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Under the draft guidance, that would change.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.

Share

Subscribe now

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.

Share

Subscribe now

Share Kids Can't Wait

• 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.

Share

Subscribe now

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.

Share

Subscribe now

Share Kids Can't Wait

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.

Share

Subscribe now

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.

Share

Subscribe now

Share Kids Can't Wait

Recent related post:

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…

Read more

15 days 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.

Share

Subscribe now

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.

Share

Subscribe now

Share Kids Can't Wait

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.

Share

Subscribe now

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.

Share

Subscribe now

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.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

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.

Share

Subscribe now

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.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

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.

Share

Subscribe now

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.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

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.

Share

Subscribe now

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.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

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.

Share

Subscribe now

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.

Kids Can't Wait

From Idaho to Texas to Florida: The Harm of Sweeping ‘Parental Rights’ Laws

The Band-Aid and Broken Arm Problem…

Read more

a year ago · 6 likes · Bruce Lesley

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

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

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.

Share

Subscribe now

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.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

There are about 4.4 million kids without insurance and about 23 million underinsured in our country. That’s unacceptable and why I introduced MediKids to cover every kid until they turn 26.

– Sen. Andy Kim, Yes, Medicaid Should Cover All Kids, Washington Post, Jul. 30, 2026

Thirty-five years ago, a bipartisan commission created by Congress and President Ronald Reagan — chaired by Sen. Jay Rockefeller (WV) and stocked with members appointed by President Reagan, the Senate, and the House — sat down for two and a half years and asked what America owed its children.

Their answer, delivered in June 1991 as a report entitled Beyond Rhetoric: A New American Agenda for Children and Families, called on the country to stop treating children’s well-being as an afterthought and to build the health coverage, income security, and family supports that would let every child in America grow up healthy, educated, and safe.

Health coverage for every child wasn’t a partisan aspiration then. It was the majority finding of a bipartisan commission built specifically so that neither party could own — or dismiss — the answer.

Here is what the National Commission said:

Good health is essential to children’s growth and development and to their future prospects. While most American children are born and remain healthy, far too many are vulnerable to problems that lead to serious illness, disability, and even death. This country has the knowledge and the tools to save children’s lives and improve their physical and mental health. Yet in recent decades, the nation’s progress in improving child health has not kept pace…

Today, we face a new crisis, as the rate of uninsured children is rising. Sen. Andy Kim (NJ) has stepped up to meet this modern-day challenge.

As background, after the National Commission on Children's report, the nation began to make significant progress on children’s health coverage with the passage of the Children’s Health Insurance Program (CHIP) in 1997. According to the Urban Institute, between 1997 and 2015, the uninsured rate for children dropped from around 15% to 4.8%.

Unfortunately, progress stalled in 2016 and has since grown to 6.1%, which, according to the U.S. Census Bureau, is nearly a 30% increase from its historic low.

That reversal is poised to get much worse.

In just the last year and a half, the Georgetown Center for Children and Families (CCF) has tracked over 2 million fewer children enrolled in Medicaid.

Consequently, the uninsured rate of children is already rising, even before the vast majority of the more than $900 billion in Medicaid and CHIP cuts enacted last year as part of the so-called “One Big Beautiful Bill (OBBB) fully take effect.

In the face of this worsening crisis, Sens. Kim (NJ), Tammy Duckworth (IL), Cory Booker (NJ), and Alex Padilla (CA) introduced MediKids (S. 5037) to get the nation back on the right track toward the goal of covering all kids.

Unfortunately, the Washington Post editorial board reviewed their proposal to eliminate that gap and shockingly missed the entire point.

What The Post Actually Objects To

MediKids would automatically default newborns into coverage through Medicaid, with an opt-out for families who have and want private coverage instead – just as the default for seniors is Medicare coverage with a similar opt-out.

The biggest failure of the Washington Post’s editorial is that it fails to acknowledge the enormous benefits to children in ensuring that all have access to health coverage.

As the National Commission on Children wrote decades ago but is still true today:

Many American children go without health care simply because of their family’s income, because of where their parents are employed, or because of where they live.

The Washington Post’s misguided critique also rests on a handful of claims that repeatedly ignore the needs and best interests of children, as if kids do not merit actual attention and focus on their health and well-being.

Analysis of the Washington Post’s criticism of MediKids

First, the Washington Post’s editorial board treats the absence of a means test in MediKids as somehow self-evidently disqualifying. But universality is not a bug in program design – it is the point.

Medicare, for example, has proven durable, popular, and hard to gut because it its universality. Every senior citizen has a stake in it.

In contrast, a means-tested children’s benefit has always been one election away from being labeled “welfare” and cut, just as happened just over one year ago when President Trump and Congress slashed Medicaid by more than $900 billion through OBBB.

Here is what was not cut in OBBB: Medicare.

Second, the Washington Post predicts that “employers will drop dependent coverage” if MediKids were to pass, as if employers have not been dramatically cutting children’s coverage already. KFF’s 2025 Employer Health Benefits Survey found workers pay an average of $1,440 out of pocket annually to add themselves to a plan — and $6,850 to cover their family, with that jumping to $8,889 at small firms (10-199 workers). In small firms, 59% offer health coverage, and among those firms, 29% do not subsidize dependent coverage.

As Sen. Kim has pointed out, in addition to the 4.4 million uninsured children, there are an estimated 23 million underinsured.

Beyond the costs, research on both Affordable Care Act (ACA) Marketplace and employer-sponsored plans has repeatedly found narrower networks for pediatric specialists than for adult ones, and children’s hospitals report that pediatric subspecialty shortages now mean waits of 13 weeks or more for some appointments.

If employer coverage for dependents is increasingly unavailable, unaffordable, under-networked, and increasingly hard to access, offering a public guarantee that has no eligibility cliffs and no paperwork churn isn’t a downside — it’s a fix.

Third, the Post’s editorial board wrongly tries to compare a U.S. children’s Medicaid guarantee to the UK’s National Health Service (NHS) plan. The fact is that nothing in MediKids nationalizes hospitals, sets global budgets, or rations care by wait time.

Instead, MediKids expands eligibility for Medicaid, a public-private partnership with a benefit structure – Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) – built specifically to address pediatric health services, pediatric developmental needs, and provider networks.

As Sen. Kim explained in his letter-to-the-editor to the Washington Post:

Kids need different health care than adults. Medicaid, through the Early and Periodic Screening, Diagnostic, and Treatment benefit, focuses on preventive care — requiring routine screenings and then providing the physical and mental health care, including dental, hearing and vision services, needed to address any issues. This comprehensive care is the gold standard for children’s health coverage. MediKids is also a smart investment. It is estimated that for every dollar spent on children’s health, the government saves $4 in future costs.

Medicaid recognizes that children are “not little adults” so its design is, as Sen. Kim notes, “specifically designed for kids in ways that employer-based health care programs, even top-of-the-line plans held by wealthy families, are not.”

Medicaid is pediatric-focused and kid-centric.

Rather than the Washington Post’s false attempt to compare Medicaid to the UK’s health care system, the real comparison is Medicare, which has focused on covering every American who is 65-and-older for the last 61 years. Medicare just celebrated its 61^st birthday and hasn’t collapsed into rationed, NHS-style care that the Washington Post’s editorial argues “always happens.”

Instead, Medicare is popular and delivers coverage to tens of millions of people every year. If universal, uncapped public coverage “always“ leads to collapse, The Washington Post should explain why Medicare is as popular and strong as it is today – some 61 years after it was created.

Fourth, the Post argues that Sen. Kim “does not know how much his idea would cost,” as if that is some kind of gotcha. Instead, all it reveals is that the Post doesn’t seem to know how Congress actually works.

The reality is that bills are introduced, support is built, cosponsors are added, and public attention grows long before the vast majority of bills are formally teed up for Congressional Budget Office (CBO) scoring. That has been the case with nearly every major piece of legislation in American history. Treating an absent score as disqualifying at the introduction stage would mean no bill could ever be introduced at all. If that were the standard, nothing new could ever get proposed to improve the lives and well-being of children.

While I often criticize the media for reporting on children’s issues almost entirely through an adult lens, this is ridiculous even for the Washington Post’s new editorial board.

Furthermore, the Post’s own numbers in the editorial inadvertently demonstrate that children are the cheapest population to cover. As even the Post unwittingly acknowledges, just 16% of all Medicaid spending is on children, despite the fact that children are nearly half of all Medicaid enrollees.

Although the Washington Post did not seem to intend to make this point, the editorial effectively highlighted the fact that kids are the least expensive population to cover.

Fifth, the Post’s editorial board cites the problem that “children are struggling to obtain care, due in part to bureaucratic hurdles and paperwork problems” in Medicaid. That is, of course, due to the fact that Medicaid is means-tested, which, by definition, establishes income-related eligibility barriers to coverage. OBBB has further complicated the problem by imposing massive new paperwork and bureaucratic barriers to coverage.

Once again, The Post is unintentionally making Sen. Kim’s point, as MediKids would explicitly eliminate these bureaucratic and red tape “denial by design” barriers to coverage for children.

That is the very point of his legislation and precisely how it aspires to achieve the National Commission on Children’s call to cover all kids.

Here Sen. Kim explains the design of MediKids in a conversation with renowned historian Heather Cox Richardson.

What The Post Fails to Address

After two decades of significant progress in cutting the uninsured rate for children after the passage of CHIP in 1997, the uninsured rate for children is heading in the wrong direction. To prevent ever-worsening rates of uninsured children, change is desperately needed to set children back on the right pathway to ensuring all kids are covered. That is what MediKids would do.

Instead, the Post’s editorial board argues for nothing other than the status quo.

Even worse, at no point does the editorial affirm that every child in America having health coverage is a goal worth pursuing. It criticizes the mechanism, the cost, the eligibility design, the politics — but it never says “yes, and here’s how we’d get there instead.”

That omission is a real tragedy and lets the Post skip past what is actually at stake here: the health and well-being of our children and grandchildren. For a child, being uninsured isn’t simply an inconvenience. The evidence demonstrates that it can lead to tragic health outcomes.

Uninsured children are less likely to have a usual source of care, less likely to get preventive visits and immunizations, more likely to have conditions go undiagnosed and untreated, and more likely to end up in the emergency room for problems that should have been caught earlier. Delayed diagnoses become worse diagnoses. In the most serious cases, kids who don’t get care in time don’t just get sicker — they die from causes that were preventable.

An editorial that spends its full length litigating income caps and CBO scores without once weighing the cost to kids fails to ask the only question that actually matters: is it good for children?

The Washington Post is certainly entitled to answer Sen. Kim’s proposal with a “not this vehicle.” However, it fails all children by skipping past the question of what happens to the kids left uncovered by its embrace of the status quo, which is effectively an embrace of rising rates of uninsured and under-insured children and worsening health outcomes.

For kids, nearly two generations have already waited for an answer to the call for health coverage for all children that the National Commission on Children issued back in 1991.

It’s been 35 years, and our kids can’t wait any longer. Rather than simply adopting defensive measures to make the trillion-dollar cuts “not so bad,” we should aspire to something much better for our children: MediKids.

While we can certainly quibble over the type of vehicle we should take, it is past time to change the debate and policy choice back toward making progress for our children and grandchildren.

Thanks to Sen. Kim and his Senate colleagues, MediKids would put the nation back on the right path to cover all kids.

Kids can’t wait.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

What You Can Do

If you would like to join the effort to support MediKids, here are some things you can do:

• Call or write your senators and ask them to cosponsor S. 3507, the MediKids Act, by Sen. Andy Kim (NJ).

• Subscribe to this newsletter to get updates and more information on how public policy issues are impacting our children.

• Join us as an Ambassador for Children.

We all want children to learn to read, write, and reason. We want to know how they’re doing – with most of us wanting to know it for every child, and not just our own child. Most of us want school to be a place where children are known, challenged, and given some reason to believe the effort will be worth it. And finally, most of us believe that all children can learn with some needing supports to overcome challenges they face through no fault of their own.

That is a broad consensus. It spans the political left and right, unions and reformers, and — as the evidence below shows — parents and kids alike.

Notice two things I left off that list: standardized testing and accountability.

Standardized testing was never the goal. It has been a somewhat terrible proxy — a rough, narrow, deeply flawed stand-in for the things we do want. And yet, school quality, teacher effectiveness, district leadership, and even children’s futures increasingly came to be judged through standardized test scores.

But no parent sends a child to school hoping they become experts at filling in bubbles and writing “brief constructive responses.” We tolerated the tests because we were told they were the price of knowing how children were doing. That was always a bargain, never a value. And they were built upon a very troubling historical purpose that is still part of the system.

Before asking whether we should preserve that system, we should ask a more basic question: did it actually deliver what it promised?

Share

Subscribe now

Ross Wiener: A Testimonial That Should Be Taken Seriously

Ross Wiener — the policy director at the Education Trust from 2002 to 2009, who testified before Congress and built coalitions to advance No Child Left Behind (NCLB) — published an op-ed in the New York Times last month arguing that the standardized testing and accountability apparatus has failed to deliver. The headline was a recanting: “I Thought ‘No Child Left Behind’ Would Fix Public Schools. I Was Wrong.”

That’s an important revelation. Wiener helped build this architecture with the right intentions, as genuinely believing it was the path for public schools to better serve low-income students and students of color. And his honest assessment of the results, as he looks back on its history, is:

Over time, I became convinced that, with the best of intentions, I and many others in the education reform community had transferred our moral commitment to children over to the standardized tests. We had done this earnestly, not cynically, but we still did damage (emphasis added).

Although he has his critics, Wiener is right.

After a quarter century of treating a narrow, poorly labeled, demonstrably biased metric as the primary answer to every question about children’s learning, the apparatus has fallen far short of what students and educators deserve and need.

The conditions that actually determine whether kids can be helped to learn, including equitable funding and poverty reduction, often went unfunded and unaddressed. Wiener’s naming of the failure of standardized testing and accountability measures built upon it is important, particularly from someone inside the movement that initially believed in it.

Wiener explains that his disillusionment with the focus on standardized testing as a “savior” began early in his career as he came across research showing that high school grade point average (GPA) predicts college graduation better than standardized test scores.

He went to his boss at the time, expecting her to help him push back, but she confirmed it was true and had always been. GPA is based on assessments that are more closely tied to mastery of a variety of subjects – not just reading and math.

Other measurements, such as that by University of Chicago Consortium research, have also found that a school’s effect on students’ social well-being and work habits predicted long-term outcomes — graduating high school, enrolling in college, staying out of the criminal justice system — about as well as test performance, and better for some of those outcomes. The thing accountability policy made the organizing principle of American schooling wasn’t what mattered most for kids’ futures.

More importantly, Wiener lays out the human cost to children. In 2023, he notes that 40% of high schoolers reported persistent sadness or hopelessness; one in five had seriously considered suicide, and nearly one in ten had attempted it. Of course, nobody is saying standardized testing is entirely to blame for the mental health crisis facing kids, but it contributed to the stress kids face, and the reporting of students that “drill and kill” curriculum that has been built around it is boring and irrelevant.

Wiener’s claim isn’t that testing caused all of that, but that the bargain American schooling relied on — “comply with adult-designed systems, defer questions of meaning and purpose, and the payoff will come” — has broken down, and a generation that no longer extends that trust, meaning, and purpose isn’t going to be reached by more compliance pressure.

As Wiener explains:

You cannot accountability-pressure your way to better educational outcomes when chronic absenteeism has skyrocketed, misbehavior is common, students are disengaged and skeptical that school prepares them for the lives they want to lead, and teachers feel not just tired but stripped of the professional trust that makes the work meaningful.

The public gets it, even if politicians and many in the “reform movement” can’t seem to accept any alternative or are so invested in the structures or the ideological gains that can be exploited. In a survey in which Populace asked adults to rank their K-12 priorities, standardized test performance ranked 49^th out of 57 measures.

While the public rejects standardized testing as a priority, it’s important to note that other assessments were embraced, as teacher-administered exams ranked 10^th, real-world application assessments ranked 19^th, and class-based projects ranked 22^nd.

Populace’s own framing is explicit that the objection isn’t to exams, but to standardized tests specifically. The people raising and teaching these children have told researchers, consistently and unprompted, that ranking kids against each other on test scores is close to the least important thing they want school to produce.

Wiener adds:

For a generation, the reform coalition took its validation from economists and accountability metrics, while treating parents, students and communities as mere functionaries rather than partners in a shared civic enterprise.

Federal policy’s original role in education has been lost but should be restored, according to Wiener. He writes:

Federal policy has an essential role to play in public education: protecting civil rights, funding quality data and research, and encouraging promising practices to spread. But the formative mission cannot be mandated by Washington. Belonging, the foundation of both learning and civic commitment, is relational and starts local; it cannot be standardized or scaled, but must be cultivated by schools that are responsive to the communities they serve.

And, over several decades, standardized testing has come to mean something that is often punitive: labeling schools as failing, ranking teachers by their students’ scores, and, in more than thirty states, authorizing officials to seize control of school districts outright – all based on standardized testing.

On this latter point, roughly 85% of state takeovers have hit majority-Black and majority-Latino districts. And the research is unambiguous about what they accomplish: a national study of takeovers between 2010 and 2018 found no meaningful gains in reading or math even a decade later, with some evidence that reading performance was actively disrupted in the early years.

Houston is the current example — the Texas Education Agency took over the eighth-largest district in the country on the strength of just one campus’s test scores, after the district’s own accountability grades had been improving and the trigger school itself had passed.

That’s part of the regime as actually built around standardized testing: a proxy measure that mostly just tells us who is wealthy and who is not, enforced by a punitive apparatus that did not deliver the learning it promised, and that fell hardest on the communities with the least political power to resist it.

Unfortunately, when people defend standardized testing “accountability” in the abstract, this is the machinery they are defending, whether they mean to or not.

So, the real question isn’t whether adults should answer for how children are served. It’s whether the machinery that was built in the name of that principle actually serves children. For decades now, the answer to many of the questions about American schooling has run through standardized test scores — not as one input among many, but as the organizing principle: what gets funded, what gets taught, which schools get called failing, which districts get taken over, which children get told they’re behind, and what perverse incentives are built around them.

That’s a specific policy choice, and it’s fair to ask what it delivered and what disasters it has created (whether intentional or not).

The “Decline” Is Not What They Say It Is

Almost every argument for doubling down on more testing rests on a premise that deserves more scrutiny than it gets: that “American kids are in academic freefall.” Note what’s happening: standardized test results are being used to justify adherence to a regime of standardized testing. A gap, generated in part by the measurement itself, cannot be closed by more of the measurement.

That is the pure definition of circular reasoning and justification.

It is also an embrace of a regime that educator Peter Greene describes as, “If that idea failed, then we should get back in there and fail harder.”

Curmudgucation

Margaret Spellings Still Doesn't Get It

Why would David Frum (or anyone else) bother to interview Margaret Spellings? But he did, and a friend told me to go look at the result (thanks a lot, Jennifer), and it’s a celebration of many of the worst, most failed ideas of 21st century ed reform…

Read more

10 months ago · 11 likes · 3 comments · Peter Greene

It is like the era when the health care system continued to call for the repeated bloodletting of patients after previous courses of bleeding had failed.

