authority rather than as independent rights-holders in their own right.

• No-Fault Divorce – Solving a Problem That Isn’t There, at Children’s Expense: Plank 211 calls for rewriting the Texas Family Code to unwind no-fault divorce, extend the mandatory waiting period for a divorce to six months after filing, and require intervention or counseling before any divorce decree can be granted. This is the wrong fix for family stability. No-fault divorce didn’t create family conflict — it gave courts, and children, a faster, less adversarial off-ramp out of what can be abusive and dangerous relationships. Mandatory extended waiting periods and forced counseling don’t heal marriages that both parties have already decided to end; they mostly just extend the period during which children live inside active parental conflict, and in cases involving abuse, they can trap a parent and children in a dangerous household for months longer than necessary. If the goal is genuinely child welfare, the evidence doesn’t point toward reversing no-fault divorce. It points toward better-funded family courts, custody mediation, better-trained and better-paid caseworkers, and support services for families — none of which this plank offers.

VI. Common Thread: Organized Abandonment

In total, the platform’s vision is one of “organized abandonment” for children and families, including:

• Cuts to public investments and supports (Medicaid, SNAP, property taxes, welfare programs, the ACA are all slashed by the various planks).

• Cuts and undermining of the public institutions that serve children directly (public school funding, school-based health programs, public health, school meals).

• Restrictions on the legal status and documentation that determine whether a child can access care and services (attacks on birthright citizenship, prenatal care, birth certificates, aid to children in mixed-status households).

• And simultaneously restrict the mechanisms (school advocacy, federal oversight, judicial protections like Plyler, even the off-ramp of no-fault divorce) that might otherwise catch and protect children.

Throughout the platform, the planks paradoxically speak about empowering parents while systematically dismantling many of the institutions that parents themselves depend upon to raise children. Parents deserve respect, but they also deserve functional schools, accessible health care, public health, safe communities, and economic security. One without the others is not empowerment – it is the very definition of “organized abandonment” of children and families.

This does not happen because all of the platform authors overtly hate children. It happens because children can’t vote, can’t organize, and can’t show up at a committee hearing to object. Consequently, children are invisible in the process and, structurally, the easiest population in American politics to deprioritize and subjugate. Platforms like this one are what deprioritization looks like when you put pen to paper.

Instead, imagine a platform that asked of every plank: Is it good for the children? Does this leave children healthier? Safer? Better educated? More economically secure? More likely to flourish and thrive?

Texas may disagree on taxes, immigration, or abortion, but they should be able to agree that children deserve to inherit stronger opportunities than the generation before them. Texans are proud of their State and should demand from their political leaders better than a ranking of 44th in child well-being for their children.

With one in every ten American children calling Texas home, the stakes extend far beyond the state’s borders. The choices Texas makes today will help determine the future well-being of children across America.

There are a handful of planks here I’d defend — the anti-trafficking and anti-FGM education language, the STAAR criticism among them. Good policy sometimes shows up in unexpected places, even in documents that largely fail children.

However, overall, the various planks in this platform reveal a pattern that, when difficult choices arise, children repeatedly are ignored, subjugated, or outright harmed.

As a result, if adopted, the governing philosophy of the Texas Republican platform would leave Texas children more uninsured, more underserved, more unheard, and more unprotected than they already are.

As we approach 90 days before election day on November 3, 2026, Republican leaders should be asked to support better policies that are supportive of children and families. Gov. Greg Abbott and others have led the state for years and years, and yet, Texas ranks a pathetic 44^th in child well-being. They should be asked to explain how they will do better for Texas kids.

Democratic leaders should be asked to put forth a better vision for the future of children, families, and Texas’s future. They should tell voters how they will take action to ensure Texas children no longer lead the nation in uninsured rates, how schools will be better funded and supported, how they will ensure Texas no longer leads the nation in food insecurity, and how to fix the Lone Star State’s horribly broken child welfare system.

Elections are about the future. In Texas and all across the country, kids can’t wait.

#VoteKids

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This is an issue that is in all of our interest.

Fortunately, just 3 months from today, on Tuesday, November 3, Americans will elect every member of the House of Representatives and a third of the Senate. Thirty-six states and three territories will elect governors, and state legislators in 88 state chambers across the country are up for election.

For the next three months, thousands of people who want legislative power are obligated to answer questions from voters. Since kids can’t vote, they need us to ask the questions of importance to their health, education, development, well-being, and safety.

