When Disaster Strikes, Policies Should Help, Not Hurt Children and Families

The Case for an Improved Child Tax Credit and Against Medicaid Block Grants

When hurricanes strike, wildfires rage, tornadoes hit, or other natural disasters occur, we see powerful images of destruction, but also communities coming together to support one another. Neighbors help neighbors, rescuers go above and beyond, and the nation collectively rallies to send aid.

But strangely, federal policies are often crafted in ways that, instead of offering relief and support, punish families with children who are the victims of natural disasters, such as hurricanes, tornadoes, wildfires, flooding, earthquakes, drought, or blizzards.

Although our politics are hyper-polarized, we should be able to agree on the simple premise that the nation’s policies should – at the very least – support and not harm families with children in such circumstances.

And yet, some are pushing Medicaid block grants, which would arbitrarily cap and make Medicaid unresponsive to help victims of natural disasters by cutting off support when it is most needed. Others oppose improving the Child Tax Credit (CTC) in a manner that eliminates or reduces penalties that are imposed upon children and families after a natural disaster. The consequence is that families with children often have their credit reduced or even eliminated when they need it most.

Public policy should never be cruel and heartless.

The Threat of Medicaid Block Grants: Cutting Lifelines When Families Need Them Most

Medicaid plays a critical role in the aftermath of natural disasters. For millions of families, Medicaid serves as a lifeline. It provides health coverage to low-income adults, children, people with disabilities, and senior citizens who might otherwise fall through the cracks.

Importantly, Medicaid is designed to be flexible and responsive. When crises arise, federal funding for Medicaid automatically increases through matching dollars, meaning the federal government shares the cost with states based on increased need. In times of disaster, this provision ensures that more funds flow into hard-hit states and communities, helping them manage surges in health care demands and other public health crises.

In 1993, I worked for Sen. Bob Graham (D-FL) in the aftermath of Hurricane Andrew.

Source: This picture from Aug. 25, 1992, shows a water tower in Florida City in the aftermath of Hurricane Andrew.

That experience taught me many things, including the important role Medicaid plays in providing immediate assistance to people and what a tragedy Medicaid block grants would be for people in desperate need. The hurricane, just like an economic recession or epidemic, created problems that often demand both short- and long-term federal assistance.

First, there is an increased immediate need associated with the flash flooding and injuries caused by hurricanes, as reporter Ben Guarino documented, including increased exposure to sharp metal bits and glass in the floodwaters, wild animals, sewage spills, bacteria, respiratory infections, jeopardized immune systems, poor nutrition, lack of access to drugs, mosquitos, mold, and increased stress and mental health problems. We saw all of these things after Hurricane Andrew in Florida.

Second, there are also longer-term consequences. In a study on the impact of Hurricane Katrina reported by Nature, “The prevalence of PTSD (post-traumatic stress disorder) in these regions rose from 15% a few months after the storm to 21% one year later, and the proportion of people experiencing suicidal thoughts more than doubled from 2.8% to 6.4%.”

When House Speaker Newt Gingrich (R-GA) proposed block granting the Medicaid program back in 1995, Sen. Bob Graham cited the lessons we learned from Hurricane Andrew, as one of the many reasons the idea of Medicaid block grants should be rejected.

As Sen. Graham said on the Senate floor:

What do the states relinquish in exchange for the marginal new flexibility that they will allegedly receive? The federal partnership to assist them, if they experience caseload growth will be surrendered.

...when Hurricane Andrew hit South Florida, our Medicaid caseload shot up by 12,000 people. Not only had their homes been blown away, their jobs had been blown away. Therefore, people who had been employed and self-supporting needed the assistance of Medicaid during that time of crisis.

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 to get back on its feet. No, Mr. President, acts of God and block grants do not mix.

In a state or community reeling from a hurricane, where hospitals are inundated with patients and families losing homes, income, and access to medical care, the state’s Medicaid funding would remain capped and static. Instead of ramping up to meet rising needs, the funding would be unresponsive, leaving states with tough choices, such as cutting benefits, reducing the number of people they cover, or cutting payments to providers.

Block grants might sound like a way to give states “flexibility,” but in reality, they are handcuffs. They yank away critical federal support at the very moment communities need it most.

In 2017, President Donald Trump proposed converting Medicaid into a block grant and cutting the program by hundreds of billions of dollars. Fortunately, it was defeated when Sen. John McCain (R-AZ) cast the deciding vote against the idea.

But bad ideas never seem to die, as Project 2025, the Center for Renewing America, the Paragon Institute, and the House Republican Study Committee have all pushed for the adoption of Medicaid block grants either this year or if Donald Trump is elected president.

Last week, Hurricane Francine struck Louisiana and devastated many communities there and across the South. There is no doubt that Louisiana and communities in Hurricane Francine’s path will be facing enormous challenges in both the short- and long-term, but the human, economic, and health care crises would have been greatly worsened if Medicaid had been converted into an unresponsive and unhelpful block grant back in 2017.