Then there’s the measurement itself. Many of the dispersions and attacks on the education system are built upon “cut scores” and NAEP “proficiency” mislabeling. NAEP’s achievement levels were never meant to signal grade-level performance — the National Center for Education Statistics (NCES) says so explicitly — yet officials in both parties routinely cite “only a third are proficient” as proof of catastrophic failure.

What has been catastrophic has been the false interpretation.

As I recently noted, researchers Gina Cervetti and Kathleen Hinchman mapped every state’s own definition of fourth-grade grade-level reading directly onto the NAEP scale and found that nearly every state’s standard lines up with NAEP’s Basic level, not Proficient. Read correctly, that means roughly two-thirds of American fourth graders are reading at or above grade level — the opposite of the headline.

What the data actually shows isn’t a system in freefall. It’s a persistent, decades-old equity gap: only 48% of low-income students scored at or above Basic in 2022, compared with 76% of their better-off peers. That is a story that is much about poverty, housing, health care, and school funding and not as much a measure of educational system successes or failures.

This demands that everyone be more careful about building sweeping policy arguments on top of a metric this unreliable. The cut scores in many standardized tests are judgment calls, not fixed points in human learning. The tests’ content carries documented cultural and geographic bias. As Greene argues:

…one of the biggest frauds perpetrated in education policy and journalism is the continued use of “student achievement” as a euphemism for “test scores.”

A decade ago, Pennsylvania teacher Steven Singer pointed out that these tests are rarely designed to find out what children have learned, but instead, are designed simply to create a bell curve. Therefore, they systematically and quite purposefully discard questions that actually measure what teachers most want children to know. This design has racial, cultural, wealth, and geographic consequences.

Emory’s Martin Shapiro has pointed out that when test makers keep the items that produce the widest gap between high and low scorers, they are selecting against minority students almost by definition — if a question is retained because the majority got it right, the students who got it wrong are disproportionately the minority. Field testing then locks this in: a question most white students answer correctly and most Black students miss survives, because white test-takers are the larger group.

The result, as education researcher Wayne Au describes it, is a self-reinforcing loop: item selection is calibrated to match existing racial score gaps, which locks those same gaps into every future version of the test, all without anyone ever explicitly considering race in the selection criteria. A question drawing on Black cultural experience would fail field testing for the same reason.

Consequently, the very act of “test norming” causes questions drawing on cultural experiences that cause children of color to score better than white children are tossed. This is referred to as “cultural validity,” the idea that a test cannot cleanly distinguish what a child knows from what a child has been exposed to.

In 1972, the psychologist Robert Williams developed a test called the Black Intelligence Test of Cultural Hegemony, using vocabulary and content drawn from Black American culture rather than the dominant culture’s frame of reference. When Black and White teenagers took it, Black students substantially outscored White students by substantial margins. That, obviously, is not the test that has been administered for the last 50 years.

As education scholar and history professor Andrew Hartman points out:

As a method of social production, as well as social reproduction, standardized testing has had serious cultural implications, not the least of which has been the eternal question of American identity… Consistent with notions of American identity, standardized testing, as an opposition to a cultural other, represents the normalization of whiteness, richness, and maleness (emphasis added).

None of this is hidden. Standardized testing in America was built in the 1910s and 1920s by men — Robert Yerkes, Carl Brigham, Lewis Terman — who were explicit eugenicists using their instruments to argue that Northern Europeans were innately superior. Brigham went on to create the SAT. The overtly racist language is gone. The architecture of sorting is not.

Hartman explains this history:

The early use of standardized testing was an education reform response to the scientific racism and eugenics movements. Early American standardized tests-referred to as intelligence tests-were a method of tracking, classifying, and ordering students.

That history matters not simply because of where standardized testing came from, but because many of the sorting functions it was designed to perform still shape the system today.

And then there’s a structural absurdity of the movement that few acknowledge. Because these tests are normed to a curve, a fixed share of children must always land at the bottom. You can raise scores at one school or one district, but the distribution itself is fixed. We passed a law called No Child Left Behind, and built it on an instrument that mathematically guarantees some children will always be left behind. There was never a version of this where every child succeeded, because the measurement itself would not permit it.

President George W. Bush explained at the time:

An accountability system must have a consequence; otherwise, it’s not much of an accountability system.

As a nation, we never equalized education funding. Wealthy kids continue to have much better funded schools than low-income kids and that advantage is built into the testing regime.

While standardized testing was formed on the promise of “no child left behind,” in practice, the opposite has occurred. Test scores have been used to justify withholding support for lower scoring schools – to label the school, fire the teachers, take over the school district, and move the money elsewhere.

If a child is struggling, the humane response is more support. However, the system was built to respond with sanctions, and then called the sanctions accountability.

John Oliver captured much of this on his HBO show Last Week Tonight over a decade ago. His revelations have aged well.

Why A Test-Centric System Produces Disengaged Kids

Testing, separating, labeling, and ordering students is devastating at the individual student level as well.

Dr. William Glasser argued that people, including children, are driven by basic needs for freedom, competence, and enjoyment in their work, and that using test scores to constantly rank, shame, or coerce students destroys the intrinsic motivation that produces genuine engagement in the first place.

Glaser was blunt about the institutional version of this failure: making a one- or two-point movement on a test score the primary goal of a school is precisely the wrong goal, and it comes at the expense of building a real culture of quality. He also warned that the right-answer/wrong-answer format of standardized testing teaches children that education is a hunt for a predetermined answer rather than a process of understanding and learning to reason.

That’s the mechanism. Not that accountability directly causes sadness in some abstract sense, but that an institution organized around external compliance with a score starves the psychological needs that make kids want to show up and try. Glasser was describing this failure mode decades before “chronic absenteeism” became a policy term. It isn’t a theory built after the fact to rescue anyone’s argument; it’s an old one that predicted exactly what we are now seeing.

What The Testing Obsession Crowds Out

Curriculum narrowing has consequences we can measure. When school success is defined almost entirely by reading and math scores, everything untested gets squeezed — civics chief among it. A Cato Institute survey this year found 58% of Americans don’t know the Constitution’s core purpose is to limit government power. That’s not a trivia gap. It’s what happens when a generation spends its entire K-12 career under a regime that never made room to teach the things it doesn’t test, including civics. Science, history, the arts, and physical education get pushed to the margins of the elementary day because they aren’t tested and therefore aren’t rewarded. And yet, those teachers are often punished for student test scores limited to math and reading.

And the testing obsession distracts from the things actually keeping kids from learning. As the saying goes, “You can’t fatten a pig by weighing it.” More testing doesn’t feed a hungry kid, insure a sick one, or house a family living in their car — and right now those conditions are getting worse, not better, for millions of American children.

Child poverty, measured by the Supplemental Poverty Measure (SPM), has more than doubled since its 2021 low, from 5.2% to 13.4% in 2024. That has been a policy choice.

Furthermore, nearly one in five households with children, or 14.1 million kids, were food insecure in 2024, essentially erasing a decade of progress. SNAP cuts enacted since then are projected to push that higher, even as the U.S. Department of Agriculture (USDA) has stopped collecting the data that help us track it.

Children’s health coverage is sliding backward too: the child uninsured rate has risen from 4.7% in 2016 to 6.1% in 2024. Compounding that negative trend, roughly two million fewer kids have been enrolled in Medicaid and CHIP since January 2025, with more than $1 trillion in cuts to Medicaid hitting children after passage of the so-called “One Big Beautiful Bill” (OBBB) last year.

A hungry, uninsured, unstably housed child does not learn better because we test him more. If we spent a fraction of the political energy currently devoted to accountability architecture on making sure kids arrive at school fed, healthy, and secure, we would do more for their test scores than another round of mandates ever could and far more for the best interests and well-being of children themselves.

Money Matters

Here is what gets lost in twenty-five years of arguing about mandates. The original civil rights case for federal involvement in education wasn’t only about measuring gaps. It was about closing them, and closing them takes resources.

The research on this is no longer ambiguous. Northwestern’s Kirabo Jackson and colleagues, in a meta-analysis of every credibly causal study on school spending, found that increased funding shows real, positive effects on student outcomes. A sustained $1,000-per-student increase raises high school graduation and college enrollment rates, and low-income students benefit most of all — with measurably higher wages and lower poverty rates in adulthood.

Money matters. It has always mattered more consistently than test-based accountability ever has.

As life-long educator Diane Ravitch explained in her outstanding book, The Death and Life of the Great American School System: How Testing and Choice Are Undermining Education:

Our schools cannot be improved by those who say that money doesn’t matter. Resources matter [and] if we are serious about narrowing and closing the achievement gap, then we will make sure that the schools attended by our neediest students have well-educated teachers, small classes, beautiful facilities, and a curriculum rich in the arts and sciences.

Unfortunately, in recent years, the actual investment has dramatically eroded.

First Focus on Children’s Children’s Budget 2025 shows federal spending on education fell from $78.5 billion in 2021 to $60.3 billion in 2025 — a 16.8% decline in real spending.

President Trump’s 2026 budget has proposed cutting it to just $39.1 billion, or less than half of 2021 levels and nearly two-thirds less than 2022 levels (cuts that are even worse if you account for inflation).

The President’s budget proposals to abolish the Department of Education, slash Title I and IDEA funding, and promote the expansion of voucher programs that redirect public dollars to private schools that carry none of the civil rights protections or accountability requirements public schools must meet are fueling an education funding cliff for our public schools.

Those aren’t neutral shifts. They fall hardest on exactly the children the accountability era claimed to protect: low-income kids, kids of color, and kids with disabilities.

Decades of standardized testing without funding the effort to close identified gaps let accountability function, in practice, as a shifting of blame to schools and teachers of the work that federal and state policymakers have repeatedly failed to address, including ending school funding inequity, concentrated poverty, and segregation.

It is important to note that Wiener and the public are not asking to stop measuring how schools perform. For example, the Populace data ranks teacher-administered exams, real-world assessments, and class-based projects far above standardized tests. It is highly disappointing that the “parental rights” crowd seems to ignore both the real priorities of parents and the related problems associated with disappearing federal investments in children.

Ask The Kids

Ask the children at any school, and they can tell you who the best and most challenging teachers are, which curricula they have found challenging and engaging, and what interests they have and wish to pursue.

And yet, in the school wars, there’s one major voice missing from this entire debate, and it’s their voice.

A Lancet Health Policy paper published this month on the “Children in All Policies” collaboration makes the point directly: children’s right to participate in decisions that affect them is routinely ignored, even by adults who otherwise mean well. One child in a CAP-2030 workshop in Ghana put it bluntly — adults assume kids’ input doesn’t make sense.

Everyone in this argument has been reasoning about what children need from data adults collected. So, what happens when you actually ask the kids?

A Voices of Gen Z study surveyed K-12 students themselves and found fewer than two in ten strongly agree their classwork feels important, interesting, challenging, or aligned with their talents. Ask them what drives engagement when it does show up, and the answers are a teacher who made the material interesting (60%), wanting to learn more about the subject itself (60%), hands-on engagement (46%), and connecting learning to the real world (35%). Test scores appear nowhere on that list — not because kids weren’t asked about testing, but because when you ask children what makes school worth showing up for, sitting for days on end filling in bubbles on a standardized test isn’t motivating and would never be the kind of thing that they would prioritize.

Kids’ own bodies say the same thing, in a study that didn’t have to ask them anything. For example, a study published by NBER measured cortisol in New Orleans students in grades 3 through 8 during high-stakes testing weeks versus ordinary weeks, using saliva samples rather than self-report. What researchers found was that cortisol levels rose about 15% on average during testing weeks, with sharper spikes among boys and among children from higher-poverty neighborhoods. That’s a measurable physiological stress response to the instrument itself.

And when kids get to ask each other, the pattern holds. A youth-led research project in New Mexico had teenage interns survey more than 270 peers about what students should demonstrate before graduating. The answers are: kindness, confidence, respect, integrity, empathy, and community involvement. As one student researcher observed, none of those are things a standardized test measures.

The CAP-2030 evidence points the same direction from another angle. When you bring children into policymaking — through art contests, school parliaments, citizen science projects, structured youth advisory boards — they produce better policy, not just more participatory policy.

We should listen to the kids more, as it is their lives, their education, their health, their well-being, their development, and their safety that this is all supposed to be about.

None of this means handing kids the pen on federal testing policy. It means that children know things no survey of adults can fully capture: which teachers actually reach them, what kind of work makes them want to show up, when they are bored out of their minds and when they are not. We rank adults’ priorities for children 57 ways. We almost never ask the children — and on the rare occasions we do, they tell us the same thing, only more starkly.

The One Question

Every institution whose work affects children should begin with one question: is this good for children?

Apply it here. A system that adults rank 49th out of 57 priorities. That produces record adolescent hopelessness and measurable spikes in children’s stress hormones. That narrows what gets taught to what gets tested. That runs on data the officials citing it chronically misread. That is built on an instrument engineered to discard the questions teachers most want to children to master, and to sort children rather than teach them. That has been used to seize control and accountability away from majority-Black and majority-Latino communities without producing academic gains. That keeps weighing children while their poverty, hunger, and uninsurance rates climb. That lets real investment in disadvantaged kids fall for four straight years. And that still doesn’t bother to ask the children themselves what they need.

Is that good for children? It isn’t close.

Kids need us to ask, honestly, whether the tools we built back then serve the children in front of us now and to spend our energy on the things that actually would, which isn’t more standardized testing.

Our kids can’t wait.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

Millions of children are losing health coverage. After years of reducing the uninsured rate for children to historic lows, America is moving backward. As Sen. Andy Kim (D-NJ) points out, the number of uninsured children has grown to nearly 4.5 million, and there are another 23 million who are underinsured.

For the sake of our children and grandchildren and their future, we must get back on the right path toward progress rather than regression.

Share

Subscribe now

A Landmark Proposal

On July 21, Senator Andy Kim (D-NJ) took a major step forward in introducing MediKids (S. 5037), a monumental piece of legislation that would guarantee health care coverage to every child in America from birth to age 26.

The Senate bill, cosponsored by Sens. Cory Booker (NJ), Tammy Duckworth (IL), and Alex Padilla (CA), would automatically enroll every child at birth in Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit — the program’s comprehensive, pediatric-specific standard of care — and guarantee continuous eligibility to coverage, regardless of income, immigration status, or health condition.

At First Focus Campaign for Children, we were pleased to work with Sen. Kim on the legislation and joined other national, state, and local organizations^[1] in support of it. Our statement explains:

At a time when the uninsured rate for children is rising and children face unacceptably high rates of infant and child mortality, a growing mental health crisis, and declining immunization rates, Senator Andy Kim’s MediKids bill puts children back on the path toward ensuring all children have health coverage and improved access to care. No child in this country should go without health care simply because of what their parents earn, their zip code, or whether they can navigate a complex and fragmented health care system. In an effort to improve the health, development, and well-being of children, MediKids represents the kind of ambitious, child-centered thinking that the moment demands for our children and grandchildren.

Sen. Kim’s vision for MediKids (S. 5037) is the right one, which is to ensure that all kids are covered, just as the nation does for senior citizens with the Medicare program.

The American Dream of Covering Every Child

The idea of covering every child goes back to the time when Medicare and Medicaid were first created. In 1965, when Secretary of Health, Education, and Welfare (HEW) Joseph Califano chaired an Interagency Task Force on Health Care that proposed to President Lyndon Johnson a comprehensive set of proposals to enable “every child to have the medical care he needs to develop his capabilities.” While political events at the time allowed Medicare to be created, children’s coverage was limited to just the lowest-income kids through Medicaid.

In a comprehensive review of the history of maternal and child health improvements [2], health policy expert Kay Johnson explains that prior to the creation of Medicaid, about one-in-four children lacked health coverage. The vision of covering all kids never went away, however, and she lays out the subsequent timeline of improvements as follows:

• Assistant Secretary (and later HEW Secretary) Wilbur Cohen championed a proposal known as “Kiddycare,” which would have provided universal social insurance coverage for maternity care and infant care during the first year of life for every mother and baby in the country, regardless of income — a true universal approach, not the means-tested program Medicaid became;

• President Carter’s 1977 Child Health Assessment Program (CHAP), which would have expanded Medicaid to hundreds of thousands more poor children under age six;

• Rep. Henry Waxman’s Child Health Assurance Act in 1979 that proposed extending Medicaid to every child under 18 and every pregnant woman, regardless of state-by-state variation; and,

• The Medicaid incremental but critically important expansions signed into law in subsequent budget bills that lowered the uninsured rate to around 15% by 1996.

In 1997, Congress passed, and President Clinton signed into law, the creation of the Children’s Health Insurance Program (CHIP). CHIP became one of the most successful bipartisan health initiatives in American history. In tandem with Medicaid, it reduced the uninsured rate among children by more than two-thirds, from 15% in 1996 to a record low of 4% in 2016.

But as Johnson explains, the story of nearly every gain child advocates have won is not through one triumphant bill, but persistence over years, sometimes decades, of different bills and different approaches, all aimed at the same underlying goal or vision of covering all kids.

This brings us to the name “MediKids” itself. This is not the first time it’s been used. Rep. Pete Stark (D-CA) and Sen. Jay Rockefeller (D-WV) introduced a MediKids Health Insurance Act in several sessions of Congress — each time proposing to guarantee coverage for all children.

Sen. Kim’s bill picks up that torch that has been carried, set down, and picked back up again for over three generations. That has always been the point of legislation like this: establishing the goal of ensuring that every child is covered is on the table, argued for, refined, and ready whenever the moment for it finally arrives.

At a time when we are living through retrenchment and rising levels of uninsured children, Sen. Kim’s proposal to set the country back on the right path of covering all kids is timely and desperately needed.

Why the Moment Is Now

MediKids doesn’t arrive in a vacuum. It arrives as a direct answer to a crisis this Congress and Administration have created with the passage of H.R. 1, the so-called “One Big Beautiful Bill” (OBBB). At the time, despite numerous warnings about the threat the legislation would pose to children, supporters of the act, including Secretary Robert F. Kennedy, Jr., asserted that kids would be protected.

They were wrong.

As I wrote last month, the promise Congress and the administration made — that children were protected and that the Medicaid cuts targeted only able-bodied adults — was false. The Congressional Budget Office (CBO) estimates that OBBB cuts federal Medicaid and CHIP spending by nearly $1.2 trillion through 2036, the largest cut to the program in its 60-year history, and projects that nearly 3 million children will lose Medicaid coverage as a result.

We don’t have to wait for that projection to play out. Georgetown University’s Center for Children and Families (CCF) has already reported that 2 million fewer children were enrolled in Medicaid and CHIP as of this spring than when President Trump took office, even though income eligibility for kids hasn’t changed and unemployment has been rising.

These are not children who became ineligible. They are children caught in what CCF describes as the “unwelcome mat” effect: a parent who can’t document 80 hours of work a month, a state’s system that isn’t automated, a redetermination notice that gets lost in the mail — and the whole family, kids included, falls off the rolls.

To a child, it doesn’t matter whether the coverage loss traces back to a work requirement, a paperwork barrier, or a congressional budget score. They experience only the outcome: a missed check-up, a skipped vaccination, a delayed cancer diagnosis, and failure to meet developmental goals.