Child poverty is one of those issues that can be successfully addressed because Congress chose to do something about it in 2021 by expanding the Child Tax Credit and making it fully refundable. Consequently, child poverty fell to a record low of 5.2%.

Then Congress let it expire, and child poverty more than doubled the following year and rose to 13.4% in 2024. Millions of children were lifted out of poverty and then pushed back into poverty, and the second half of that sentence was as deliberate — even if done so passively, through inaction — as the first. That is what organized abandonment looks like.

Parents and grandparents, child advocates, and children themselves should not accept this outcome. Unfortunately, in the last few years, children’s advocacy in this country has been forced into a largely defensive posture, as cuts from DOGE, the Administration’s budget, the so-called “One Big Beautiful Bill” (OBBB), and a raft of executive orders all threatened the health, education, development, well-being, and safety of children.

That defense has been necessary. But a movement that only asks to keep what it has is a movement negotiating its own decline, one budget at a time. We cannot accept disinvestment, rising poverty, rising uninsured rates, increased hunger, and rising numbers of children without a stable place to sleep as the future for our children. And this list is not even everything — child homelessness, child care deserts, and child safety all demand attention too.

Elections are about the future, and so are our children. So here are ten things we should demand that politicians who want our vote answer to. These aren’t partisan questions. They are children’s questions, and every candidate should have an answer and a plan.

Kids can’t vote, so we must #VoteKids and push candidates to do better on their behalf.

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1. Restore the Fully Refundable, Expanded Child Tax Credit

Let’s start with the thing that already worked: a fully refundable Child Tax Credit.

Before 2021, the Child Tax Credit’s earnings requirement left out an estimated 16 million low-income children, preventing them from qualifying for the full credit. The structure of the credit excluded the children who needed it the most — an estimated one-quarter of all children — because their families earned too little to receive the full credit.

Babies whose mothers lost income during pregnancy, childbirth, and the postpartum period, children and families who were victims of natural disasters, and children who lost a parent due to death were all far more susceptible to being denied access to the full Child Tax Credit.

A tax benefit that requires earnings to unlock it is, by construction and by choice, a benefit that reaches poor children last and the poorest children never.

The 2021 expansion removed that requirement. That single design change, more than the increased dollar amount, is what produced the historic drop.

The Child Tax Credit changes in the OBBB are being touted as a “win” by proponents of the legislation, although the changes actually increased the number of children “left behind” by the credit to an astounding 20 million children, or 28% of all kids.

Children deserve better. They need a Child Tax Credit that restores full refundability and the monthly payment, which matters enormously to families who face the monthly reality of rent, car payments, groceries, and other expenses important to raising a child.

We must not accept the current reality that 10 million children are living in poverty. That is a choice, and we should demand that our political leaders do better by the children most in need.

2. A Young Child Allowance, Birth to Five

Our nation’s youngest children have the highest child poverty rate for a variety of reasons:

• Parents of young children are early in their careers and have lower income.

• Mothers of babies lose income during pregnancy, childbirth, and through the postpartum period (income-to-needs drops an estimated 38%).

• Parents are more likely to be out of work or working reduced hours due to caregiving needs.

• Early childhood and child care costs are highest in the early years of a child’s life.

The case for an added investment is also developmental. Material hardship in the first three years does damage that later intervention cannot fully undo — to brain architecture, to health trajectories, to educational outcomes measured decades later.

Consequently, this is the period when the return on public investment is highest, and yet, when family earnings are lowest.

We already have American proof for making this added investment: the Child Tax Credit and critically important cash benefit demonstration projects, including Rx Kids, Bridge projects, and others that provide unconditional cash to pregnant women and babies in participating communities that have resulted in enormous benefits, including reductions in maternal and child mortality and other related outcomes.

Politicians pay significant lip service to supporting moms and babies, but the policies have not matched the rhetoric. It is past time to demand better.

3. A Binding National Child Poverty Reduction Target

Set a target. Set a deadline. And demand accountability.

The British did it under the leadership of Tony Blair in 1999 and cut child poverty by more than half. Canada did it as well, setting targets in its 2018 poverty reduction strategy and entrenching them in law with the Poverty Reduction Act in 2019 — a 20% reduction by 2020 and 50% by 2030, measured against 2015 levels, with a National Advisory Council on Poverty required to report publicly every year. Canada hit its first target three years early.

Scotland did it in 2017 with the Child Poverty (Scotland) Act — statutory interim and final targets, with a legal obligation on ministers to publish delivery plans and report annually on progress. If a target is missed, there is accountability, because it generates news coverage, parliamentary questions, and political costs. A goal with no number generates nothing.