As Andy Schneider with Georgetown Center for Children and Families put it:

Under block grants, there’s a fixed amount of money, come hell, high water, or hurricane.

Public policy should be responsive to the needs of the people of this country. Medicaid block grants would fail to do so and should be soundly rejected.

The Child Tax Credit: Why Disaster Victims Deserve Better

While Medicaid ensures healthcare coverage, the Child Tax Credit is a tool that helps vulnerable families stay afloat financially. Yet, under current law, it has one terrible flaw, which is that it perversely punishes children in families that experience economic hardship such as being a victim of a natural disaster.

When I was an infant, a tornado hit Silverton, Texas, where my parents were teaching, and destroyed our home while we sheltered underground. The fact is that when a natural disaster, such as a tornado, hurricane, wildfire, flood, earthquake, or blizzard sweeps through a town, families can lose homes, possessions, and often, their jobs. Such a financial blow can be devastating, especially for low- to moderate-income families and their children.

Unfortunately, under the current Child Tax Credit, the children whose families lose income can have their Child Tax Credit reduced or eliminated. Essentially, the families who need the most support during times of crisis often receive the least. This occurs because the CTC is designed to phase in based on earned income, meaning that when a family’s income drops (as it would after a disaster), their credit is often reduced or eliminated. This is referred to as the policy’s “baby and child penalties.”

These penalties can have devastating consequences for children in both the short- and long-term and should be fixed. Instead of punishing children and families for circumstances often beyond their control, public policy should help cushion the blow for families in need.

This isn't hypothetical.

As an example, close to where my family’s home was destroyed by a tornado years ago, wildfires earlier this year raged and burned to the ground many homes, farms, and ranches. To save lives, people all across the Texas Panhandle had to be evacuated and now those families are trying to rebuild and figure out a way to cope with having lost everything: their homes, their ranches, their farms, their livestock, their crops, their personal belongings, and their livelihood.

One such family is the Grishams, who were forced to flee the wildfires and their family ranch between Fritch and Borger, Texas. They escaped with their five children and pets, but everything else was burned to the ground and all that is left is “just ash and hollowed, burnt remains.”

Rather than slashing the Child Tax Credit for the Grisham’s five children, eliminating the penalty is much better policy. The American Rescue Plan Act (ARPA), which was signed into law by President Joe Biden in 2021, protected such families. For that year, the Child Tax Credit was made fully refundable, meaning families received the full value of the credit regardless of their income. This policy helped millions of children, lifting nearly 3 million out of poverty in 2021. For the first time, the Child Tax Credit was truly responsive to the needs of families, protecting them from income shocks like job loss due to natural disasters, the birth of a child, or the death or illness of a family member.

Unfortunately, the provision expired and the Child Tax Credit reverted to a system where children and families like the Grishams are at risk of being subjected to steep reductions in the Child Tax Credit after losing everything in the natural disaster.

Fortunately, there is renewed momentum to fix this problem. In fact, Vice President Kamala Harris and policymakers like Rep. Rosa DeLauro (D-CT) and Sens. Sherrod Brown (D-OH) and Michael Bennet (D-CO) have proposed improving the Child Tax Credit by making it fully refundable and increasing the benefit.

For example, Vice President Harris’s proposal would increase the benefit to $6,000 for newborns, $3,600 for kids to age 6, and $3,000 for kids to age 18. In fact, if she were to be elected president, Harris has committed to making the Child Tax Credit a Day 1 priority of her administration.

Such a policy change would ensure that families, particularly those struck by disasters, do not see their Child Tax Credit slashed just because their income drops.

Policy Should Help, Not Harm, in Times of Disaster

Children don’t have lobbyists. They don’t have political action committees advocating for their needs in Washington, D.C. Yet, they are often the most affected by our policy decisions. When disaster strikes, children can lose not only their homes and schools but also their sense of stability. We owe it to them to ensure that our policies help, rather than harm, their recovery.

Opposing Medicaid block grants and improving the Child Tax Credit aren’t just technical policy tweaks. They are moral imperatives. Public policy should not fail children and families at the very moment when support is most needed. As we continue to face more frequent and severe natural disasters, we must ensure that children are at the heart of our disaster response, not an afterthought.

Our children deserve a government that stands by them, especially when the storms of life — literal and figurative — strike hardest. In the coming days before the election, we urge voters to carefully examine the policies proposed by federal, state, and local policymakers and ensure they protect the very people who need it the most – our kids.

If you would like to help ensure that children and their needs, concerns, and best interests are no longer ignored by policymakers and to protect our nation’s public schools from continued assault, please consider joining us as an “Ambassador for Children” or becoming a paid subscriber to help us continue our work on behalf of children.