MediKids is, in effect, the opposite bet.

OBBB uses technology to create added friction, barriers, and redetermination hurdles to make eligibility harder to maintain. MediKids removes those barriers to care for children and, as Medicare does for seniors when they turn 65, creates a default and expectation of enrollment at birth, guaranteed, continuous coverage, no annual paperwork barriers, no churn, and no families navigating a bureaucracy to keep a child covered.

Children Are Not Little Adults

Any serious approach to covering kids must recognize, although it is routinely ignored in health policy debates, that children are not little adults. Children’s bodies and minds are actively developing, which means their care should lean toward prevention, habilitation, and developmental milestones rather than the maintenance and rehabilitation that defines most adult and senior care.

Healthy child development depends on preventive care, developmental screening, early intervention, immunizations, and continuous monitoring during years of rapid physical and neurological growth. Interrupting that care carries consequences that can last a lifetime. This difference, in fact, explains the creation of the medical field of pediatrics and the establishment of children’s hospitals and other pediatric specialty care.

Dr. Kurt Newman, former president and CEO of Children’s National, put it simply in his book Healing Children:

[Children] need specialty centers with doctors, nurses, psychologists, social workers, orderlies, administrators, and maintenance staff devoted to fostering an environment attuned to their unique psychology, biology, and medical conditions.

This is exactly why Medicaid’s EPSDT benefit exists, and why it’s the right foundation for a bill like MediKids to build on. Unlike a generic insurance benefit designed around adult care patterns, EPSDT was built in recognition of children’s unique need for developmental screening, immunization schedules, and the full range of physical, dental, vision, and behavioral health services. A pediatric-focused benefit isn’t a nice-to-have: it’s the whole point.

Children’s health coverage is also one of the country’s smartest long-term investments. Healthy children are more likely to succeed in school, graduate, participate in the workforce, and avoid costly medical crises later in life. Covering children isn’t simply compassionate policy – it reduces future public costs while strengthening the nation’s future workforce.

There is strong support by the American people for recognizing the unique needs of children. When pollsters have asked voters directly whether they support “ensuring that all children have health coverage,” the answer has come back nearly nine-to-one in favor. When CHIP itself was on the chopping block, voters opposed eliminating or scaling it back by overwhelming three-to-one margins. There is no meaningful constituency in this country that wants to see kids uninsured.

Back in 2019, child advocates – including the American Academy of Pediatrics, Children’s Defense Fund, Children’s Hospital Association, Family Voices, First Focus on Children, Georgetown’s CFF, March of Dimes, and National Association of Pediatric Nurse Practitioners – laid out a set of principles for health reform for children. The core of those principles still holds:

As a nation, we must build on what is working for millions of children, pregnant women and their families by keeping Medicaid and CHIP strong and enrolling all eligible children, strengthening private coverage, and working toward a health care system that meets the needs of ALL children, pregnant women, and their families, regardless of their health or immigration status, family income, or zip code. Any change to our health care system must further improve coverage for children and pregnant women. They must not lose ground.

Put simply: first, do no harm. That principle exists because history has taught child advocates, repeatedly and painfully, that “reform” is not automatically good for kids just because it expands coverage somewhere else in the system. There have been many steps forward, but also steps backward, as we are witnessing at this very moment.

Repeated threats to children’s coverage have demanded vigilance by child advocates over the years. In 2017 alone, proposals to block grant Medicaid would have targeted children with extreme harm, including a Senate proposal by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA), that would have disproportionately slashed children’s coverage by nearly one-third, or 31.4%.

As the legal scholar Michael Freeman has written, in a passage I’ve returned to for years:

It is important that all those that formulate policy should be compelled to consider the impact their policies have on children... All too rarely is consideration given to what policies. . .do to children. This is all the more the case where the immediate focus of the policy is not children. But even in children’s legislation the unintended or indirect effects of changes are not given the critical attention they demand.

That is the single question we’ve tried to hold every piece of federal legislation to for years: “Is it good for children?” Not incidentally, not as an afterthought, but as a direct, deliberate test applied before the vote, not discovered afterward in a CBO score nobody read carefully enough.

MediKids asks and answers that question in the positive for children.

The Goal Is Covering All Kids, but the Ways and Means Do Matter

In a 2020 “Covering All Kids” piece, I explained how the children’s community has been genuinely skeptical of proposals to move children wholesale into other programs, such as the Affordable Care Act (ACA) and Medicare.

The ACA was built for uninsured adults and, despite the support from some health plans, hospitals, and non-kid advocates, the data demonstrated that children would have been left worse off by moving children from CHIP to the ACA marketplace.

As for Medicare, it was built for seniors and people with disabilities. Although some initial skeptics of Sen. Kim’s MediKids bill have argued instead for a Medicare for All approach, it is important to note that Medicare lacks pediatric benchmarks, pediatric provider networks, and habilitative benefits that Medicaid and CHIP have spent decades building out, and its cost-sharing structure is far less generous to kids than what they have today. Moving millions of children out of Medicaid and CHIP into a program never designed for them risks leaving them worse off in the name of simplicity — the opposite of “do no harm.”

The goal isn’t simply giving every child an insurance card. It is ensuring every child receives the pediatric care they need to grow, learn, and thrive. Insurance is the means. Healthy childhoods are the end.

To achieve that, MediKids builds upon Medicaid and on EPSDT’s comprehensive, pediatric-specific standard of care that already anchors coverage for the tens of millions of children on Medicaid today — rather than replacing it with something built for someone else. In First Focus Campaign for Children’s letter of support for MediKids, we explained why its design meets that “do no harm” standard while embracing the vision of being a guarantee of coverage for every child in the country. Mental and behavioral health, developmental services, dental, vision, and other pediatric benefits are built in from the start.

The automatic enrollment and continuous eligibility provisions go directly at the administrative churn that has been the real driver of coverage loss for children year-after-year. Kids don’t age out of needing health care every twelve months, and their coverage shouldn’t depend on a parent successfully clearing a redetermination hurdle on that same schedule. The legislation’s embrace of covering ALL kids, regardless of immigration status, is important, as it recognizes the need for every child to be able to be immunized or to receive treatment for asthma, cancer, or cystic fibrosis.

There’s a useful, if imperfect, analogy here to the Vaccines for Children (VFC) program. VFC doesn’t require a child to prove they’re uninsured through a complicated application process before they can get immunized. It reaches children who are uninsured, underinsured, or on Medicaid, not every child regardless of coverage status. But the point is that no kids with health care needs should be denied necessary care and treatment.

The Bottom Line

Kids didn’t create the coverage crisis they’re living through, and they can’t wait for Washington to decide it’s ready to fix it. The public has been asking for “covering all kids” in landslide numbers for as long as anyone has bothered to poll it. What’s been missing is legislation that takes that mandate seriously enough to write it into statute rather than treating it as background noise.

MediKids reasserts, in the clearest possible terms, a principle and vision that should never have needed reasserting: no child should go without care because of their parents’ income, their zip code, their immigration status, or the country’s political mood in a given year.

MediKids reminds us that progress is still possible, and that the destination has never really changed. Enough with the backtracking and harm. Now is the time to move forward.

Our kids can’t wait.

What You Can Do

If you would like to support this legislation, you can:

• Contact your senators and urge them to cosponsor Sen. Kim’s bill, MediKids (S. 5037).

• If you are not already, consider becoming a paid subscriber to this newsletter to support our work on this and other policies of importance to children.

• Donate directly to First Focus Campaign for Children to support our advocacy efforts on behalf of children.

• Consider joining us as an Ambassador for Children to be a voice for better children’s policies.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

ENDNOTES

^[1] The initial list of endorsing organizations includes: First Focus Campaign for Children, What To Expect Project, American College of Obstetricians & Gynecologists, (ACOG), ZERO TO THREE, Society for Maternal-Fetal Medicine, American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry (AACAP), Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN), Association of Maternal and Child Health Programs (AMCHP), National Association of School Nurses, National Education Association (NEA), Families USA, MomsRising, NAACP NJ, Save Our Schools, New Jersey Citizen Action, SPAN Parent Advocacy Network, The Arc of NJ, The New Jersey Chapter - American Academy of Pediatrics, and CASA of New Jersey.

^[2] Johnson K. (2021). Medicaid and CHIP Coverage for Women and Children: Politics and Policy. Chapter 20. In Russell Kirby and Sarah Verbiest (editors): Kotch’s Maternal and Child Health: Problems, Programs, and Policy in Public Health. (Textbook 4th Edition). Jones and Bartlett Learning.

None of that is therapy. It’s not a screening. It’s not a clinical intervention. It’s just what a decent adult does when they’re paying attention to a kid.

Under a new rule the Texas Education Agency (TEA) has proposed, it might require a permission slip.

TEA’s Proposed Rule

To implement Senate Bill 12, a Texas parental rights bill that affects children’s education and health care, TEA is proposing a rule — 19 TAC §103.1105 — that sets out how school districts must notify parents and obtain consent before a student receives certain mental, emotional, or physical health services.

The law began from the premise that parental authority should be close to absolute inside a school building, and that a child’s well-being is best protected by maximizing parental authority rather than by asking what a specific kid, in a specific situation, actually needs in public schools.

The proposed rule is solely focused on parental rights. The language is rather sweeping, as section (c) reads:

Parents rights and access to information may not be restricted. Unless otherwise provided by or in accordance with other law, parental rights. . .must not be infringed upon by a school district, nor may a district withhold information from a parent regarding their student.

The definition of a parent with such sweeping language only limits parents whose “rights have been terminated” or “whose rights have been modified by court in relation to parental rights and duties.” Beyond the matter of how schools are supposed to know this information about every parent, granting parents such sweeping rights would include situations school staff regularly encourage, including:

• A parent whom a child fears or considers dangerous to them, including fear of physical or emotional abuse and rejection.

• A parent who has a family violence protective order against them, sought by the other parent or by the student’s other guardian, but whose parental rights have not been terminated.

• A parent who is incarcerated for an offense involving violence, and whose custodial rights have not been formally modified because they are in prison.

• A parent with a documented history of family violence in the home, known to the district through a custody dispute or a prior finding, but who retains full legal parental status.

• A parent who has had little or no relationship with the student for years and reappears to assert access rights under this rule, in a manner that can itself signal risk to the student.

• A student and custodial parent living in a family violence shelter, or a family operating under an active CPS safety plan that limits or supervises the other parent’s contact with the student.

• A student or family enrolled in Texas’s confidential address program for survivors of family violence, sexual assault, stalking, or trafficking, where disclosing location-identifying information to the other parent could endanger the family.

The rule’s definition of what counts as a “service” needing parental consent includes language covering any method “presented or characterized as a survey, check-in, or screening or is embedded in an academic lesson” that touches on a student’s attitudes, habits, beliefs, or feelings. Pair that with the rule’s opt-in requirement, and you get a genuinely strange result: read literally, a teacher, coach, counselor, or school nurse asking a student how they’re coping with a hard week could require prior written parental consent, the same as a formal psychological evaluation.

Although the Texas Legislature certainly wants TEA to implement SB 12, it did not direct TEA to maximize parental authority at the expense of every other interest the education system exists to protect, including students' interests. Those are two different instructions, and the proposed rule reads as if it is solely focused on parents.

Share

Subscribe now

Texas Has Already Had Problems Associated with This Approach

Texas didn’t have to imagine what happens when a rule like this is written too broadly. It found out in real time on this same bill.

The text of SB 12 reads that health care services cannot be provided without parental consent unless it is “necessary to further a compelling state interest, such as providing life-saving care to a child….”

Short of care to prevent death, the bill’s language requires parental consent, and it is nearly identical to language in other “parental rights” bills being promoted by groups like Moms for Liberty, ParentalRights.org, Family Research Council, Focus on the Family, and the Foundation for Government Accountability in Congress and in states across the country.

The Texas Education Agency (TEA) made that clear in a proposed rule last August (days before the new school year began).

Consequently, within days of SB 12 taking effect on September 1, 2025, school nurses across the state were unsure whether they could hand a kid a Band-Aid, an ice pack, or any type of first aid without written parental consent on file.

It got so bad that the bill’s own authors, Rep. Jeff Leach and Sen. Brandon Creighton, wrote to Commissioner Mike Morath asking TEA to issue “clear and consistent guidance,” saying they expected schools “not to suspend common sense when it comes to providing basic care for the children at their schools.” They referred to it as “common sense.”

TEA put out emergency guidance in September 2025 clarifying that first aid didn’t require active consent. Subsection (q) of the newly proposed rule is essentially that fix, made permanent.

This history is about to repeat itself in the newly proposed rule but with different services. The same instinct that made a nurse hesitate over a Band-Aid last September is going to make school officials hesitate over asking a kid how they’re doing this coming school year, for exactly the same reason.

Unfortunately, the rule’s language is broad enough that the cautious, liability-conscious reading will win by default, and it may take a public outcry and emergency guidance to fix it after the fact.

This is what happened in Idaho after it passed its own parental consent law in 2024. That law produced identical confusion — school districts told parents that first aid and all other health services required parental consent. But in Idaho, the same broad language restricted those providing health care services to children in a manner that included the state’s 988 suicide crisis line.

Teenagers later testified to lawmakers that hotline responders had hung up on them mid-crisis because they couldn’t confirm parental consent in the moment. One student told the committee he knew a girl who’d been hung up on twelve separate times during twelve separate crises. Another described being minutes from a suicide attempt and said he still thinks about how that night might have gone differently if someone had simply stayed on the line.

It took Idaho two legislative sessions, hearings, press conferences, podcasts, and more to get legislators to admit on the record that their own law was “a mess” and to begin fixing it. Even with the passage of a recent cleanup bill, problems with the original bill remain unresolved.

Fortunately, after Texas received its first aid warning, the Lone Star State moved quickly to fix it. That’s to the state’s credit.

But TEA’s latest rule fails to close and, in fact, opens up new problems that should not require a viral story about a school official afraid to ask a kid how they’re doing, or worse, before it reaches something as serious as what Idaho went through. Texas children shouldn’t need a second scramble, or a repeat of what it took Idaho years and real harm to fix, to protect something so basic and — to use Leach’s and Creighton’s own words — “common sense.”

I don’t think most legislators pictured a teacher needing a permission slip to “check in” with a kid as to how they’re doing when they voted for SB 12. But that’s exactly what happens when a law is built around a single value and never stops to ask what it costs the kids who don’t fit the assumption underneath it.

Furthermore, rules don’t get read the way legislators likely imagined them in a hearing room, either. They get read by a school district’s lawyer trying to keep the district and its education professionals out of trouble, and when a rule is this broad and confusing, the safe answer for that lawyer is always going to be: don’t ask kids how they are doing. Don’t demonstrate concern, compassion, or even basic humanity.

Get the bureaucratic signed form first. When in doubt, stay quiet. Even if the parent has provided consent, educators can’t possibly know which parents have and have not, so the default will be to not “check in.”

That’s the part that should worry every parent, not just the ones who feel strongly about consent — the rule as written doesn’t clearly distinguish between a clinical intervention and a caring adult paying attention. And for the rest of you living outside Texas and Idaho, the “parental rights” bills being introduced and passed in states and by school boards across the country are doubling down on these problems.

Why This Matters More Than It Sounds Like It Should

This debate also comes at exactly the wrong moment. Young people are facing unprecedented levels of anxiety, depression, loneliness, and suicidal ideation. According to the Centers for Disease Control and Prevention’s (CDC) Youth Risk Behavior Survey, nearly 40% of high school students reported persistent feelings of sadness or hopelessness, and about one in five seriously considered attempting suicide.

At the same time, the CDC identifies school connectedness — the feeling that adults and peers at school care about you — as one of the strongest protective factors for adolescent mental health.

What actually keeps kids safe: adults who notice things. The teacher who clocks that a normally talkative kid has gone silent. The coach who sees a player pull away from the team. The counselor a kid trusts enough to say something is wrong before it becomes a crisis. That noticing never starts with a form. It starts with someone asking a few questions, because they were paying attention and they cared enough to ask.

If the rule makes staff hesitate — if it teaches them that a “check in” might expose them to discipline, a fine, or a licensing complaint — the predictable outcome is less noticing and less caring. Kids become more invisible and less safe. The people best positioned to catch a problem early stop asking the questions that would have caught it.

This isn’t only a child-safety argument. It’s also an education argument. Schools don’t just deliver academic content; they educate whole children, and a kid who’s scared, isolated, hungry, or in crisis cannot learn well no matter how good the lesson plan is. Trusted relationships between students and the adults at school aren’t a nice extra on top of the academic mission — they’re part of how the academic mission gets accomplished.

Schools have never been places where adults simply teach math or English. Teachers notice bruises. School nurses identify untreated asthma. Coaches recognize eating disorders. Counselors intervene before anxiety becomes crisis.

A rule that makes those relationships riskier to maintain doesn’t just put kids at risk. It undermines the very thing schools are there to do – to serve as caring adults supporting the education, growth, and development of the students in their care.

The Kids Most Likely to Fall Through

There’s another way this rule quietly pulls the caring adult out of a kid’s life, as it requires a parent to actively opt in before a student can receive certain health care services, such as counseling..

For some students, you can send the form home, get a parent to sign it, and be done. But think about which kids are most likely to have a form that never comes back: foster youth moving between placements, with no single parent consistently in the loop. Kids experiencing homelessness, doubled up with relatives or living out of a car, whose family has bigger problems than a school form that week. Kids in households where a parent is working two jobs and never sees the folder of school paperwork at the bottom of a backpack. Kids who live in arrangements that might include grandparents or other kinship where those adults don’t have the authority to sign and provide consent.

This is the reality of what life looks like for many children and families, and it describes many of the students research consistently shows are already the most likely to be falling behind and the ones most in need of having an adult in their lives – including teachers, counselors, coaches, and nurses in schools – “checking in” with them.

An opt-in requirement with no fallback doesn’t ask whether a service is a good idea for a specific kid. It just asks whether paperwork made it home and came back signed. When it doesn’t, the rule doesn’t pause and check in on that kid. It just quietly removes them from the list of kids allowed to get help.

That’s not a hypothetical about bad parents. It’s what happens to good kids in hard situations when a system is built to default to “no service” rather than “let’s make sure someone follows up.”

There are other places where this same instinct — treat every disclosure as something to manage, not something to hear — creates real danger. For example, the rule also requires staff to notify a parent within one school day of a student disclosing anything involving “sexual behaviors,” and it does not distinguish between two very different things: a student telling a counselor they’re gay, and a student telling a counselor an adult has touched them inappropriately.

One of those is a student sharing who they are. The other is a student who may be in danger. These are nowhere close to the same thing.

And yet, the rule treats both the same, which means the disclosure that most urgently needs fast action gets exactly the urgency it deserves, while a student’s own sense of who they are becomes something a school is required to report on a clock, whether or not it’s safe for that student’s family to know.

Leaning on the rule’s existing abuse-and-neglect exception isn’t enough of a fix, because that exception requires a staff member to predict and document that real abuse is likely before they’re allowed to protect a student — a student who reasonably fears rejection or being pushed out of the house, without a documented risk of physical abuse, gets no protection under that standard at all. A student’s control over their own personal information shouldn’t need to clear that bar. It’s the student’s information, experience, and life to begin with.