The United States has never set a child poverty reduction target. We set targets for deficits, for emissions, for troop levels, for reading scores. We have never told the country what child poverty rate we intend to reach, and by when, which makes the current situation of 10 million children living in poverty seem to be acceptable.

It should never be. This item demands a commitment, and a commitment demands at least some level of accountability.

4. Covering Every Child — MediKids

We should cover every child in America, automatically, from birth.

Sen. Andy Andy Kim’s (NJ) MediKids Act, joined by Sens. Tammy Duckworth (IL), Cory Booker (NJ), and Alex Padilla (CA), is the current vehicle for an idea with a 60-year history: enroll every child at birth, attach the coverage to the child rather than to a household’s paperwork, and stop pretending that a system built around parental employment can produce continuous coverage for children — just as we do through Medicare for senior citizens.

Under current law, nearly half of American children are covered through Medicaid or the Children’s Health Insurance Program (CHIP). That is not a marginal program serving a marginal population. It is the largest children’s health insurer in the country, and it is under the most serious threat in its history.

The OBBB enacted the deepest Medicaid cuts ever, and the mechanism matters as much as the number. Almost none of it was described as a cut to children. Work requirements were debated as adult policy. More frequent eligibility redeterminations were described as program integrity measures aimed at adults. But children lose coverage anyway, in large numbers, through procedural disenrollment — the household paperwork fails, and everyone in the household comes off, including children who remain fully eligible under rules nobody changed. Coverage losses at this scale also destabilize the hospitals, community health centers, and pediatric practices that serve children regardless of who insures them, which means the damage reaches children who were never on Medicaid at all.

We watched exactly this happen during the unwinding of continuous enrollment, when millions of children lost coverage and the overwhelming majority of those disenrollments were procedural rather than substantive. We know the mechanism. We have the receipts. It is being run again on purpose.

The defensive response is to fight each redetermination rule as it comes, and we must, because children are losing coverage right now. The structural response is to notice that the failure mode exists at all because coverage is contingent on a household successfully filing something, and to remove the contingency. A child does not become less of a child because a parent missed a deadline.

So the ask, again, has two halves. Will you reverse the Medicaid cuts and restore the near-term floor — 12-month continuous eligibility for all children, multi-year continuous eligibility for the youngest, express lane enrollment? And will you commit to covering every child in America automatically, from birth, and end this argument permanently?

Now is the time to demand that we cover all kids.

5. Ending Child Hunger

As a nation, no child should experience the pangs of hunger. We should fully fund SNAP, WIC, and school meals. No child should experience lunch debt or be denied food.

Start with the affirmative case, because we have already run it. Universal school meals were tested at national scale during the pandemic, and the results were what everyone who works in a school building predicted: participation up, stigma gone, cafeteria debt gone, administrative cost gone, food insecurity down. Then Congress allowed it to end and reimposed the barriers.

The means-tested version fails on its own terms. Eligible children go unenrolled because the paperwork is a barrier and the stigma is a deterrent. Families just above the line get nothing while being nowhere near able to absorb the cost. Districts spend real money chasing unpaid balances from parents who cannot pay them. Universal service is cheaper than it looks the moment you count what means-testing costs to administer.

But we cannot only play offense here, because the ground under children is actively being cut away. The OBBB imposed the largest cut to SNAP in the program’s history, and already, the Center on Budget and Policy Priorities estimates that more than 1.5 million fewer children are receiving SNAP since enactment of that legislation. These declines cannot be explained by any improvement in families’ economic circumstances. The OBBB expanded work requirements reaching parents of older children, put restrictions on future benefit adjustments, and imposed an impossible to meet cost-shift to states that is already pressuring them to tighten eligibility, and reduce coverage on their own. When a state facing a new bill from the federal government for benefits it did not budget for looks for savings, children do not have a lobbyist in that room. Every one of those provisions was debated in the language of adult work incentives, and every one of them reduces what children eat.

There is a second, quieter cut that nobody has to vote for. Most eligible families who lose nutrition benefits do not lose them because they became ineligible. They lose them to paperwork — recertification notices sent to old addresses, verification documents a working parent cannot assemble during business hours, interview requirements scheduled against shift work, online portals that time out.

Administrative burden is a benefit cut that falls most heavily on the families with the least capacity to absorb it. New work requirements make this worse by design, because every additional reporting obligation is another opportunity for an eligible family to fall out of the system through no fault of their own.

Furthermore, children whose family loses SNAP eligibility are dealt a double blow: they also lose automatic eligibility for free school meals, which adds yet another layer of administrative burden and stigma between them and their next meal at school.

