A new report from the Georgetown Center for Children and Families shows that a state’s decision on whether to expand Medicaid has a profound impact on women of childbearing age (18-44). In 2019, across all racial and ethnic groups, women in non-expansion states were more likely to be uninsured than women in states that had expanded Medicaid. New Jersey is one of the states with expanded Medicaid.
Offering affordable, comprehensive and permanent health coverage to those who fall into the coverage gap in non-expansion states is a critical first step to ensuring all women have the support they need to care for themselves and their families before, during, and after pregnancy. Yet CCF’s report found that in both expansion and non-expansion states, disparities in coverage rates between racial and ethnic groups remain. Federal and state policymakers must keep working to achieve health equity in coverage and care.
These findings come amid a worsening maternal health crisis in our country. The U.S. has the highest mortality rate of any industrialized country, and that rate is climbing. We must do all that we can to combat this trend—particularly for Black and Indigenous women, who experience the highest maternal mortality rates, and Latinas, who experience some of the highest uninsured rates of any racial or ethnic group.
Research shows that expanding Medicaid health coverage helps to lower maternal mortality rates and increases access and use of health care among women of childbearing age. Closing the coverage gap is a critical first step to combatting the maternal health crisis in our country and addressing persistent racial and ethnic health inequities.
The COVID-19 pandemic has underscored the need for federal and state policymakers to close the Medicaid coverage gap for women of childbearing age in non-expansion states and to address persistent racial and ethnic health disparities in all states. Permanent, comprehensive health coverage is a critical step to ensuring women have the support they need to take care of themselves and their growing families before, during, and after pregnancy.
Register to receive an overview of this evidence-based model aiding in the mental well-being of babies, and learn more about the efforts being made to bring the HealthySteps program to families throughout the state.
Last week, the U.S. Census Bureau released the first of the data from the 2020 Decennial Census. These data will allow states to begin the redrawing of voting districts across the country - a reminder of the power of accurate Census data. The August 12th release included data for the total population and the population of adults ages 18 and over. Though the count of children may not be a part of redistricting, child population counts are included in the numbers used to determine funding for important programs like SNAP, NJ FamilyCare, Special Education Grants, school meal programs and more.
Thanks to an interactive dashboard produced by the Census Bureau, we are able to hone in on the child population for all 50 states, and their respective counties. New Jersey saw a decline in its total child population, dropping three percent, from 2,065,214 in 2010 to 2,007,684 in 2020. Though the state saw its overall child population decrease, Ocean, Essex, Hudson and Union counties saw an increase. The remaining counties all saw their child populations decline, with Sussex, Hunterdon, Warren and Monmouth seeing the largest percentage decrease over the past ten years.
New Jersey Child Population Under Age 18, 2010 vs. 2020
It is important to remember that this initial data release does not provide information regarding population counts for specific age groups of kids. In the lead-up to the 2020 Decennial Census, ACNJ worked alongside groups across New Jersey to ensure that young children under age five, in particular, were accurately counted. Young children under age five are the most undercounted age group for a variety of different reasons, but most frequently because households do not include their young children as part of their Census responses. We will have to wait for more detailed data and further analysis on other age groups to be released in 2022. Stay tuned as more Census data are released!
Cecilia Zalkind (R) with ACNJ Parent Advocate Alice Lu (L) at the bill signing event
It's official! Last week, Governor Murphy signed the universal home visiting bill (S690/A4530) into law, guaranteeing new parents at least one free home visit from a nurse within two weeks of their child’s birth, with the option of receiving two more within the next three months. This is thanks to new legislation sponsored by Senators Ruiz and Vitale, and Assemblymembers Armato, Huttle and Speight.
I wish you could have been at the bill signing. There were so many compelling stories from parents, legislators and others in attendance, including a parent advocate from ACNJ’s Parent Leadership Council. The universal home visiting law brings together so many systems that serve families with young children. For me, the most exciting result was the connection between early care and child protection. The state Department of Children and Families (DCF) will be responsible for implementing the law, as it already oversees an existing home visitation program that serves higher-risk families. As DCF Commissioner Christine Norbut Beyer noted,“Through the provision of universal home visiting, we can offer education and support, identify potential challenges early and refer out to additional services if needed. The universality ensures that all families have equal access to the same critical resources and supports, without stigma, that will enhance the health and well-being of the entire family."
Creating an infrastructure for a universal home visiting system was one of the key goals in ACNJ’s 2020 Unlocking Potential prenatal-to-three plan, but home visiting has actually been a part of our infant-toddler agenda since we began focusing on this work in 2012. Recognizing that the existing voluntary statewide system of evidence-based home visiting reaches just two percent of families that could benefit from these services, ACNJ, along with our home visiting partners, began strategizing on how to expand services to reach more families.
Over this past year, we worked with Senator Ruiz and her staff to strengthen the bill.This included facilitating a meeting with Ruiz and Senator Steiner Hayward from Oregon, a state that passed the first statewide home visiting law, to learn how they designed, funded and advocated for their legislation. ACNJ and several of our partners testified before the Senate Health, Human Services and Senior Citizens Committee in March 2021. In addition, several of our partners submitted written testimony, including the NJ Chapter of the American Academy of Pediatrics, the NJ Association for Obstetrics and Gynecology and the NJ Hospital Association.
Key recommendations that were incorporated in the final legislation included:
the home visitor should be a specially trained nurse,
the program should offer more than one visit,
the model utilized should be based on criteria established by the US Department of Health and Human Services for an evidence-based early childhood home visiting service delivery model that has been rigorously researched
The passage of this legislation happened much faster than any of us had anticipated and we are so excited for what’s to come. I want to acknowledge the work of ACNJ policy analyst Diane Dellanno in making this possible. In her earlier role at Prevent Child Abuse NJ, Diane actually helped to bring the first home visiting program to the Garden State. Her expertise and her strong relationships with the home visiting community were instrumental in removing barriers and securing support for this legislation. Her advocacy also included working with the existing home visiting programs to ensure they received additional funding in the FY 2022 state budget, so that we can have a true continuum of home visiting services for families. It’s important to note that this new program is not a replacement for these existing programs that provide more visits over a longer period and are targeted to higher-risk families but rather a complement to these programs, providing the missing link that can help identify what all families of newborns need and want from local resources and provide referrals to a variety of supports, including these more intensive home visiting programs.
There is a lot ahead to do as the state now plans for implementation but I felt it was important to pause for a moment to reflect on this success for our youngest children and their families. Thank you to our state leaders, our home visiting partners and advocates for your support in making this possible.