The rule’s list of disclosures requiring mandatory same-day parental notification puts a student getting a tattoo in the same sentence, under the same urgent reporting requirement, as a student disclosing suicidal ideation.

This language in the rule bears repeating: a piercing and a suicide risk, treated by the state as belonging to the same category of concern. That’s not a rule protecting kids. The rule doesn’t distinguish between a teenager making an ordinary adolescent choice about their own body and a teenager in crisis, and it asks school staff to treat both the same way. Not everything a student does or says needs to become a data point in a state-mandated report that weaponizes school personnel as snitches.

These aren’t hypotheticals. They’re what happens when a rule is built around a single value — parental notification and consent — without building in the same safeguards that every other child-serving system already knows it needs, and without ever asking whether the thing being disclosed is actually the state’s business to report.

None of these problems are inevitable. TEA still has the opportunity and the responsibility to revise the rule before it becomes final.

What We’re Asking For

First Focus on Children filed formal comments with TEA this week.

We’re not asking the agency to abandon SB 12 or to pretend parents shouldn’t know what’s happening with their kids at school. We’re asking TEA to fix the parts of the rule that would sweep up the good with the bad:

• Make clear that routine, informal check-ins by educators aren’t the kind of “examination” this rule was meant to regulate.

• Build in a real fallback for students whose opt-in forms never come back, so a kid isn’t quietly cut off from support just because paperwork didn’t make it home.

• Stop treating disclosures about who a student is — their sexual orientation, gender identity, or relationships — the same as disclosures that signal a student is at risk, and stop requiring mandatory parental notification for the former.

• Drop tattoos and other ordinary body-autonomy choices from the list of disclosures that trigger mandatory reporting; that list should be reserved for genuine safety risks.

• Close the gap that lets a parent with a protective order against them, a history of family violence, or a violent incarceration still invoke full, unqualified access rights.

• Make sure a kid with asthma, diabetes, or epilepsy doesn’t lose access to daily medication because a form didn’t come back in time.

• Hold a listening tour so TEA hears directly from students across Texas before this rule is finalized. It’s their education and their schools. They should get a say before the rule governing their daily interactions with trusted adults is locked in.

File Your Own Comment: It Takes Five Minutes

TEA is required to read and consider every comment it receives, and the comment period closes Monday, July 27.

You don’t need to write eight pages as we did. A few sentences saying which part of this rule concerns you, in your own words, is important, and it counts more than you’d think — agencies notice when the same concern shows up in dozens of independent comments, not just one organization’s letter.

• Submit online: through TEA’s proposed commissioner rules comment form.

• Submit by email: rules@tea.texas.gov.

• What to say, if you want a starting point: pick whichever piece of this landed for you — the permission slip for an educator’s check-in, the outing risk, the tattoo-versus-suicide-risk list, the gap for kids with a dangerous parent, the kids who fall through an opt-in form that never comes back — and just say why it worries you. You’re welcome to borrow language straight from this post or from our full letter.

If you’re a parent, teacher, coach, counselor, school nurse, school administrator, or a student yourself, your comment carries particular weight, because you’re the one this rule will actually land on. TEA needs to hear from the people who ask kids how they’re doing every day, not just from advocacy groups.

This Isn’t Just a Texas Story

Texas isn’t alone in this.

Over the past few years, a wave of states have passed some version of a “parents’ bill of rights,” and they share more than a label. They share a design choice: treat parental authority as close to absolute, and treat a child’s independent interests — education, health, development, safety, privacy, well-being, and dignity — as an afterthought.

Children become invisible when a law is written around parents as a category and a slogan, instead of around the actual range of kids and families a school serves — including the kid whose home isn’t safe, the kid whose parent can’t be reached, and the kid who just needed one adult at school to pay attention without a form standing in the way.

Kids are not their parents’ property, and their well-being is not automatically identical to their parents’ preferences. Most of the time the two align. However, when they don’t, a law that never planned for that gap doesn’t stay neutral — it comes down on the side of the parent, every time, by default, because that’s the only case it was built to handle.

Texas is where this particular rule happens to be up for public comment right now, but the same gap is baked into similar laws in other states, and it will keep producing the same results until legislatures start treating children as people the law owes something to directly, not just as extensions of whoever has custody of them.

The One Question: “Is It Good for the Children?”

Every piece of federal or state policy affecting children deserves one question: “Is it good for children?”

We should never build a school system where compassion requires paperwork or where caring adults need a permission slip to be human. A rule that makes a teacher, counselor, coach, school nurse, or athletic trainer think twice before asking a struggling kid how they’re doing does not pass that test.

Children deserve schools where trusted adults can notice when something is wrong, ask caring questions, provide appropriate support, and protect students from harm, all while respecting parents’ legitimate role in their upbringing. That’s not a contradiction. It’s what a rule that actually works would look like. TEA should revise this one so it advances that shared goal instead of undermining it.

The comment period on this rule runs through July 27. If you work in a Texas school, or you’re a parent who wants your kid’s teacher to feel free to ask how they’re doing, TEA needs to hear from you too.

And if you’re reading this from another state where a similar bill is moving, or has already passed, don’t wait for a rulemaking to say something — the earlier protections for children get built in, the fewer kids fall through before anyone notices.

Kids can’t wait.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

Every institution whose work affects children should begin with one question: “Is this good for children?”

By that standard, the National Assessment of Educational Progress (NAEP) has some important issues that deserve to be resolved. First and foremost, your achievement-level labels — “Basic,” “Proficient,” and “Advanced” — are being weaponized against the very children NAEP exists to serve, and you know it, because your own staff has been saying so for twenty-five years.

To be clear, this open letter is not a claim that NAEP’s underlying data is necessarily wrong, and it is not an argument against NAEP. The argument and request is narrower: you have a real and critically important ethical responsibility to correct the public misuse of your own data. NAEP should defend its credibility against those currently diminishing it.

Share

Subscribe now

This Week’s House Mark-Up Provides Another Example

On July 15, 2026, the House Education and Workforce Committee marked up a ten-bill package to facilitate the dismantling of the U.S. Department of Education.

In his opening statement, Chairman Tim Walberg (R-MI) argued that “too many children can’t read or do math at grade level,” and used that claim as a central justification for several of the bills. That claim is false.

Chairman Walberg was drawing on NAEP data — the statistic that roughly two-thirds of American fourth-graders do not score “Proficient” in reading, which is wrongly cited as evidence of failing to meet grade-level reading levels. For some, this is done out of confusion and, for others, to promote a political agenda to undermine public schools. In reality, NAEP proficient is aspirational and reflects a standard that is well above grade level.

Unfortunately, during the markup, multiple members of Congress repeated the same error. But again, NAEP Proficient is not grade level. It has never been grade level.

When the public, the press, the administration, and Congress repeatedly miscite this fact, the National Assessment Governing Board (NAGB) must do much more to clarify and correct misstatements about what it means.

Education expert Peter Greene explains:

The problem is two fold. One part of the problem is that “proficient” is used on many state and local assessments to mean “at grade level,” or what once upon a time would have been called a gentleman’s C; this leads to some honest confusion for some folks. The other part of the problem is folks who are invested in the narrative that public schools are failing and who benefit from the confusion surrounding the term.

Greene adds:

And every time NAEP scores are released, education journalists write piece after piece explaining “proficient” all over again, usually in the wake of some prominent person decrying the large number of students not “at grade level.”

That confusion is NAGB’s responsibility to address, and it has deserved attention for years, but all the more NOW.

This Is Not a Partisan Problem

Chairman Walberg and his colleagues’ misstatements are only the most recent officials to make this mistake (whether unintentionally out of confusion or internationally), and the pattern runs through both political parties.

Secretary Betsy DeVos, in the first Trump Administration, told the public that two-thirds of American students could not read at grade level — the same inaccurate conflation Chairman Walberg and his colleagues made yesterday.

Secretary Miguel Cardona, testifying before Congress in April 2023 under the Biden Administration, told lawmakers directly that only one-third of students were reading “on Grade level,” treating a NAEP proficiency figure as if it were a grade-level statistic, in nearly identical language.

Potential Democratic Party presidential candidate Rahm Emanuel is doing it as part of his tour of early primary states.

And Secretary Linda McMahon, in the current Trump Administration, has used more careful wording — noting that nearly 70% of eighth graders are “not proficient” in reading — but has paired that technically accurate phrase with language implying total system failure. A Snopes piece by Rae Deng described this claim as lacking its own level of reading comprehension because, again, it completely mischaracterizes what NAEP’s “proficient” standard means.

Outside advocacy groups have been considerably less careful than any of them.

Moms for Liberty has publicly proclaimed that 68% of children cannot read at grade level, a direct misstatement of NAEP data. Here is just one of many examples.

Furthermore, one of the organization’s co-founders has separately misread a state’s NAEP proficiency rate as that state’s overall literacy rate. Wrong again.

Corey DeAngelis, a leading advocate for school privatization, vouchers, and against public education, has cited NAEP proficiency figures directly, without qualification, as evidence that public schools are a system-wide “disgrace.”

Greene captures these types of political misuse of NAEP data in this Substack post.

Curmudgucation

The Most Misused Statistics In Education.

If someone is telling you that some extraordinary percentage of students can’t read at grade level, they’re probably wrong…

Read more

3 years ago · 2 likes · 1 comment · Peter Greene

This confusion is intentional by people arguing for both the dismantling of public education and federal investments in children.

Unfortunately, NAGB’s silence has allowed that rhetorical usefulness to go unchecked under Republican and Democratic administrations alike, and it is being used right now, this week, on Capitol Hill to justify eliminating the very agency that funds and safeguards the data NAGB produces.

NAGB’s Own Experts Have Been Saying This for Years

In 2001, Mary Lynne Bourque and Susan Loomis — a staff member and a board member of the National Assessment Governing Board itself — wrote plainly that the Proficient achievement level “does not refer to ‘at grade’ performance,” and that performance at Proficient is not the same as being “proficient” in a subject as any ordinary person would use that word.

Chester “Checker” Finn, Jr., who chaired the panel that adopted the achievement levels in 1992, has been candid that the levels were designed to be aspirational — a description of where students should ideally arrive, not a diagnosis of where most currently stand.

NCES itself has attached a caution to NAEP score reports for years: the Proficient level “does not represent grade level proficiency as determined by other assessment standards.”

If NAEP’s own architects and NAGB’s own website already say this, it is past time to be diligent in correcting the record when people misuse and misstate what it means. It is also on NAGB to stop publishing results in a format that predictably, foreseeably, and repeatedly gets misread as a verdict on grade-level performance, especially when you can see exactly how that misreading gets used again and again.

The clearest confirmation of all of this comes from NCES’s own data. Researchers Gina Cervetti and Kathleen Hinchman mapped every state’s definition of fourth-grade “grade-level” reading proficiency directly onto the NAEP scale and found that, as of the most recent analysis, nearly every state’s own standard for grade-level reading lines up with NAEP’s Basic level, not NAEP’s Proficient level. That means the honest translation of the data runs the opposite direction from how Chairman Walberg and others use it: by the states’ own definitions of grade level, roughly two-thirds of American fourth graders are reading at or above grade level, not below it.

Cervetti and Hinchman are also blunt about what actually is a crisis in the data: not a reading crisis, but an equity crisis. In 2022, only 48% of students eligible for free or reduced-price lunch scored at or above NAEP Basic, compared with 76% of students who were not eligible — a 28-point gap that has persisted, largely unchanged, for decades.

That is a story about generational wealth and unequal access to housing, healthcare, and school resources, not a story about failing classrooms, and NAEP’s own framing continues to let people tell the wrong story with your numbers.

What Education Writers and Researchers Have Been Saying

Diane Ravitch, who served seven years on the National Assessment Governing Board under President Clinton, has called out the confusion between NAEP Proficient and grade level as one of the most damaging and persistent falsehoods in American education discourse, noting that NAEP itself explicitly warns against the equivalence you continue to permit others to make.

Greene has argued that cut scores like “Proficient” function as scaled, curved judgments dressed up as fixed standards — noting that if every child scored above a cut, the establishment reaction would be to declare the cut too easy, not to celebrate the achievement. That is not how a genuine, fixed criterion is supposed to behave, and it is worth NAGB’s honest reckoning.

Mark Weber, a New Jersey teacher and education researcher, has done careful public work mapping state proficiency standards onto the NAEP scale, and his conclusion undercuts a favorite talking point of your critics-turned-allies in this fight: there is no empirical evidence that closing the so-called “honesty gap” between state and NAEP proficiency rates does anything to improve student achievement. If setting state cut scores to match yours were actually the lever for better outcomes, we would expect to see it in the data. We do not. That matters because it means the standard is being imported into state accountability systems on faith, not evidence — exactly the kind of unsupported claim NAGB should be correcting rather than allowing to spread.

The Brookings Institution’s Brown Center on Education Policy has been making this same case for nearly two decades. Tom Loveless, the Brown Center’s longtime director, authored a 2007 report concluding bluntly that NAEP’s cut scores were set too high.

His 2016 Brookings piece, “The NAEP Proficiency Myth,” went further, noting that the achievement levels came under critical review from the U.S. Government Accountability Office, the National Academy of Sciences, and the National Academy of Education shortly after they were adopted — with the National Academy of Sciences review concluding the achievement levels were fundamentally flawed.

Loveless adds:

Advocates of the NAEP proficient standard want it to be for all students. That is ridiculous. Another way to think about it: proficient for today’s eighth graders reflects approximately what the average twelfth grader knew in mathematics in 1990. Someday the average eighth grader may be able to do that level of mathematics. But it won’t be soon, and it won’t be every student.

That is not a stray outside critique. That is respectable experts in the field, writing for decades, about the very categories NASB is still using today without correction.

One Point Should Not Separate “Failing” from “Successful”

NAGB also owes the public an honest accounting of what a cut score actually is. A cut score is a single point on a continuous scale, chosen somewhat arbitrarily by a panel, above which a child is declared “Proficient” and below which the same child, one point lower, is declared “Basic,” which is actually grade level.

Two children who are functionally indistinguishable in what they know and can do are sorted into entirely different public categories — one used as evidence that a school, a state, or a federal agency is failing, the other treated as evidence of success — because of a single point set by a committee, not because of any meaningful difference in the children themselves.

That is not a rounding error. It is the mechanism by which your data gets converted into political ammunition.

If NAGB cannot explain, in terms parents can understand, why the child who scores one point below the line is a different kind of learner than the child one point above it, then the line is doing rhetorical work the data was never built to support.

As the psychiatrist and educator William Glasser warned schools decades ago, chasing a point or two of movement on a test score is precisely the wrong institutional goal — and yet that is the goal NAEP’s cut scores hand every state, district, and school in the country by default.

Researcher Andrew Ho makes a similar point. He has identified proficiency cut scores as arbitrary markers, set through what he calls an “overwrought, judgmental, and ultimately political process,” not derived from any fixed line in human learning.

Ho has also documented a specific illusion that follows from that arbitrariness: because a large cluster of students always sits near the middle of the score distribution, a cut score placed close to that cluster will make small, ordinary shifts in performance look like dramatic gains or losses, purely as an artifact of how many students happen to sit right at the line — not because anything real changed in how much they learned. A researcher with no stake in the politics of this issue is describing the identical mechanism that turns your data into a rhetorical weapon: the closer the line sits to where children actually cluster, the more your data will appear to swing wildly for reasons that have nothing to do with children’s learning.

Criterion-Referenced in Name, Arbitrary in Practice

NAEP describes itself as a criterion-referenced assessment, distinct from norm-referenced tests like the SAT that simply rank students against one another. That distinction matters, and I want to represent it accurately rather than overstate it — NAEP does not “grade on a curve” in the way the SAT’s percentile scoring does.

However, the practical effect on families is not so different as the label suggests. NAEP’s cut scores were set by hand-picked panels making judgment calls about what students “should” know, not derived from an external, agreed-upon standard of competence, and independent evaluators — including a National Academies review in 2017 — have called for stronger evidence connecting NAEP performance levels to any real-world outcome at all.

A test that is criterion-referenced in name but whose criteria were set arbitrarily, and whose results still track family income and race as tightly as any norm-referenced test on the market, produces the same practical harm as the norming bias critics have long raised: it tells us more about a child’s zip code than about a fixed, meaningful standard of what that child knows.

Notably, NAGB has conceded the point this year. The 2026 NAEP reading framework — administered to students for the first time this spring — now explicitly disaggregates racial and ethnic subgroup results by socioeconomic status, on the premise, well documented for decades, that apparent racial differences in test scores largely track socioeconomic differences. That is a welcome and overdue acknowledgment.

But it is also, in effect, NAGB admitting in 2026 what critics have argued for years: that the results have been measuring wealth and family circumstance as much as they measure “proficiency,” all along. If that acknowledgment is real, it should extend backward, to how NAGB talks about every score ever published, not just forward, to a single new breakdown in the data tables.

The Test Itself Is Not Neutral

Even setting the cut scores aside, the content of the test carries its own bias, and NAEP’s own commissioned reviewers have said so. The NAEP Validity Studies Panel — a technical review body NCES itself created and funds — published an analysis by Gerunda Hughes in 2023 documenting that the statistical methods used to build NAEP-style test items can systematically disadvantage the very students the test is supposed to serve fairly.

When an item is answered correctly by nearly every student, it gets treated as a poor “discriminator” between high and low performers and is typically cut from the test in favor of harder items, even though that easy item may represent exactly the content that should be mastered.

This is not a hypothetical risk. Education researcher Wayne Au, in Unequal by Design: High Stakes Testing and the Standardization of Inequality, documents exactly how this mechanism has played out on the SAT, a test built using the same basic pretesting logic NAEP relies on.

In his book, Au cites researchers Kidder and Rosner, who examined more than 300,000 SAT test-takers and the pool of trial questions used to build future exams and found that some trial questions were answered correctly by Black students, or by Latino students, more often than by White students. Those questions were then discarded — not because they were poor measures of the content, but because they failed to reproduce the racial score gap the rest of the test already produced. A question only “counted” as valid if high-scoring test-takers, who are disproportionately White, tended to get it right in pretesting.

My mother has verified the same process when she was asked to be on a panel to evaluate whether the item questions were “fair”. The publishers of the Texas State assessment at the time ran through the questions and kept throwing out questions as biased toward Black or Hispanic children if they scored the same or close to the scores of White children.

In contrast, questions in which there was a substantial gap in favor of White students were not flagged – thus, “norming” the disparity in test score outcomes into subsequent tests. Although my mother repeatedly objected, she was overruled throughout the day and, not surprisingly, never asked back to be a reviewer.

The result, as Au describes it, is a self-reinforcing loop: item selection is calibrated to match existing racial score gaps, which locks those same gaps into every future version of the test, all without anyone ever explicitly considering race in the selection criteria.

NAEP is a different test administered by a different organization, and I am not asserting that NAEP’s item-selection process has been documented to work in the same way. But NAEP uses the same category of item statistics that made this outcome possible on the SAT, and NAGB’s own validity panel has already flagged the risk. Given what is now documented on a test as consequential as the SAT, NAGB owes the public a direct, public answer to a direct question: has anyone checked whether NAEP’s item-selection process does the same thing?