So the ask has two halves, and candidates should be made to answer both. Will you reverse the SNAP cuts, simplify recertification, extend certification periods, and use data matching instead of document demands? And will you make school meals universal, so that no child in this country is ever handed a bill for lunch?

6. Investment in Child Care

Child care costs function as a poverty trap with remarkable precision. In much of the country, infant care costs more than in-state college tuition, and more than rent. For a parent earning near the minimum wage, the arithmetic frequently produces a negative number — working costs more than not working — and the parent leaves the labor force, which then becomes evidence in somebody’s argument for work requirements.

Tax-side tinkering does not fix this. A credit claimed in April does not pay a bill due in March, and it does nothing about the underlying supply shortage: providers operating on margins too thin to raise wages, workers leaving for jobs that pay better and demand less, entire counties qualifying as child care deserts.

This requires direct public investment in supply, sustained, on the model of how we fund every other public good that markets underprovide. We do not ask parents to purchase their child’s second-grade classroom on the open market. The reasoning that makes public education obvious does not stop applying at age five; we just stopped applying it.

7. Paid Family and Medical Leave

Child care answers the question of what happens after a parent returns to work. This item answers the question of how a family survives before that.

The United States is the only wealthy nation on earth without a national paid family leave program, and one of a small handful of countries anywhere with no national paid maternity leave at all. We are not in a debate with the rest of the developed world about the details of paid leave. We are outside the conversation entirely.

What we have instead is the Family and Medical Leave Act (FMLA) of 1993, which was a genuine achievement and is now more than thirty years old. It guarantees job protection, not income. It covers roughly half of the workforce, because of employer-size and hours-worked thresholds that exclude part-time workers, workers at small businesses, and workers who recently changed jobs. For a family living paycheck to paycheck, an unpaid leave is a right they cannot afford to exercise. FMLA offers such a family a choice between the newborn and the rent.

And access to paid leave through an employer runs precisely backwards from need. It is common among high-wage salaried workers and rare among low-wage hourly workers — the very families for whom a few weeks of lost income is the difference between stability and eviction. We have built a system in which the parents most able to absorb the cost of leave are the ones most likely to be paid during it.

The consequences land on children first. Paid leave is associated with lower infant mortality, higher rates of breastfeeding, better maternal mental health, higher well-child visit and immunization rates, and reduced infant hospitalizations. These are not soft outcomes. They are the health of babies in their first year of life.

States have been running the experiment for us. California began in 2004, and more than a dozen states and the District of Columbia now operate paid family and medical leave programs. They function. Businesses have adapted. Small employers in those states report that a shared social insurance pool is easier to manage than the alternative of losing trained workers permanently. The remaining objection to a national program is not that we do not know how to build one.

Note also that this item and the one before it are a single continuum. A family that exhausts an unpaid leave and then cannot find or afford infant care faces the same cliff twice in the first year of a child’s life. Paid leave without child care simply moves the crisis from month three to month five, and child care without paid leave asks a mother to return to work before she has recovered from giving birth. Neither policy finishes the job alone.

Ask every candidate whether they support a national paid leave program — one that covers all workers, including part-time and low-wage workers, that covers the birth of a child and serious family illness alike, and that replaces enough income that a working parent can actually use it.

Everything Above Is One Reconciliation Bill Away from Reversal

We know this because it happened. The American Rescue Plan Act (ARPA) in 2021 was, quite frankly, the most successful anti-poverty policy for children in modern American history. It lasted a year. Its expiration was barely a story. The children who fell back into poverty had no vote, no PAC, and no lobbyists, and the political system responded accordingly. Child poverty grew from 5.2% in 2021 to 13.4% in 2024.

And it happened again in the other direction. The OBBB cut Medicaid and SNAP through the same reconciliation process, in a single bill, with the effects on children never once separately scored or debated.

Congress should correct these policy choices. Every politician asking for your vote should be asked to explain their plan for cutting child poverty by half.

The remaining three items are not smaller than the first seven. They are what would make the first seven survive contact with the next budget.

8. Make Children a Budget Priority

You cannot fix what you refuse to count. Politicians should be asked to put their money where their mouth is.

Unfortunately, the children’s share of federal spending has been declining and is projected to keep declining, squeezed between interest payments, increased military spending, and funding for older Americans.

Sources: First Focus on Children. Children’s Budget 2025 and Babies in the Budget 2025.

