Poor Kids. Pitiful Us – The Health Care Blog

By KIM BELLARD

Well, congratulations, America.  The child poverty rate more than doubled from 2021 to 2022, jumping from 5.2% to 12.4%, according to new figures from the Census Bureau.  Once again, we prove we sure have a funny way of showing that we love our kids.

The poverty rate is actually the Supplemental Poverty Measure (SPM), which takes into account government programs aimed at low income families but which are not counted in the official poverty rate. The official poverty rate stayed the same, at 11.5% while the overall SPM increased 4.6% (to 12.4%), the first time the SPM has increased since 2010.  It’s bad enough that over 10% of our population lives in poverty, but that so many children live in poverty, and that their rate doubled from 2021 to 2022 — well, how does one think about that?

The increase was expected. In fact, the outlier number was the “low” 2021 rate.  Poverty dropped due to COVID relief programs; in particular, the child tax credit (CTC).  It had the remarkable (and intended) impact of lowering child poverty, but was allowed to expire at the end of 2021, which accounts for the large increase. We’re basically back to where we were pre-pandemic.

President Biden was quick to call out Congressional Republicans (although he might have chided Senator Joe Manchin just as well):

Today’s Census report shows the dire consequences of congressional Republicans’ refusal to extend the enhanced Child Tax Credit, even as they advance costly corporate tax cuts…The rise reported today in child poverty is no accident—it is the result of a deliberate policy choice congressional Republicans made to block help for families with children while advancing massive tax cuts for the wealthiest and largest corporations.

Many experts agree: child poverty, and poverty more generally, is a choice, a policy choice.

“This data once again highlights that poverty in our country isn’t a personal failing, but rather a policy choice,” said Melissa Boteach, vice president of income security at the National Women’s Law Center.

Economist Paul Krugman blasts the failure to continue the expansion of the CTC, calling it both stupid and cruel for two reasons:

First, avoiding much of this human catastrophe would have cost remarkably little money. Second, child poverty is, in the long run, very expensive for the nation as a whole: Americans who live in poverty as children grow up to become less healthy and productive adults than they should be.

Bruce Leslie, President of First Focus on Children, agrees, telling Time that poverty “really does affect every aspect of the lives of kids. It affects kids’ education, their health, their nutrition, and then has negative consequences on things like child abuse and homelessness.”

But, as Professor Krugman noted: “Unfortunately, children can’t vote and poor adults tend not to vote either. So politicians can get away with policies that harm poor children.”

We’re better than that…aren’t we? “Ensuring that children have their basic needs met is the bare minimum of what we can and should do,” Renee Ryberg, senior research scientist at Child Trends, a research organization, told CNN. “The payoff for the health and wellbeing of our nation’s children and for our society as a whole is immeasurable.”

It’s worth pointing out that, compared to our peer nations, we fare badly, in the bottom quartile, with child poverty rates comparable to Bulgaria and Chile. So, no, we’re not remotely even doing the bare minimum. 

Speaking of child statistics on which the U.S. falls far short, we have both maternal and infant mortality rates that rival third world nations. It’s hard to argue that we love mothers and children when we allow them to die at these shockingly high levels.

A bare minimum we should be doing for moms and kids is to make sure they have health insurance, yet ten states still have not passed Medicaid expansions despite the federal incentives to do so. I’ll leave it as an exercise for the interested reader to compare the states without Medicaid expansion with the ones with the worst maternal/infant mortality

To add insult to injury, COVID allowed millions more to qualify for Medicaid, but those special provisions are “unwinding” and – you guessed it – children are being disproportionately impacted, with millions losing their coverage (often due to procedural reasons rather than ineligibility).

I’ve written before about the value of programs that give direct assistance to low income individuals (e.g., cash transfers and SNAP), and there’s new evidence that such a program helps mothers and infants in particular. The Delaware Healthy Mother and Infant Consortium is testing giving a guaranteed income of $1,000/month to low income pregnant women, and is already claiming a 324% return on investment. Mothers are more likely to get prenatal care and less likely to have birth complications. 

“We’ve demonstrated not only that there’s a great return on investment, but there’s actually decreased cost on the healthcare side,” says DHMIC Chair Dr. Pricilla Mpasi. 

Similarly, despite SNAP and various school lunch programs, the Children’s Defense Fund estimates that 1 in 7 kids – some 10.5 million – are still food insecure, living in households where not everyone gets enough to eat. Massachusetts is trying to put a dent in that for its school-aged children, by making school breakfast and lunch free for all K-12 students. No more red tape, no more stigma for poor kids getting subsidized meals. 

California, Colorado, Maine, Michigan, Minnesota, New Mexico, and Vermont have similar programs. For Pete’s sake, why don’t all states?

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It’s embarrassing that our overall poverty rate is so high, among the highest in the world. We’re the richest nation in the world but have among the highest percentage of poor people. It is literally killing us. Somehow, we’ve allowed poverty to be a political debate, a policy decision we persist in. 

But child poverty? Allowing it to double? When asked about it, Joe Manchin shrugged: “We all have to do our part. The federal government can’t run everything.” I agree, the federal government can’t do everything, but if it is going to do one thing, helping poor kids should be pretty high on the list.

We shouldn’t just be embarrassed; we should be ashamed.

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented Tincture.io, and a regular THCB contributor.