There is also cultural and geographic bias. As the son of an English teacher and a math teacher, it should be no surprise that I did fairly well on standardized tests throughout my life. But I vividly recall a reading passage from the PSAT that focused on nautical issues and the definition of a “flotilla.”

Having grown up in El Paso, Texas, a city located hundreds of miles from any coastline, the passage and vocabulary word were unfamiliar to any of us taking the test in the desert borderlands. On the other hand, we would crush a passage referring to “tortillas.” NAEP’s own reviewers have a name for this: cultural validity, the idea that a test cannot cleanly separate what a child knows from what a child has been exposed to.

Research that NAEP’s own validity panel cites has found that when students are allowed to choose among reading passages on different topics, rather than being assigned a single passage that may be unfamiliar or uninteresting to them, some groups of students — including Black eighth graders and Hispanic twelfth graders in the panel’s own cited study — score much higher. That is evidence that some of what NAEP currently measures is exposure and familiarity, not just reading ability, and it argues for reform in how passages and vocabulary are chosen, not just in how results are labeled.

Again, the validity panel’s report contains proof that this is a design choice, not a fact of nature. In 1972, the psychologist Robert Williams built a test called the Black Intelligence Test of Cultural Hegemony, using vocabulary and content drawn from Black American culture instead of the dominant culture’s frame of reference. When Black and White teenagers took it, Black students substantially outscored White students by substantial margins.

Nothing about the underlying children changed between that test and the SAT. What changed was whose knowledge and cultural fluency the test happened to be built around.

That single fact should end, permanently, any claim that a test’s outcomes reveal some fixed truth about which children “can” or “cannot” read, think, or reason. What these tests reliably measure is often which cultural and economic frame of reference a child was raised in, and how well that frame matches the one test-makers chose to build around — which is another way of describing accumulated wealth, school funding, and generational inequity, not a verdict on a child’s mind.

That is real, and policies that address school finance inequity, child poverty, childhood hunger, and adverse childhood experiences (ACEs) deserve real policy attention. These issues would undoubtedly do more to improve educational outcomes in this country rather than privatization of public schools or the elimination of the Department of Education.

Claims that two-thirds of American children cannot read at grade level are simply false, and their interpretation by policymakers and advocates is harming children. There is an old warning that was popularized by author Mark Twain but attributable to British Prime Minister Benjamin Disraeli about three kinds of falsehood — “lies, damned lies, and statistics.”

In this case, even a true number, presented without its context, can mislead more effectively than an outright fabrication. NAEP’s “proficiency” level is an aspirational one, but the grade-level story built on top of it is doing real harm. NAGB is a position to explain the difference, and the public is not, until you tell them.

The Damage Is Not Abstract: What Gets Tested Is What Gets Taught

This is not a technical quibble.

Every time “below Proficient” gets reported to the public as “can’t read” or “can’t do math,” it becomes ammunition for defunding public schools and for portraying millions of children — disproportionately low-income children and children of color — as failures because of a label your board itself has said should not be read that way.

It also reshapes what happens inside the classroom. When reading and math scores on tests built around NAEP cut points become the metric by which schools, teachers, and even state superintendents are judged, instructional time follows the incentive:

• Short, decontextualized passages crowd out real books — my children were taught how to write a brief constructive response (BCR) before they were even taught what a paragraph was.

• Science, government, history, the arts, and physical education are pushed to the margins of the elementary school day because they are not tested and therefore not rewarded.

Children end up narrower, not better educated, in the very subjects that make them informed citizens — and NAEP’s own cut-score architecture is a direct contributor to that narrowing, whether or not that was your intent.

NAGB tried a partial fix in 2018, adding the word “NAEP” before each level — “NAEP Proficient” rather than “Proficient” — so people would stop equating your terms with generic ones.

James Harvey, executive director of the National Superintendents Roundtable, was right to call that gesture insufficient at the time. Harvey said:

…the American people should understand that the misleading term “proficient” sets a performance benchmark beyond the reach of most students in the world.

Harvey argued “proficient” should be changed to something like “high” to avoid being “fooled.”

His point has been proven many times, including this week when a sitting congressional committee chairman, citing NAEP-adjacent data to justify eliminating a federal agency, still used the word “grade level” as if it meant what NAEP’s Proficient level does not mean.

The Perverse Incentive NAEP Has Inspired: Grade Retention As Score Manipulation

The clearest evidence that NAEP’s cut scores create perverse incentives and “manufactured” crises, rather than honest information, is what states have started doing in response to them: holding back third-graders who miss an early-literacy cut score, in order to produce a fourth-grade NAEP cohort that looks better on paper.

Education professor and researcher Paul Thomas has documented this closely in states such as Mississippi, where fourth-grade reading gains celebrated as a “Mississippi miracle” tracked closely with a mandatory third-grade retention policy.

A child who is nine years old competing against classmates who are eight will predictably score higher on a test built around the same content; that is a fact about test administration, not about literacy. Furthermore, those same “gains” have been shown to fade by eighth grade, once the retained cohort catches up in age to its peers without having genuinely caught up in learning.

This is worth NAGB’s own honest reckoning, not because the research on retention is unanimous — reasonable analysts, including some closely tied to NAEP’s own governing board, dispute how much of Mississippi’s gain is genuine instructional improvement versus retention’s effect on cohort composition — but because NAEP’s achievement levels are the mechanism creating the incentive either way.

States are not retaining eight-year-olds because it is good for those children. They are retaining them because a single cut score on a single test has been elevated to a measure of whether a state’s education policy is working. The cost of that incentive falls on children: retained students who show a short-term score bump can, over time, experience the opposite of what was intended — greater disengagement, higher rates of dropping out before graduation, and the well-documented psychological toll of being told, at eight or nine years old, that they failed.

William Glasser spent much of his career, in Schools Without Failure, and later in The Quality School, explaining exactly why this backfires. He argued that standardized testing reduces learning to disconnected, memorized facts at the expense of critical thinking and real application — and that the “right answer, wrong answer” format of a multiple-choice test teaches children that education is a hunt for a single predetermined answer rather than a process of genuine understanding.

In the schools Glasser held up as models, closed-book tests were replaced with open-book, collaborative assessments that actually resembled the problems students would face outside school. His deeper claim, grounded in what he called Choice Theory, is that people — including children — are driven by needs for freedom, power, and simple enjoyment in their work, and that using test scores to rank, shame, or coerce students destroys the very motivation that produces quality work in the first place.

Labels matter. When children repeatedly hear that two-thirds of them “cannot read at grade level,” many internalize failure that is not supported by the evidence. Parents lose confidence in neighborhood schools. Teachers become demoralized. Policymakers propose increasingly radical structural changes to fix a crisis that has been inaccurately described.

Glasser also warned explicitly against making small, arbitrary numerical gains — his example was raising a test score by a point or two — the primary institutional goal of a school, insisting instead on building a genuine culture of quality. That is precisely the trap a single-point NAEP cut score sets for states, and it is the trap third-grade retention policies walk students directly into.

That is the opposite of what an assessment meant to serve children should produce, and it deserves your acknowledgment, not your silence.

What We Are Asking You To Do, Now

1. Issue a direct, public correction each time a federal official misstates NAEP Proficient as “grade level,” the way you would correct any other material misuse of your data. Silence is not neutrality; it is acquiescence in the misuse.

2. Publish, prominently and alongside every score release, the state-by-state mapping showing that “grade level” as states themselves define it corresponds to NAEP Basic, not NAEP Proficient — the analysis your own data already supports and that outside researchers have had to do on your behalf.

3. Publish a plain-language document — “What NAEP Proficient Does, and Does Not, Mean” — and require it alongside every score release, every webpage, every press briefing, and every congressional testimony that cites NAEP data. Most of this letter’s argument could be prevented by a single page NAGB.

4. Stop using “Basic,” “Proficient,” and “Advanced” as headline labels without their NAEP qualifier in every release, chart, and public statement — not as a footnote, but as a mandatory part of the label itself, displayed with the same prominence as the number.

5. Retire “Basic,” “Proficient,” and “Advanced” altogether in favor of terms that do not already carry a plain-English meaning your data does not support. If the words themselves are the problem, changing a modifier in front of them has not been enough.

6. Extend the honesty of the 2026 reading framework’s socioeconomic disaggregation backward, not just forward. If you now accept that racial gaps in your data are substantially explained by family socioeconomic status, say so plainly every time a racial achievement gap is reported, and stop letting that gap be cited as evidence of school failure without that context.

7. Commission and publish the external validity evidence the National Academies asked for in 2017 — a transparent accounting of what your cut scores do and do not predict, so the public can evaluate the standard rather than take your word for its meaning.

8. Publicly acknowledge the perverse incentive your cut scores have created for third-grade retention policies, and commission independent, longitudinal research — tracking students well past eighth grade, through high school graduation — before any state is permitted to point to NAEP gains as proof that retaining eight-year-olds is good policy.

9. Act on your own validity panel’s 2023 findings, and answer the question the SAT evidence now raises. Publicly disclose whether NAEP’s item-selection process has ever been audited for the same self-reinforcing bias documented on the SAT — where trial questions that marginalized students answered correctly were discarded for failing to reproduce the existing score gap — and commit to an independent audit if it has not. Explain how tests are “normed” from one year to the next and made comparable in a manner that is understandable to the public.

Kids can’t wait for another year of this same correction being offered and ignored, or for another cohort of eight-year-olds to be held back so a state’s chart can look better. NAGB has the power to end the confusion your own board identified more than two decades ago. Please do so. Kids deserve it.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

Update: On July 15, 2026, the House Education and Workforce Committee passed this package of 10 bills on largely partisan votes (Republicans in favor and Democrats in opposition), with the one exception that Rep. Kevin Kiley (R-CA) voted against passage of H.R. 9610, which would shift a number of K-12 education programs from the Department of Education to the Department of Labor.

These bills now move to the House Rules Committee to potentially receive approval for House floor consideration.

Tomorrow, the House Education and Workforce Committee will mark up ten bills — H.R. 9602-9611 — that share a single purpose dressed up in ten different names. Each carries the same “Less Bureaucracy, Better [X]” branding. Each follows the same template: strip a program or set of programs out of the Department of Education and hand it, along with the staff, the money, and the legal authority that came with it, to another federal agency.

If you read past the branding, these bills do absolutely nothing to improve educational and developmental outcomes for children. Instead, Congress is being asked to ratify an administrative restructuring the Executive Branch has already begun — without any meaningful examination of what happens to the children these programs exist to serve.

Based on a Project 2025 proposal, it’s Congress seeking to legalize something the Administration has already been trying to do without authority. There is no analysis as to how this will or will not impact the children federal education programs exist to serve.

The children are being treated, once again, as a mere afterthought.

Share

Subscribe now

Congress Fails in Its Responsibility to Children

In January, the Department of Education announced six “interagency agreements” dispersing core ED functions to the Departments of Labor, Interior, Health and Human Services (HHS), and State — before Congress had authorized any of it.

Tomorrow, a House committee will attempt to codify moving K-12 and postsecondary programs to Labor, Tribal and Native American education programs to Interior, and other programs to HHS.

More specifically, H.R. 9610 hands the Secretary of Labor nearly the entire portfolio of Title I, Impact Aid, and the rest of the Office of Elementary and Secondary Education’s programs. H.R. 9604 sends Tribal, Alaska Native, and Native Hawaiian education programs to the Department of Interior. H.R. 9608 and H.R. 9606 route family engagement, school safety, and student-parent child care programs to HHS.

There is no evidence that any of this will improve education, operations, or services to children. None.

Based on a Project 2025 proposal, this is merely a congressional committee rubber-stamping the Administration’s adoption of this mechanism to further target cuts to children’s programs. At its core, the committee action is embracing a backdoor mechanism to authorize program-specific transfers rather than holding a single up-or-down vote to abolish the Department of Education itself.

Why?

First, no one has demonstrated that this is good for children. At best, Administration officials have argued it will do no harm. But the truth is, it will do harm.

Despite the bill titles attempting to characterize the legislation as offering “less bureaucracy,” families and school districts would need to interact with numerous different federal agencies with newly hired staff at agencies scattered across the government that lack history, relationships, or knowledge as to how to run education and child development programs. In light of the long history of federal agencies failing to coordinate with one another, these changes promise to be an unmitigated disaster.

This is why 92 education, civil rights, and disability organizations, including First Focus Campaign for Children, came together to “strongly oppose” this package of bills.

Second, the public opposes the dismantling of the Department of Education. A Phi Delta Kappan (PDK) International poll released in August 2025 found, by nearly a 3-to-1 margin (66-22%), that adults overwhelmingly oppose plans to eliminate the U.S. Department of Education. By a 65-19% margin (over 3-to-1), they believe that its elimination would have a negative impact on the nation’s public schools.

That public’s opposition holds across the specific things the Department funds and protects. As the National Parents Union points out, Title I support for 26 million low-income students, IDEA services for 7.4 million students with disabilities, Title III instruction for 5 million English learners, and federal support for the 9.8 million students in rural schools who rely on it to fill gaps state and local budgets cannot.

This week’s House markup flies in the face of both the needs of our nation’s students and public sentiment. It engages in an attempted end-run by moving programs one-by-one instead of addressing the issue directly because they know an up-or-down vote on abolishing the Department of Education will fail miserably.

The Promise That’s Already Been Broken

Secretaries McMahon, Kennedy, and Chavez-DeRemer have repeatedly assured the public that these transfers change nothing that matters. The Department’s own materials on the interagency agreements state plainly that the agreements “do not change funding, eligibility, or legal protections for states and territories.” Secretary McMahon has said the goal is to “reduce the need for states to consult multiple federal agencies to effectively manage their programs.” Secretary Kennedy, announcing HHS’s role in school safety programs, said “nothing matters more than the safety of our children.”

These bills prove those promises are false.

A school district dealing with a bureaucratic transfer isn’t left with less bureaucracy — it’s left with more. Instead of working predominantly with the Department of Education, districts now have to navigate the remaining pieces of ED, plus HHS, plus the Department of Labor, plus the Department of Justice, depending on which program they’re trying to administer.

A single district running a Title I program, a family engagement grant, an Individuals with Disabilities Education Act (IDEA) funded special education service, and a school safety initiative could now be coordinating across four separate federal agencies where one used to suffice. Every additional agency means another bureaucracy, another grant process, another legal office, potentially conflicting rules, and another delay when problems arise.

That is the literal the very opposite of “less bureaucracy.”

It is, by definition, more and less competent bureaucracy, more points of failure, and more opportunities for a check to arrive months late — exactly what already happened when career and technical education moved to the Department of Labor and the agency’s grant system didn’t even recognize state education agencies’ bank accounts.

Handing Children’s Futures to Agencies That Don’t Know Children

In the end, these bills take the one federal department built around the interests of children and hand its functions to agencies where children are not the focus and are, at best, an afterthought.

The Department of Labor exists to manage the American workforce. The Department of the Interior exists to manage public lands and resources. The Department of Health and Human Services is primarily focused on managing the infrastructure of our nation’s health and human services programs.

None of these agencies has the statutory mission, the institutional expertise, or the staff culture built around asking what a seven-year-old with a learning disability needs from her school. They were not built to hold that question, and nothing in these ten bills requires them to develop the capacity to hold it before the transfer takes effect. When children’s programs become side responsibilities inside agencies whose primary purpose is something else, children inevitably become secondary priorities.

Furthermore, dismantling the Department of Education would eliminate the one cabinet-level seat at the table whose entire job is to represent the interests of children and their education. This is important because Cabinet officials do more than administer programs. They participate in decisions across the federal government, advise the President, and advocate for their department’s priorities during budget and policy debates. Eliminating the Department of Education would remove the only Cabinet official whose primary responsibility is to speak for the interests of America’s children.

Once these programs are dispersed and that department is hollowed out, that seat disappears and with it, the one place in the highest levels of the federal government where a decision-maker’s job description requires them to ask whether a policy is good for kids.

Children are already among the most politically invisible constituencies in this country: no vote, no PAC, no lobbyists, no seat at this week’s markup table. Eliminating their one seat in the Cabinet doesn’t correct that invisibility. It cements it.

The Question the Committee Is Failing to Ask

We’ve made this argument before, and here it is again: the debate over eliminating the Department of Education has been conducted almost entirely in terms of partisanship and adult preferences, including states’ rights theory, parental control, and the long-standing goal of shrinking federal education spending. What’s missing, yet again, is any accounting of and attention to what these transfers mean for the millions of children ED’s programs actually serve.

Consider what’s tucked into H.R. 9604, the bill moving Tribal education programs to Interior. Buried in its list of transferred authorities are the IDEA Special Education Grants to States and the IDEA infants-and-families program, but only as they apply to American Indian children. This funding would now be split apart from the rest of IDEA, administered by a different agency with a different mission, and placed on a different timeline than the special education services the same child receives at the same school.

That is not a bureaucratic footnote. It is a fracture running straight through a disabled child’s right to a free appropriate public education, based on nothing more than which program line their services happen to fall under.

Every one of these bills follows the same procedural pattern beyond that: OMB is handed broad authority to make “incidental” determinations about what counts as transferred, with no requirement to consult the families affected. Most bills take effect six months after enactment, but nearly all also contain an “early implementation” clause letting the transfer begin immediately on enactment, well before the receiving agency has any obligation to show it’s ready.

The Tribal education bill is the sole exception, requiring consultation with Indian Tribes before transfer — a protection that should tell the committee something about which children it did not think to protect in the other nine bills: Title I students, English learners, homeless students, disabled students, student parents.

A Simple Test or Question

There’s a simple test or question that should be asked: “Is it good for the children?”

What children deserve during consideration of these bills is a plain accounting of which children are served, how the receiving agency’s mission and expertise compare to the Department of Education’s, and what continuity of services looks like for a kid mid-school-year when the transfer takes effect.

Children have no vote on this committee. They have no PAC, no lobbyists, no seat at the markup table — and if these bills find their way to the President’s desk for signature, one fewer seat at the President’s Cabinet table as well. That is exactly why someone has to ask the one question this process keeps skipping.

Fortunately, the groups that signed the letter to “strongly oppose” this package of bills have asked and answered that question. Here is their conclusion:

We urge the Committee to reject these misguided bills and to instead exercise their oversight authority over the executive branch, and align with Congressional majorities in rejecting the dismantlement of the Department of Education. The American people support public education and want their leaders to focus on improving educational opportunity, not dissolving the agency tasked with that very mission.

What You Can Do

The public overwhelmingly opposes the dismantling of the U.S. Department of Education (only 22% support its elimination), and so the House committee is attempting to move this package of bills with as little attention as possible. Let’s change that.

If you agree that these bills should be opposed, please consider:

• Calling your Member of Congress and urging them to oppose the package of bills from H.R. 9602-9611.

• Sharing this post with others to alert them to what the House Education and the Workforce Committee is trying to do.

• Becoming a paid subscriber to this newsletter, which supports our work in trying to give voice and attention to the critical public policy issues facing our nation’s children.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

On June 30, 2026, in the case of Trump v. Barbara, the Supreme Court struck down Executive Order 14160 and, with it, the Trump administration’s attempt to end birthright citizenship. The vote was 6-3.