This has not necessarily been the product of politicians deciding children matter less. It is the product of nobody being required to look. Children’s spending is scattered across dozens of accounts in a dozen agencies, and the aggregate figure exists at all only because First Focus on Children reconstructs it by hand every year.

Watch how this works in practice over the next several weeks. FY 2027 funding will expire on September 30. The likely outcome is a continuing resolution running to early December — which parks the entire fight in a lame-duck session, after the election, before the new Congress is seated, in the narrowest window of accountability the calendar offers. The children’s share of the federal budget will be decided there. Nobody will announce it, and children will be an afterthought.

Instead, we should require the President’s budget and the Congressional Budget Office (CBO) baseline to report children’s spending as a distinct, standardized line — a statutory Children’s Budget — with a separate breakout for the birth-to-three window, a Babies Budget, given how differently that spending behaves and how much it determines.

Publishing the number does not by itself change it. But it converts a slow structural decline into an annual, quotable, contestable fact. That is how budget priorities get made.

9. Child Impact Statements

Require that major legislation and major rulemaking include a published assessment of the effects on children, before the vote.

We already do this for things we have decided to take seriously. Bills get a CBO score. Rules get a regulatory impact analysis. Federal actions are supposed to get environmental review. Each of these requirements exists because we concluded that a particular kind of consequence was too easy to ignore unless somebody was formally obligated to write it down.

The consequences for children are precisely that kind. They are diffuse, they are delayed, and the affected population cannot complain. A Medicaid provision drafted with adults in mind removes coverage from children. A nutrition provision drafted as a work incentive reduces what children eat. In each case the harm has been foreseeable, but no one was required to even consider the consequences.

We just watched this happen in real time. The two largest cuts to children’s health coverage and children’s nutrition in modern American history moved through Congress as adult policy, and at no point was anyone obligated to publish what either would do to children.

A Child Impact Statement does not prevent Congress from harming children. It prevents Congress from doing so without knowing.

10. A National Independent Children’s Commissioner

Finally, children need a voice — someone whose only job is to monitor, focus on, and report on how our children fare under different policy decisions.

Dozens of countries have an independent children’s commissioner or ombudsperson — an office with statutory independence, authority to investigate, an obligation to report publicly, and a mandate to represent children as a group that has fundamental needs, best interests, and rights. The United States does not.

What we have instead is fragmentation. Children’s interests are the partial responsibility of the Departments of Health and Human Services (HHS), Education, Agriculture, Housing and Urban Development (HUD), Justice, and Homeland Security, which means they are the full responsibility of no one. Far too often, children who fall between two agencies fall all the way through.

Fortunately, there is already a bill. Sen. Edward Markey (MA) and Rep. Morgan McGarvey (KY) introduced the Child Safety and Well-Being Act of 2026 (S. 4763/H.R. 9287) with Reps. Rosa DeLauro (CT), Jimmy Gomez (CA), Sara Jacobs (CA), and Rashida Tlaib (MI). The legislation would establish a 15-member independent Children’s Commission — with the authority to hold hearings, collect data from federal agencies, monitor how laws are implemented, and report to the President and Congress — and that Commission would appoint an independent Children’s Commissioner.

Every candidate should be asked whether they will cosponsor it.

An independent commissioner would have a narrow charge and real teeth: investigate systemic failures, compel data, report annually to Congress and the public, and speak for children in proceedings where at present nobody does. The independence is the whole thing. Children can’t vote and desperately need a voice in the process — one that prevents their needs and best interests from being left invisible.

The One Question

We ask one question of every federal policy: is it good for children?

Applied to the current trajectory of the federal budget, the honest answer is no. Not because anyone decided against children, but because these decisions get made in rooms where the question is never asked, by people who face no cost for failing to ask it, on behalf of a constituency with no vote, no PAC, and no lobbyists.

For the next three months, that last part is temporarily less true than usual. Candidates need something from voters between now and November 3, and voters can decline to give it away for free.

So let’s ask.

Ask whether a family should be denied the Child Tax Credit because of lost income due to the birth of a child, a natural disaster, or a death in the family. Ask what child poverty rate they intend to reach and by when. Ask whether they will vote to reverse the Medicaid and SNAP cuts in the OBBB, and what they will do to make sure no child goes without health coverage or a meal. If enough voters ask these questions, politicians will eventually have to start preparing answers.

And then, let’s publish what we find and encourage friends and family to #VoteKids. If we want politicians to stop ignoring the needs and best interests of children, now is the time to demand that they commit to kids and to make them a priority.

Kids can’t wait for more of the same.

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