Chief Justice Roberts wrote for the majority, joined on the constitutional question by Justices Sotomayor, Kagan, Barrett, and Jackson. Justice Kavanaugh concurred in the judgment on statutory grounds alone. Therefore, on the constitutional question, the vote was just 5-4.

Justices Thomas, Alito, and Gorsuch dissented.

By any measure, this is a win for children.

It is an affirmation of the centuries-old practice since our nation’s founding (extensively documented in Chief Justice Roberts’ opinion), confirmed with the adoption of the Fourteenth Amendment to the Constitution in 1868, confirmed with the Supreme Court decision in Wong Kim Ark in 1898 and multiple other court decisions, federal statutes (as Justice Kavanaugh noted), and decades of federal practice and administrative law.

Children’s advocates, immigration lawyers, and constitutional scholars have fought for this outcome for a year and a half, and it is the right outcome.

In contrast, if President Trump and his advisor Stephen Miller had their way, babies would have been born into legal limbo, and many would have been made permanently stateless and subjected to increased exploitation unless they were able to prove their own parent(s)’ citizenship status. Birth certificates would no longer prove a bright-line of proof of citizenship.

If the Executive Order had been allowed to go into effect, all 3.6 million babies born in this country would have to petition for citizenship (with children of color placed under more intense scrutiny) and potentially be denied access to critically important and life-saving health care and nutrition services while awaiting a determination from an undefined bureaucrat in some agency somewhere in the bowels of the federal government.

And if a mere Executive Order could overturn the meaning of the Constitution’s Citizenship Clause, then another Executive Order could make it retroactive and threaten the status of people like Secretary of State Marco Rubio, FBI Director Kash Patel, and Ohio Republican gubernatorial candidate Vivek Ramaswamy, among others. Prosecutory discretion could threaten and put under scrutiny just about anyone and they would have to prove parental status at intent when they were born.

These facts have not received much attention. While there is much discussion about a myriad of other issues, this case is fundamentally about the lives, well-being, and rights of babies. While most of the focus is on the status of parents, the harm would be imposed on one group and one group only: BABIES.

This bears repeating: this is, in the most literal sense possible, a case about who is a citizen at the exact moment of birth. Full stop.

At First Focus on Children, we often decry the invisibility of children – the tendency of our political institutions to focus on the adults surrounding children while overlooking the needs and best interests of children themselves. In the opinions of the dissenting judges, they reveal a related problem: judicial blindness to children.

If you read the opinions and are looking for the baby — for sustained attention to what it means to impose a legal status test on a person who cannot speak, cannot testify, cannot produce a document, cannot explain her parents’ state of mind — you will mostly come up empty. In this and other cases, children are the prime beneficiaries or casualties without ever becoming a part of the analysis.

That absence is not evenly distributed.

Ever so briefly, the majority opinion by Chief Justice Roberts touches on how children are the focus, but the opinion is dominated by history and precedent — Wong Kim Ark, English common law, Dred Scott, the Reconstruction Congress — important doctrine about what past courts decided, but little in the way of sustained reasoning about the children impacted by the decision.

Justice Jackson’s concurrence is the one opinion that actually stops and looks at the baby as a person entitled to dignity in their own right.

Sadly, Justices Thomas and Alito did something well beyond mere inattention and neglect of babies and children: they built entire, elaborate constitutional theories in which an infant’s legal existence is wholly derivative of the status of their parents — where those parents were “domiciled,” what “allegiance” they held, and are facts a newborn cannot know, cannot prove, and in a meaningful number of real American births, nobody can know.

That goes beyond neglect. That is a design choice two Justices were prepared to impose on this country, and the immense harm to would impose on babies is ignored. Their position of allowing the president to overturn well over a century of constitutional precedent and understanding lost by a single vote.

This piece is about the range of opinions — from the majority’s borrowed reasoning, to Jackson’s exception and focus on children, to what Thomas and Alito would actually have done to the lives of countless children if they had prevailed.

Share

Subscribe now

II. The Majority: The Right Answer, but Missing the Focus on Children

Chief Justice Roberts’ opinion for the Court is, on its own terms, a serious piece of constitutional history. It walks through English common law and the concept of natural allegiance owed by anyone born within the sovereign’s protection. It walks through the Civil Rights Act of 1866 and the Fourteenth Amendment’s repudiation of Dred Scott in 1868, including the actual congressional debates. It addresses United States v. Wong Kim Ark and rejects, at length, the government’s attempt to read a domicile requirement into that 1898 decision. All of this is careful, well-supported, and correct – although not all that focused on the child.

If you read the majority opinion end to end, you will find a legal argument organized around precedent, sovereignty, and the historical meaning of “subject to the jurisdiction thereof.” What you will not find, for most of its length, is attention to what any of this actually means for an infant — to the fact that the entire dispute is about a person who, at the moment the law says citizenship attaches, has done nothing at all except be born.

There are two exceptions, and they are worth highlighting because they show the majority glimpsed the point about newborns but then largely moved past it. The first is in the Court’s summary of how the domicile theory of the Citizenship Clause developed in the late nineteenth century.

Describing the scholars who first proposed conditioning citizenship on parental domicile, Chief Justice Roberts wrote that they “focused on the parents’ status, not the child’s.”

Later, Chief Justice Roberts added:

Words appearing frequently in the Executive Order – “mother,” “father,” “lawful”, temporary” – are absent from the [Citizenship] Clause. For a simple reason: they did not matter.

Chief Justice Roberts saw the sleight of hand by the presidential decree. He recognized that the Constitution’s text is child-centered in its clear description:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside.

The Citizenship Clause is about the baby, not the parent. The text clearly says “all persons born…in the United States.”

Born. That is the constitutional subject. The child. At the moment of birth. On American soil.

That is why it is called birthright citizenship and not bloodright.

What is not mentioned is who a child’s parents are. Not whether they were lawfully present, temporarily present, or permanently settled. It also only mentions where the child was born. The constitutional inquiry begins and ends with the baby, not the parents.

This mirrors language from the Declaration of Independence, adopted in 1776, when it declared that “all men are created equal.” The Declaration’s promise was aspirational but, at the founding, betrayed by slavery. The Fourteenth Amendment was the moment the Constitution tried to make that promise literal and enforceable — to say that being born here grants all babies the fundamental right of citizenship.

A newborn does not need to earn their way into “all.” They are already inside it, by the same word the country used to describe itself at its founding and again when it rewrote the Constitution’s Fourteenth Amendment to truly mean it.

At oral argument, Justice Jackson pressed the Trump Administration’s Solicitor General on how gutting the meaning of birthright citizenship would actually function — asking directly whether hospitals would need to check parents’ papers “in the delivery room.”

The government’s answer was that a federal agency would make citizenship determinations after birth, with the child free to contest such determinations “after the fact.” During that interim period, it seems that babies would be “stateless.”

That exchange and response by the Solicitor General — a newborn’s citizenship subject to bureaucratic determination and after-the-fact appeal — gives us a glimpse into what was at stake for actual children as the entire case produced. It surfaced only when a Justice pushed the government, out loud, to say what its rule would practically mean for every single baby born in this country.

Justice Barrett also dismissed the domicile-and-allegiance theory put forth by the Solicitor General succinctly:

But they don’t focus on the parents. It’s the child.

It is difficult to imagine a clearer statement of the constitutional issue before the Court. Justice Barrett recognized, in 10 words at oral argument, what much of the litigation had obscured: the Citizenship Clause is about the child.

III. Jackson: The Opinion That Saw the Children

As in the case of oral arguments, Justice Jackson’s concurrent opinion is critically important, as it is not just centered on a doctrinal outcome but on recognizing that a child has fundamental rights and whose dignity is the point.

Jackson joined the majority in full. She wrote separately because the majority’s framing, careful as it was, was not the whole story she wanted told — and because Justice Thomas’s dissent, in her view, badly mischaracterized what the Fourteenth Amendment was for.

Whereas Thomas argued that the Citizenship Clause was a narrow, race-specific remedy meant only for the children of freed slaves and those who shared their particular history of dispossession, Jackson called that reading “myopic.” She argued instead that the Amendment was written as an “anticaste, antisubordination reset” — a guarantee of “equal dignity” that does not run out at the edges of any one group’s historical experience, including the group Thomas said it was written for.

Jackson asked what kind of person the Clause was designed to protect, and answered: any child born here are entitled to what Frederick Douglass said was “the glorious birthright of our common humanity” — a birthright that does not depend on bloodline, parental status, or caste.

Justice Jackson explains why birth is the trigger for citizenship and points out that the alternative is a system that sorts newborns into castes based on facts about people other than themselves. The Fourteenth Amendment’s Citizenship Clause exists specifically to foreclose that kind of sorting.

Justice Jackson asks what kind of Constitution we have, and concludes it is not one that assigns children a caste at birth. Every child, at birth, has the fundamental right to citizenship.

That makes what comes next difficult to read. Because if one Justice could look directly at the child and conclude that dignity forecloses caste, two other Justices looked at the same child and built entire theories of the Fourteenth Amendment in which the child’s status was completely ignored.

IV. Thomas and Alito: Not Neglect, But a Hostile Theory of the Child

Justice Thomas’s dissent, joined by Justice Gorsuch, runs 91 pages — his longest in nearly three and a half decades on the Court. Justice Alito wrote separately, joined by no one. Between them, they proposed two different legal tests, “domicile” and “allegiance”, to uphold the Executive Order.

It is worth being precise about what each test actually asks, because the abstraction is doing a lot of work to hide how little either one has to do with the babies whose citizenship are at stake.

Domicile. Thomas’s theory holds that the Fourteenth Amendment extends citizenship only to children whose parents were “domiciled” in the United States at the time of birth — a legal concept borrowed from adult civil law, describing a person’s fixed, principal home along with the intention to remain there. Thomas describes what domicile does in the ordinary case: it determines “which government had the power to impose personal taxes on a person,” and it governs “his personal affairs, his conduct abroad, his personal taxes, and the natural duties of protection and allegiance.”

Read that list again with an actual newborn in mind. A baby has no personal affairs to speak of. They have no conduct abroad. They pay no taxes and never have.

Justice Thomas also wrote, “The Citizenship Clause was enacted for people who were born in this country and called it home.” Again, we are talking about infants.

Everytime Thomas tried to make “domicile” sound like a serious, well-established legal concept in this case is a consequence that has no content whatsoever for the person this case is about: BABIES.

That is not a minor omission. It is evidence that the entire doctrinal apparatus was built for adults making choices about where to live and work, and it is being imported wholesale into a context — the legal status of a person seconds old — where none of its machinery actually makes sense.

Allegiance. Alito’s test asks whether a child, at birth, owes “complete allegiance” solely to the United States, rather than being — in his words — automatically made a “national” of a parent’s home country by that country’s own laws. This has the same problem as domicile, dressed in different vocabulary.

Allegiance, as a legal concept, has always been evidenced by things a person does: where they live, what oaths they take, whether they serve, whether they vote, whether they pay taxes here rather than somewhere else.

A newborn has done none of these things and is capable of none of them. “Complete allegiance” as applied to an infant is not actually a measurement of the infant at all — it is a proxy for the citizenship laws of a foreign country the child has never seen, operating automatically and without anyone’s consent.

If a baby born in an American hospital happens to also acquire, say, Indian or Nigerian citizenship the instant she is born, because those countries confer citizenship by descent regardless of anything her parents intend, Alito’s framework treats that foreign legislature’s rule — a rule the baby, her parents, and the United States had no hand in writing — as evidence about where her loyalty lies.

Alito is effectively arguing a foreign parliament gets a vote in whether an American-born child qualifies for full American citizenship. The baby does not.

The self-refuting concession. Alito’s opinion actually contains its own rebuttal. He acknowledges directly that children are “not responsible for their parents’ violation of our immigration laws.”

And yet, his legal conclusion strips them of citizenship anyway. That is not a close call he is wrestling with in good faith. Alito’s stated point is immediately abandoned in his very next breath, and the distance between the concession and the holding is, by itself, close to a complete rebuttal of the position.

“Birth tourists” and the EB-5 asymmetry. Furthermore, Alito writes that the majority’s rule “produces grotesque results,” pointing to the example of a “birth tourist” — his term for a woman who enters the country solely to give birth and then leaves — whose child becomes an automatic citizen, while a foreigner “who wish[es] to immigrate lawfully must sometimes wait for many years.”

This framing is utterly unfair to the child in question, who has done nothing except be born here and, in most cases, grow up here. Children born and raised here learn the Pledge of Allegiance, sing the national anthem, are taught about our nation’s history and the Constitution, and often know no country but this one.

Compare it instead to a program Alito does not mention: the EB-5 immigrant investor visa, which for years has offered a green card, and eventually citizenship, to wealthy foreign nationals, their spouses, and their children in exchange for a qualifying investment — no residency history required, no civic knowledge tested, no upbringing here at all.

If Alito’s objection is that birth tourism produces citizens who have not “earned” the tie he thinks the Clause requires, that objection applies with far more force to a program that sells the identical outcome to people with money but no connection to this country whatsoever. That is more fitting of the definition of “grotesque results.”

Alito’s “grotesque results” framing, in other words, only seems to trouble him when the children are born to a parent who is poor, undocumented, or here temporarily, but never when they are to wealthy immigrants, their spouses, and their children with potential no ties or understanding as to the culture and norms of our country.

Kavanaugh’s partial concurrence. Justice Kavanaugh’s partial concurrence with the majority was brief and rested on statutory grounds rather than the Constitution itself. Kavanaugh at least acknowledges that Congress has passed laws and the “Executive Branch consistently interpreted” the practice of birthright critizenship.

But like the Thomas and Alito opinions, it devoted little attention to the newborns whose citizenship was at stake. Even his choice to not engage the constitutional question meant leaving largely unexplored the children most directly affected by the outcome.

Gorsuch’s partial break. Justice Gorsuch joined Thomas’s dissent but wrote separately as well. In it, he expressed real doubt about applying the executive order to children whose parents had made the United States their home for years, even without legal status — questioning whether the government’s own theory could coherently answer where such parents were “domiciled,” if not here. That doubt did not change his vote. But it is worth noting plainly: even inside the dissent that would have upheld the Executive Order, the justices radically disagreed over what the rule would actually do to real children of parents who had lived here for a decade or more. Thomas and Alito did not pause, but Kavanaugh and Gorsuch did.

What is disturbing is that none of these opinions ask what constitutional principle justifies making a newborn’s legal identity depend entirely upon facts about other people. The infant disappears from view. Their opinions ask that a newborn be judged on facts about someone else’s status and caste — facts that are, for the child, not simply hard to prove but unknowable in principle at the moment the law says citizenship attaches.

The next section shows how far from hypothetical that unknowability really is.

V. What Conservative Policy Already Assumes

Here is a fairness point worth making, because it cuts against the very people who built the domicile and allegiance tests, using their own policy record rather than anything from the plaintiffs’ side of this case.

A number of other laws that conservatives strongly embrace incorporate the very concept of birthright citizenship. As one example, federal law allows states to extend Children’s Health Insurance Program (CHIP) coverage to what is called the From Conception to End of Pregnancy (FCEP) option with the openly stated understanding that the child is a citizen automatically upon birth, without any inquiry into the parents’ status.

That premise is written into both federal and state policy, and it assumes exactly what Thomas and Alito’s dissents deny: that birth alone, not the domicile or allegiance of the parents, is what makes a baby a citizen. It is also strongly supported by the pro-life community.

In addition, Donald Trump personally led the charge and served as the public faces of the conservative “birther movement” in 2011 when he questioned President Barack Obama’s citizenship and demanded that he release his birth certificate as proof of citizenship — not proof of domicile, allegiance, or intent of his parents’ status.

And again, President Trump, at this very moment, is promoting the SAVE Act, which is legislation that conservative lawmakers are championing as a citizenship-verification measure for voter rolls. Once again, it treats a birth certificate as sufficient documentary proof of citizenship.

It seems that everybody, regardless of political ideology, gets that a birth certificate is fundamental to citizenship status. And what it records: the date, the place, and the names of the parents says nothing whatsoever about where those parents were domiciled, what allegiance they held, whether they had dual nationality, or what their immigration status was at the moment of delivery.

If a birth certificate is good enough to prove citizenship for “birthers” and for voter-eligibility purposes of SAVE Act proponents, then how is it that they suddenly decry Chief Justice Roberts’ majority opinion that place of birth is treated as conclusive for citizenship.

It is impossible to reconcile these positions, and it exposes the attack on birthright citzenship as being completely out of step with centuries of precedent of how our legal system has treated newborns and their birth certificates.

While some opponents of birthright citizenship have declared the decision will have catastrophic consequences, such claims are ludicrous. Again, it is important to emphasize that the Court’s decision actually made no change to practice and policy: it simply affirmed the Constitution’s clear language, Supreme Court precedents, numerous other similar federal and state statutes, and centuries of practice based on the practice of granting newborn’s birthright citizenship.

And yet, it has somehow sparked some to declare the end of civilization. Justice Alito, himself, made the following cringeworthy statement:

This is one of the most important decisions in the history of the Court, and in my judgment…, the Court has made a mistake that will seriously affect the country’s future.

Again, the Roberts majority opinion literally changed nothing.

VI. The Amici: How Far from Hypothetical This Really Is

In contrast, several briefs in the case before the Supreme Court highlighted the unworkability of the President’s Executive Order for American babies and families.

First, Project Rousseau’s amicus brief in the case opened with a critically important statistic: over one longitudinal study period, 11.7% of all births nationwide were registered with an unknown father — no name at all on the birth certificate. That number climbs to nearly a third of births to mothers under twenty.

Under a domicile or allegiance test keyed to parents, an unknown father is not an edge case. It is more than one in ten American births.

The brief’s most affecting example is anonymized as “A.” — a young client born to a mother with temporary residency who had been raped by A.’s American citizen father. A.’s birth certificate lists an unknown father; A. herself was never told his identity. Her mother, traumatized by repeated assaults and afraid of what reporting a rape might mean for her immigration status, never pursued any legal process to establish paternity.

Under the Citizenship Clause (current law), none of that matters — A. is a citizen because she was born here. However, under the Trump, Thomas, or Alito framework, establishing her father’s citizenship or lawful status would have been the only way to secure hers, which means the law would have handed her mother an impossible choice: reopen a horrific trauma to try to identify and legally establish a connection to her rapist, or leave her daughter’s citizenship unresolved.

The brief also documents a second, more mundane but equally telling scenario: a woman separated — but not legally divorced, for religious and family reasons — from a husband who is not her child’s biological father. In every state, that husband is listed as the presumed father on the birth certificate by default. The child’s actual biological father, a U.S. citizen, has no legal path onto that document. Under a parentage-dependent citizenship test, this ordinary, unremarkable family situation — separation without formal divorce, common across many communities for reasons having nothing to do with immigration — would leave a citizen’s biological child unable to establish citizenship through the parent who is actually a citizen.

In addition, the brief details what may be the most institutionally embedded example of all: every state’s Safe Haven law, which allows a parent to surrender a newborn anonymously with no questions asked or identification required. At least thirteen states go further, issuing a “Foundling” birth record with no parental information at all — continuing a legal tradition, codified in federal law since 1940, of treating a child of literally unknown parentage as a citizen by default.

The Foundling Statute assumes citizenship does not depend on identifying anyone’s parents. Thomas and Alito’s domicile or allegiance tests, respectively, assume the opposite and cannot be reconciled with a legal system that, in these specific instances, is deliberately designed to make parentage unknowable.

Furthermore, my own organization’s brief, joined by the Center for Law and Social Policy, other child advocacy groups, and several physicians and psychologists, made a point the doctrinal debate tends to skip past entirely: even for babies who remain citizens under a parentage-based rule, the process of proving it would itself cause harm.

If the President’s Executive Order was allowed to overturn radically change the meaning of the Citizenship Clause, every baby born in this country — not just the children the order targeted — would have faced new paperwork burdens, bureaucratic delays, and the very real possibility of a lapse in health and nutrition support during, as our brief put it, the most critical period of life and early development.

The brief also lists the specific family circumstances the executive order simply had no answer for: children conceived via IVF or IUI, births via surrogacy, and children of same-sex parents, where the order’s own text defined “mother” and “father” only as biological progenitors — leaving the non-biological parent in a same-sex marriage with no defined status under the order at all.

None of this is hypothetical. It is what every fertility clinic and every state vital records office already handles routinely. It is these children that the President’s Executive Order would disproportionately threaten to harm.

As we argued in our brief:

In the United States, citizenship at birth is a fundamental right. By operation of the Fourteenth Amendment, every baby born within our borders claims citizenship equally, regardless of parentage, ethnic heritage, race, or any other factor.

Elimination of birthright citizenship would irreparably harm babies and children, regardless of whether their parent is an American citizen or permanent resident.

In addition, the United States Conference of Catholic Bishops’ (USCCB) brief forcefully argues human dignity is inherent in personhood and does not depend on citizenship, immigration status, or parentage. Denying an innocent newborn citizenship based on her parents’ immigration status is not merely unfair, but the brief cites this Court’s own precedent, which held that stripping citizenship is a punishment this Court does not permit even for someone convicted of a crime. As USCCB point out, citizenship stripping of a child, who is guilty of nothing, is a harsher sanction than what the Court itself has said is too severe for a criminal.

Read together, these briefs from three different disciplines — family law, child advocacy, and moral theology — arrived at the identical conclusion: a citizenship test keyed to parental status fails constantly, across ordinary and common features of American family life, and for reasons that have nothing to do with anyone’s immigration status but everything to do with how families are actually formed.

VII. Corruption of Blood: The Constitution Already Has a Name for This

Finally, there is a clause in the Constitution that almost never comes up outside of law school, but it belongs in this argument because it names precisely what Thomas and Alito’s tests would do and why the Framers wrote it specifically to forbid their proposed outcome.

That clause, Article III, Section 3 gives Congress the power to punish treason, but forbids the “corruption of blood,” which protects the family and descendants from being penalized.

Prior to the nation’s founding, corruption of blood was a real and devastating punishment. A person convicted of treason was deemed to possess “corrupted” blood, stripped not only of their own property but of the ability to pass anything to their children, and their children’s ability to inherit through them at all — what one legal historian called the “legal death of the family.” A parent’s guilt did not just punish the parent. It reached forward and disabled the next generation, regardless of anything that generation had done.

The Framers despised this. James Madison, writing in Federalist No. 43, described the clause as designed to prevent Congress from “extending the consequences of guilt beyond the person of its author.”

When the Supreme Court interpreted the clause in Wallach v. Van Riswick, it put the point as plainly as it can be put: the clause exists “for the benefit of the children,” a declaration that “children should not bear the iniquity of the fathers.”

As Max Stier wrote in a 1992 Stanford Law Review article, this principle did not stay confined to treason. It has surfaced, unstated but doing real work, in a line of Supreme Court cases.

For example, it was invoked in King v. Smith, which called Alabama’s denial of welfare benefits to children based on their mother’s conduct “reminiscent of the archaic corruption of the blood.”

The Supreme Court also struck down a Louisiana law burdening illegitimate children in Weber v. Aetna Casualty and Surety Co. that “imposing disabilities on the illegitimate child is contrary to the basic concept of our system that legal burdens should bear some relationship to individual responsibility.”

And in Plyler v. Doe, the Court struck down Texas’s attempt to bar the children of undocumented immigrants from public schools, holding that “legislation directing the onus of a parent’s misconduct against his children does not comport with fundamental conceptions of justice.”

Babies are innocent and have committed no crimes. And yet, it is babies that would have been subjected to harm by the President’s Executive Order.

It is akin to imposing a fine on a child sitting in the back seat of a speeding car driving by their parents, but with far graver consequences.

VIII. Not Settled, and Not Hidden

Although the Court has ruled in favor of protecting the fundamental rights of children, it would be a mistake to read this decision as the end of the story, because within days of the ruling, the people with the power to reopen it said, plainly, that they intend to.

President Trump called the decision “too bad for our Country” and posted that Congress should “start TODAY to work on ending expensive and unfair to our Country, Birthright Citizenship,” insisting that “no long and unwieldy Constitutional Amendment is necessary.”

House Speaker Mike Johnson, appearing on Fox News, said he was “very disappointed” and told viewers that the ruling “subjects the country to serious challenges going forward,” predicting that “the conclusion from this opinion is going to be you’ve got to amend the Constitution to fix that.” He went further in a separate interview, explicitly praising Justice Thomas’s dissent as a roadmap, framing birthright citizenship as something that has “devalued” American citizenship.

A number of legislators have also already announced their intentions to pursue either a formal constitutional amendment or other forms of legislation to undermine and tear away at birthright citizenship.

Although they are not agreed on the mechanism to overturn birthright citizenship — some acknowledge that only a constitutional amendment would work. However, Justice Kavanaugh’s separate opinion has been read by some in Congress as an invitation to try rewriting decades-old federal statutes instead.

Innocent babies, it seems, must be targeted for some form of harm. Every one of these routes ends in the same place: a newborn’s citizenship would be put at risk and made conditional.

It is also worth being honest about the tone some of this advocacy has already taken, because “the babies are invisible in the reasoning” understates what is happening in parts of the conservative commentariat.

On the same day I was writing this piece, columnist Kurt Schlichter published a Townhall piece laying out, in specific and practical terms, how conservatives should “chip away” at birthright citizenship until, as his headline put it, they can “finish it off entirely.”

Among his proposals: prioritizing the deportation of pregnant women, detaining them at Guantanamo Bay, barring from re-entry any woman who gives birth here while not a permanent resident, and pursuing denaturalization proceedings against children after the fact, despite his own acknowledgment that such proceedings would raise serious due process problems.

Schlichter described the newborns themselves this way:

How are we going to change the view of the 14th Amendment citizenship clause that says that essentially any unwanted foreigner’s brat who pops out with a placenta on U.S. soil is a U.S. citizen just like you or me?

This is no longer about the invisibility of babies and children in the discussion. The framing by Schlichter, is a description of a newborn — using birth itself, the placenta, and the child as the object of contempt — as something less than a person, an “unwanted foreigner’s brat.”

The Bulwark’s Adrian Carrasquillo documents how others in the MAGA movement are calling for more extreme measures, such as Sean Davis (CEO of the Federalist) calling for the “forced sterilization” of “all foreign visitors” or the outright “Dissolution of the Union” — all because the Supreme Court upheld current law and century’s old practice of the treatment of babies born in this country.

The Bulwark

MAGA Goes Batshit Over SCOTUS Birthright Citizenship Ruling

HAPPY JULY FOURTH! Who’s ready for some forced sterilizations…

Read more

2 months ago · 667 likes · 219 comments · Adrian Carrasquillo

It is worth naming, plainly, what the tactics of opponents to children are seeking to do here. Opponents of birthright citizenship cannot attack children and propose harm to babies directly. Instead, they will be employing six framing and communications tactics, on repeat, until the public no longer sees babies and children in the conversation. These tactics are well documented in political psychology and communications research.

• Relevant target substitution. The public generally regards children as one of the most sympathetic, “deserving” groups there is — high sympathy, no capacity to have brought their circumstances on themselves. Attacking a baby directly risks significant backlash. So the relevant target is swapped in opposition framing: the debate is shifted to attack their parent’s constructed “unworthiness”. The child disappears from the argument not because no one is looking, but because the subject has been switched. They want attention focused on “birth tourism” rather than the extreme harm the policy change would have on babies.

• Dehumanization and in-group/out-group framing. Attacks on immigrants have long been prevalent in our nation, despite the country being a nation of immigrants. Words like “aliens,” “cockroaches”, and “vermin” — language documented for decades as a hallmark of divisive rhetoric that has migrated into our politics and are prevalant again today. Once a person is coded as something other than a person, ordinary moral reasoning about harming them stops applying. Notice, too, what Schlichter’s own phrasing does beyond the slur: “just like you or me” only works as a jab if the reader already accepts that the pregnant mother (and her baby) are not, in fact, like you or me — a boundary line drawn between “us” and “them” in the same breath as the insult, which is exactly how in-group/out-group psychology recruits an audience into buying into “othering” rhethoric and division.

• Appeals to fear and disgust. “Pops out with a placenta” reaches for disgust, a distinct moral lever from harm or fairness, meant to make a reader recoil rather than think. Alongside it runs a cruder fear: the notion, increasingly common in this discourse, that foreign countries are engaged in a conspiracy to use babies to undermine the nation — a demographic-invasion narrative with no basis in fact, closely related to the debunked “Great Replacement” conspiracy theory that has migrated from the political fringe into the White House. Fear and disgust work together: one says the immigrant family are repulsive, the other says they are dangerous.

• Administrative burden as covert denial. A right can remain nominally intact while being made functionally inaccessible through paperwork, documentation requirements, and bureaucratic delay — exactly what this piece documented in Section VI, where every newborn, not just the children the executive order targeted, would have faced new hurdles to prove a status the Constitution says they already hold. Opponents are trying not to say “we are taking away your citizenship” or “we are about to impose complicated new paperwork and verification procedures on every baby born in this country”). But their goal is to make citizenship too burdensome or hard to obtain for the babies of immigrants.

• Technocratic laundering. “Domicile,” “allegiance,” “subject to the jurisdiction thereof” are terms used to convert a moral question (“should a newborn be rendered stateless?”) into a technical one that allow a Justice to write 91 pages without ever writing the plain-English sentence his conclusion actually requires.

• Strategic incremental harm. Schlichter’s own word, “chip away,” is itself a tell: an admission that a frontal assault on children’s citizenship would fail, so the strategy moves slowly enough to stay under the threshold that would trigger public sympathy for kids.

Again, none of these tactics are unique to this political debate. They recur across nearly every children’s policy fight this country has — Medicaid, child hunger, child care, public schools, the Child Tax Credit, and immigration. The campaign to reverse birthright citizenship will not be powered by a legal argument. It will run through these six communications tactics, deployed on repeat, until enough of the public stops seeing the baby too.

This is not just about invisibility. Invisibility is what much of the majority opinion does, and what this piece has spent most of its length examining. But this framing is seeking to shift the focus away from babies, to otherize and demonize the new target — immigrant pregnant women, and to distract from the true harm this will have on all babies born in this nation.

IX. One Vote

Returning to the vote count, six Supreme Court justices struck down Executive Order 14160. But the constitutional holding — the part of the decision that answers, permanently, what the Fourteenth Amendment actually means — commanded only five votes: Roberts, Sotomayor, Kagan, Barrett, and Jackson.

With the change of just one vote, the Citizenship Clause could now mean something very different. That is how close this country came to a regime in which a newborn’s citizenship depended on their proving facts about their parents that are, for a meaningful share of American births, unknowable in principle — not because the parents are hiding anything, but because the facts themselves do not exist in any form a bureaucracy or a court could ever retrieve.

The public must understand that every child – all 3.6 million born in this country – would have to apply for citizenship if birthright citizenship were undermined. And as Justice Jackson’s and Justice Barrett’s questions of the Solicitor General exposed, nobody can explain just how this might work.

The Supreme Court justices willing to gut birthright citizenship didn’t even really try because they did not even agree. Under Thomas and Alito’s tests, a difficult, retrospective, evidence-dependent inquiry would need to be resolved for every newborn, at the moment of birth, before her citizenship could be established at all. And because domicile and allegiance are conclusions drawn from evidence and intent rather than facts fixed at a point in time, a citizenship determination made today could, in principle, be reopened years or even generations later if new evidence about a parent’s — or a grandparent’s — intentions surfaced.

A citizenship that can be revisited “years or generations later by new evidence,” to borrow language from one summary of this argument, is nothing more than provisional and subject to revocation pending an investigation that never actually closes. That inverts the entire purpose the Citizenship Clause was written to serve, which was to settle the question of citizenship at birth, permanently, so that it would never again be a live political question a subsequent government could reopen and arbitrarily determine.

That is what one vote stood between clarity and the protection of children versus chaos and uncertainty. Consequently, the Supreme Court majority gave American babies a real win.

And yet, a case this explicitly about babies — about who counts as one of us from the first instant of life — should not require this much digging and excavation to find the child inside the reasoning. Advocates should not allow themselves to be dragged into debate’s over opponents’ framing, and should center children in the debate and the harm opponents are seeking to impact on babies.

Justices Jackson and Barrett saw the child. Roberts glimpsed it in a few places.

But for the most part, judicial blindness to children is real. Even when courts faithfully interpret the Constitution, judges often lose sight of the children whose rights are actually before them. And if we cannot clearly see babies in a case about babies, we should ask ourselves how often children disappear from the countless other legal and political debates that shape their lives.

As this battle moves back into the political sphere, advocates for children and families cannot rest. The judicial blindness in the opinions often works the same way in politics — by making the child disappear from the argument.

Opponents are already stepping up their rhetorical and legislative attacks on birthright citizenship, using the six tactics named above. Advocates must not let that happen again. Every hearing, every bill, every campaign ad has to put the baby back at the center, because no one else in this fight is going to do it for them.

The Court, by a narrow margin, got this right. Whether the country does is now up to the rest of us.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

What You Can Do

You can call your member of Congress and senators to urge them to oppose any legislative effort — whether by constitutional amendment or legislation — to undermine birthright citizenship.

At First Focus Campaign for Children, we have no dedicated funding to engage in this fight. Our work on this issue comes from the support of individual donors such as yourself. If you are not already, we would appreciate your consideration of either becoming a paid subscriber to this newsletter or donating to our organization to keep up the fight to protect our babies and children from harm.

"Every generation inherits a world it never made; and, as it does so, it automatically becomes the trustee of that world for those who come after. In due course, each generation makes its own accounting to its children.” — Robert F. Kennedy (Apr. 25, 1963, in Columbia, South Carolina)

Something is happening to the demographic map of childhood, and it should concern every American worried about our future.

First, across most of the country, children are slowly disappearing.

New Census Bureau 2025 estimates, reviewed by Axios, show the under-18 population fell 2.4%, or by 1.8 million children, nationally between 2020 and 2025.

The West lost more than a million children — down 5.7%. The Northeast dropped 4.1%. The Midwest, 3.9%. Classrooms are emptying, maternity wards are quieting, and the median American is now older than ever, at 39.4 years.

Every region is shrinking its child population, except for one: the South.

The South gained 303,969 more children than it had in 2020 — the only region in the country adding kids, and the only region growing across every age group the Census tracks, from newborns to retirees. Its overall population grew 6%, nearly double the national rate. The growth is concentrated in metro counties, which added nearly 362,000 children even as the rural South kept losing them.

This is not simply a story of families relocating. County-level change reflects births and deaths as much as migration, and the data can’t tell us how much of the South’s growth comes from families moving in versus children being born and staying. However, what it does tell us is where the children are, and increasingly, where they are not.

Here is the issue that should worry us all: The one place in America where the child population is still growing is the one place least prepared and least willing to care for them.

Share

Subscribe now

Where the Need is Greatest, the Outcomes are Worst

The recently released Annie E. Casey Foundation’s 2026 KIDS COUNT Data Book tells a second part of this story.

On their index of overall child well-being, 11 of the 15 lowest-scoring states in the country are in the South. Mississippi sits dead last. Louisiana is 48th. Texas and Oklahoma are tied at 44th. Arkansas, Alabama, West Virginia, Georgia, South Carolina, Tennessee, and Kentucky all fall among the bottom one-third of states.

Meanwhile, five of the seven highest-scoring states in the nation are in the Northeast — one of the regions hemorrhaging children.

Pull the lens back, and the pattern is unmistakable. The children are increasingly concentrated in the states where they are least likely to have health coverage, stable housing, a well-funded classroom, or a path out of poverty — while the states that have built the strongest foundations for kids are watching their child populations shrink.

This will likely have devastating consequences for the next generation because, if this trend continues, an ever-increasing percentage of children will grow up farthest from the greatest opportunities.

The South Is Also a Region with Far Fewer Champions for Children

As for the third piece of the story, which is where our own data comes in, the story turns from troubling to damning.

Each year, the First Focus Campaign for Children issues our Legislative Scorecard and names the members of Congress who consistently show up for kids: our Champions and Defenders of Children. This year we honored 120 of them. When you map where they come from, the regional divide is striking.

The Northeast (Maine, Vermont, New Hampshire, Massachusetts, Connecticut, Rhode Island, New York, New Jersey, Pennsylvania, Maryland, and Delaware) produced Champions or Defenders from 42.1% of its delegation.

The West (Alaska, Hawaii, California, Oregon, Washington, Idaho, and Nevada) finished a strong second at 29.7%.

The Midwest (Ohio, Michigan, Indiana, Illinois, Wisconsin, Minnesota, Iowa, and Missouri) finished in the middle at 21.4%.

But the two regions that together make up the South finished dead last: just 11.9% of Southeastern members (Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida, Tennessee, Kentucky, Alabama, Mississippi, Louisiana, and Arkansas) and 10.5% of Southwest (Arizona, Utah, Colorado, New Mexico, and Texas) and Plains members (Oklahoma, Kansas, Nebraska, Wyoming, Montana, North Dakota, and South Dakota) earned the distinction.

So overlay the three maps. The region gaining children has the worst outcomes for children and the fewest leaders willing to defend them. The places filling up with kids are precisely the places sending the fewest Champions to Washington.

In fact, when we sorted states into KIDS COUNT’s four performance tiers, the share of Champions and Defenders fell at every step down — from 33.7% in the best-performing tier to just 13.3% in the worst. The states with the worst outcomes for kids elect the fewest leaders who fight for them. Those bottom-tier states are, overwhelmingly, Southern.

This Is What Organized Abandonment Looks Like

Ruth Wilson Gilmore gave us the phrase “organized abandonment” — the deliberate, structured withdrawal of public investment and care from people and places treated as disposable. It is the right phrase for what these three datasets, read together, describe.

This isn’t a natural disaster or a demographic accident. It’s a set of choices. The same Congress that participated in reducing the share of the federal budget devoted to children from 11.98% in 2021 to 8.57% in 2025 spent this year slashing Medicaid and SNAP — two of the most important lifelines for children.

The lawmakers casting those votes disproportionately represent the South, the region where the most children now live. For example, Texas has the highest rate of uninsured children in the country, but its congressional delegation (House and Senate) voted 27-12 to make the problem worse by slashing Medicaid by nearly $1 trillion.

Southern lawmakers are even making choices that disproportionately harm their own children. In the so-called “One Big Beautiful Bill” (OBBB) that passed Congress nearly a year ago, Columbia’s Center of Poverty and Social Policy (CPSP) finds that Congress made a policy choice to deny more than 1 in 4 children across the country the full Child Tax Credit because their parents made “too little.”

Incredibly, CPSP finds that:

…there will be 14 states — most located in the South — where more than 30% of children will be ineligible for the full Child Tax Credit. . .because their family income is not high enough to qualify fully, including Mississippi (45%), New Mexico (44%), and Louisiana (43%). There will also be 163 congressional districts where more than 30% of children are ineligible for the full credit for this reason.

The vast majority of those districts are from southern states whose representatives disproportionately voted to shortchange their own children.

Gerrymandering, exacerbated by the Supreme Court’s decision in Louisiana v. Callias, will only make this worse.

Sadly, a generation of American kids is growing up in the place where the public commitment to them is thinnest. Children are increasingly concentrated in the regions that invest the least in them, and then we act surprised when poorer outcomes follow.

But the South Is Also Proof That This Is a Choice

The most hopeful finding, according to the KIDS COUNT Data Book, is that the South saw some of the biggest gains from 2019 to 2024. Eight of the fifteen states that made overall progress were from the South.

In certain places, politicians have recognized the poor outcomes their kids face and chose to make investments and policy changes to improve their lives. Money matters, and these policymakers are demonstrating that progress for children is possible when they actually choose to prioritize them.

In a democracy, politicians are supposed to work for the people.

Considering that people from the South do not love their children any less than people in other places, it is well past time for them to demand better from their political leaders. This requires southern voters to reject the political agenda of “organized abandonment,” which is responsible for the defunding of their public schools, their children’s health care, and nutrition. They have failed to hold their policymakers accountable for voting for policies, including a Child Tax Credit that disproportionately shortchanges their children.

House Speaker Mike Johnson (R-LA), for example, pushed through the package last year despite it denying 42% of his own district’s children the full Child Tax Credit and imposing a “baby penalty” in which babies and their siblings see a reduction or lose access to the Child Tax Credit entirely when household income drops during pregnancy and childbirth.

Instead, imagine what the South’s kids could do with a Congressional delegation that fights for them at Northeastern rates. Imagine the gains if the region adding the most children were also the region adding the most Champions at both the federal and state levels.

The children and our nation’s future will increasingly come from the South. It is long past time the people sent to Washington to represent them acted like it.

#VoteKids

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

What You Can Do

If you live in one of the states below the national average (Mississippi, New Mexico, Louisiana, Alaska, Nevada, Texas, Oklahoma, Arkansas, Alabama, West Virginia, Arizona, Georgia, South Carolina, Tennessee, Kentucky, Florida, Michigan, California, North Carolina, Delaware, New York, Indiana, Missouri, Ohio, and Rhode Island) on the KIDS COUNT ranking of states by child well-being, please consider calling your federal and state lawmakers and ask them this one simple question:

Our kids can’t wait.

Fortunately, in Trump v. Barbara, the Court struck down President Trump’s Executive Order 14160 — his attempt to rewrite the Constitution’s Citizenship Clause with the stroke of a pen — as unconstitutional and unlawful.

Let me say it plainly, because babies and children so rarely get to hear it: we won.

This victory is about far more than a birth certificate or a passport. Citizenship is the legal foundation for the fundamental rights of people in our society. For a child, it means they can obtain a Social Security number, qualify for health care and nutritional services for which they are eligible, travel with the protection of an American passport, and fully participate in the civic life of the only country that they have ever known. More importantly, it gives children the security of belonging rather than a life of statelessness and increased exploitation.

This is a good day for babies born all across this country. I want to sit in that for a moment before I tell you why I am deeply concerned by today’s dissents in the case.

Share

Subscribe now

What We Told the Court: This Is Fundamentally a Children’s Case

For more than a year, I have been writing about this case on this blog — since before the inauguration, through the constitutional bedrock of it, the congressional hearings, the oral arguments on the injunctions, the chaos that followed, and the bureaucratic nightmare the order would have imposed on babies and maternity wards across the country.

And in an amicus brief that First Focus on Children filed along with the Center on Law and Social Policy (CLASP) and a coalition of child advocates, we argued something surprisingly absent from much of the litigation: this is fundamentally a children’s case.

The whole argument we put before the Court came down to a single, fundamental point. The Fourteenth Amendment’s Citizenship Clause is about the baby, not the parent. The text says “all persons born in the United States.”

Born. That is the constitutional subject. The child. At the moment of birth. On American soil.

President Trump’s order inverted that completely, making a newborn’s citizenship hinge on a dossier of their parents’ paperwork. It turned birthright into something closer to bloodright.

I have called citizenship “the right to have rights” in this space before. I borrowed that line from the Court’s own words in Perez v. Brownell. For children, this is not an abstract principle. It is the gateway to security, health care, opportunity, and equal treatment under the law. It means growing up with the assurance that your country recognizes you as fully belonging from the very first breath on the first day of your life.

So you will understand why I caught my breath when I read Chief Justice Roberts had written, almost word for word:

Citizenship, then and now, was the right to have rights — to freely participate in our political community.

And then:

We keep that promise today.

The majority kept the focus exactly where it belongs — on the child born here, not on the status of the parents who brought that child into the world. The Court even noted that the words doing all the work in the Executive Order — “mother,” “father,” “lawful,” “temporary” — appear nowhere in the Citizenship Clause. They are absent from the Constitution because the Framers of the Fourteenth Amendment put them nowhere near it. The Clause was written for the child.

Now the Part That Should Worry Child Advocates

Here is where I have to call this one the way I see it — balls and strikes, as always.

The headline says 6-3. That is the vote to strike down the order, and it is real. But that number hides something that we must not miss.

On the actual constitutional question — does the Fourteenth Amendment itself guarantee citizenship to these babies? — the Court issued a razor-thin majority decision of 5-4.

Only five justices (Chief Justice Roberts, joined by Justices Sotomayor, Kagan, Barrett, and Jackson) held that the Constitution protects these children. The sixth vote, Justice Kavanaugh, concurred only in the judgment. He agreed that the Executive Order is unlawful, but on the far narrower ground that it violates a federal statute, the Immigration and Nationality Act.

On the Constitution, he actually sided against babies and children. In his own words, he “respectfully disagree[d] with the Court’s constitutional holding,” writing that in his view “the Executive Order does not violate the Fourteenth Amendment.”

Read that again. Four sitting justices of the Supreme Court were prepared to read birthright citizenship out of the Constitution for these children. The long-standing constitutional protection, which was affirmed in 1898 by the Court’s decision in Wong Kim Ark and rooted in the repudiation of Dred Scott — was affirmed on the merits by the barest possible majority. One vote.

And Justice Kavanaugh’s narrower reading did not merely decline to find a constitutional violation. He went out of his way to point out that Congress “could — consistent with the Fourteenth Amendment — amend [the statute] or otherwise enact new legislation establishing exceptions to birthright citizenship,” adding only that “Congress has not yet done so.” In other words: the President could not do this by executive fiat, but in Justice Kavanaugh’s view, Congress could do it by statute. He left the door propped open.

The three dissenters — Justices Thomas, Gorsuch, and Alito — would have gone further still and upheld Trump’s executive order in whole or in part. And notice how they got there. Justice Thomas, writing for himself and Justice Gorsuch, built his entire theory on the parents’ “domicile.” Justice Gorsuch asked whether the parents had made “a permanent home here.” Justice Alito asked whether a child owes “allegiance solely to this country.” Every one of those tests does exactly what we warned the Court not to do: it makes a baby’s citizenship turn on the conduct, status, and paperwork of the adults around them. It is bloodright, dressed up in the language of allegiance and home.

Even Justice Alito, in dissent, could not bring himself to deny the obvious — conceding that these children “are not responsible for their parents’ violation of our immigration laws.” And yet, he voted to make their status 100% contingent upon their parent(s)’ status.

What This Means for the Work Ahead

So yes, we won. The Constitution held. Every baby born in this country today had their citizenship affirmed, and the President’s attempt to threaten their status with a signature failed.

But it was also far too close. A guarantee this old, this clear, and this fundamental should not survive by a single vote — and one of the deciding votes should not come with an invitation to Congress to finish by legislation what the President could not finish by decree.

That last part is precisely where First Focus on Children lives. The fight Justice Kavanaugh handed off to Congress is the fight we are built for. Over the last thirty years, Congress has considered bill after bill to strip birthright citizenship — and never once passed one. That democratic record is not an accident. It is a wall that advocates for children have helped hold, decade after decade. Today’s decision tells us that wall now matters more than ever, because four justices have signaled they would not stop Congress from tearing it down.

So we keep watch. We keep counting the children that too many in power would rather not count. And we keep saying the thing this case was always, fundamentally about: a baby born in America is one of us. Not because of who their parents are or are not. Instead, they are part of this country because of where they were born.

The Constitution said so back 158 years ago and again today. We intend to make sure it keeps saying so tomorrow.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait

First Focus on Children filed an amicus brief in Trump v. Barbara alongside CLASP and a coalition of child advocates. You can read more about our argument here.

Subscribe to Kids Can’t Wait — because kids can’t vote, but with your support, we can advocate for them.

The Administration calls these “partnerships.” In reality, they are the latest and largest step in a campaign to dismantle the Department of Education without ever asking Congress, which is the only body with the power to abolish it.

With this move, more than 8 million students with disabilities now face a fragmented federal system in which special education, civil rights enforcement, and other educational programs are scattered across multiple agencies with overlapping authority and limited expertise.

Since the Department of Education still has the authority to administer these programs, the Administration has created overlapping, duplicative bureaucratic structures that will lead to confusion and conflicting lines of accountability. Administration officials insist nothing will change, which begs the question as to why it is being done, but you cannot create a duplicative authority in an agency that has no education expertise, force school districts across this country to now have to deal with several different federal agencies (some on the same topic), and argue that students and families will be unharmed.

For the child with dyslexia who needs reading supports, the teenager with an intellectual disability preparing for adulthood, or the child whose parents are fighting for speech therapy, this is not a bureaucratic debate. It is about whether the people overseeing their education understand schools, teaching, and learning.

Unfortunately, HHS lacks the educational expertise or orientation needed to administer IDEA effectively, and the people who do have it are being eliminated.

Share

Subscribe now

HHS Has Zero Education Expertise, and That Is the Whole Problem

Start with what HHS is. It runs Medicare and Medicaid. It runs the National Institutes of Health, the Centers for Disease Control and Prevention, the Maternal and Child Health Bureau, the Health Resources and Services Administration, and the Food and Drug Administration.

HHS is one of the largest agencies in the federal government, and every one of its flagship programs operates on a medical model: diagnose a condition, treat it, manage it. That is the right model for a hospital or a health clinic. It is the wrong model for a classroom.

IDEA was built on the opposite premise. It does not treat disability as a health care diagnosis to be managed. It treats it as a natural part of human life and guarantees something a doctor cannot prescribe: a Free and Appropriate Public Education in the Least Restrictive Environment, delivered alongside a child’s general education peers. The people who make that real — the staff who understand Individualized Education Programs (IEPs), child find, transition planning, instructional practice, due process, and state compliance — work in education, not medicine.

As Denise Marshall, head of the Council of Parent Attorneys and Advocates (COPAA), told NPR:

There is no logical sense why anyone would move [students with disabilities] under HHS. We’re not going to all of a sudden go to our surgeon to learn how to read.

Chad Rummel, CEO of the Council for Exceptional Children (CEC) added:

[IDEA is] an education law. That means we need to have special education interacting with all of education at the department, not over [at HHS] on its own in a medical environment.

HHS does not employ people with expertise in pedagogy. It has never run a classroom, written an IEP, or held a state education agency accountable for serving students with disabilities. Handing it IDEA doesn’t “align” anything; it severs the program from the only federal workforce that knows how it works. And the career experts at OSEP who do know and have built 50 years of institutional knowledge are exactly the people this administration has spent the past year pushing out.

We have run this experiment before, and we already know how it ends. Before 1979, education, including special education, was housed within the sprawling Department of Health, Education, and Welfare (HEW), where it was perpetually an afterthought.

Congress created a standalone Department of Education precisely to rescue education from a health-and-welfare bureaucracy that kept it buried and ignored. According to the Department of Education’s own website on the history of IDEA:

Congress enacted the Education for All Handicapped Children Act, also known as the EHA, in 1975 to support states and localities in protecting the rights of, meeting the individual needs of, and improving the results of infants, toddlers, children, and youth with disabilities and their families.

In a subsequent reauthorization of the law in 1990, the name was changed to the Individuals with Disabilities Education Act or IDEA. As the Department of Education explains:

Before EHA, many children were denied access to education and opportunities to learn. In 1970, U.S. schools educated only one in five children with disabilities, and many states had laws excluding certain students, including children who were deaf, blind, emotionally disturbed, or had an intellectual disability.

Since the passage of EHA in 1975, significant progress has been made toward meeting major national goals for developing and implementing effective programs and services for early intervention, special education, and related services. The U.S. has progressed from excluding nearly 1.8 million children with disabilities from public schools prior to EHA implementation to providing more than 8 million children with disabilities with special education and related services designed to meet their individual needs in the 2022-23 school year.

Sending IDEA back to HHS doesn’t modernize anything. It turns back the clock to the era this country deliberately left behind — when children with disabilities were treated as patients to be managed and largely ignored rather than students to be taught.

The Cruelest Irony: A Kennedy Is Dismantling the Kennedy Legacy

There is a bitter historical irony at the center of this decision, and it carries the name of the very Cabinet secretary now taking custody of these children: Kennedy.

The federal commitment to educating children with disabilities, rather than warehousing them as medical patients, was built in no small part by President John F. Kennedy.

In February 1963, President John F. Kennedy, delivered a landmark Special Message to Congress on what was then called mental illness and mental retardation, calling for “a bold new approach.”

JFK’s entire purpose was to end the era of institutional confinement — to replace, in his words, “the cold mercy of custodial isolation” with “the open warmth of community concern and capability.” The laws JFK signed that fall moved the federal government toward educating these children and training their teachers.

Two years later, in 1965, RFK Jr.’s father — then-Sen. Robert F. Kennedy — paid an unannounced visit to the Willowbrook State School, a New York institution where thousands of disabled children were confined. RFK found them “living in filth and dirt, their clothing in rags, in rooms less comfortable and cheerful than the cages in which we put animals in a zoo.”

RFK called Willowbrook a “snake pit,” declared that the whole country was at fault, and said action was long overdue. His outrage helped ignite the movement to close such institutions and to insist that children with disabilities belong in classrooms and communities — not custodial wards.

And it was RFK Jr.’s other uncle, Sen. Ted Kennedy, who turned that conviction into durable law. He was an original cosponsor of the 1975 Education for All Handicapped Children Act — the statute that became IDEA — and the lead Senate negotiator of its reauthorizations, whose explicit aim was to align special education more closely with general education and hold schools accountable for the outcomes of every student.

Sen. Ted Kennedy was a chief sponsor of the Americans with Disabilities Act, which he argued would serve as “an emancipation proclamation” for disabled citizens. Disability advocates have said plainly that without Ted Kennedy, IDEA would have been stripped of the very due-process protections that let parents enforce it. (The family thread runs deeper still: their sister Eunice Kennedy Shriver founded the Special Olympics and chaired by her son Timothy Shriver.)

So look at where we now stand. The federal architecture that pulled children with disabilities out of the snake pit and into the classroom — the work of a president, a senator, and a half-century of bipartisan effort, much of it bearing the Kennedy name — is being unwound, with a Kennedy presiding over the agency absorbing it. And not a reluctant one: Robert F. Kennedy Jr. has championed this move, insisting that special education consists of “health-related” programs rather than education programs — the exact reframing his uncle JFK spent his presidency trying to undo. He arrives at it carrying a long record of promoting the thoroughly debunked claim that vaccines cause autism, and of rhetoric that disability advocates have condemned as stigmatizing toward the very children he would now oversee.

That is the danger in a single sentence. The moment a child with a disability is treated as a medical case to be managed rather than a student to be taught, the promise of inclusion begins to slip away. We know where that road leads, and the Kennedy family, of all families, is the one that documented it and then spent three generations leading the country in the other direction.

Civil Rights Without a Home: The Justice Department Split

The same reorganization that sends special education to HHS sends civil rights enforcement somewhere else entirely — to the Department of Justice. That split deserves its own alarm.

The Department of Education’s Office for Civil Rights (OCR) exists to protect students from discrimination based on disability, race, sex, and national origin by enforcing Title IX, Section 504 of the Rehabilitation Act, and the disability protections that operate alongside IDEA.

For a child with a disability, special education and civil rights are not separate concerns: they are the same concern. When a student is improperly restrained or secluded, disciplined for behavior tied to their disability, or denied an accommodation they are legally owed, that is at once an IDEA matter and a civil rights matter.

As Katy Neas, CEO of The Arc, told The 19^th:

A student who is denied services, disciplined for disability-related needs, or blocked from an accessible classroom needs one federal education system that can see the whole picture and act. Moving special education to HHS and civil rights enforcement to DOJ would split apart the offices responsible for making disability rights real in schools, leaving families chasing answers across the federal government instead of getting accountability from one education agency.

Until now, one agency could see the whole child. After this reorganization, a single family may have their child’s special education administered by HHS, their general education programs run out of Labor, and their civil rights complaint routed to DOJ — three departments, no coordination, and no one accountable for the student as a whole.

The mismatch gets worse when you look at how these agencies actually work. OCR was built for education: its staff worked directly with school districts on compliance, resolved complaints administratively, and understood what “reasonable accommodation” or “free appropriate public education” means in a real classroom. DOJ, on the other hand, is a prosecutorial agency built around litigation. It does not have OCR’s education-specific expertise, its established relationships with districts, or its complaint-resolution machinery. A parent whose child is being denied services needs a fast administrative remedy, not a federal lawsuit they have no power to file. Handing education civil rights to DOJ also subjects students’ protections to that department’s shifting enforcement priorities, with no guarantee that disabled children stay anywhere near the top of the list.

And this handoff is happening to an office that has already been hollowed out. Mass layoffs gutted OCR over the past year, and the damage is measurable: a recent Government Accountability Office (GAO) report found that between March and September 2025, roughly 90% of the discrimination complaints OCR handled were resolved by simply dismissing them — closed without review.

Moving a depleted enforcement function to an agency with different priorities does not repair it. It risks formalizing the collapse. For students with disabilities, who account for a large share of those complaints, it means the one federal door built to hear them may now be closed, relocated, or both.

Accountability and Funding Are on the Line, Too

The expertise problem is the root. The damage radiates outward into accountability and funding, the other two areas our fact sheet flagged as most exposed.

Accountability. For 50 years, IDEA has guaranteed students with disabilities a real education, and the results are undeniable. The high school graduation rate for these students climbed from 27.2% in 1995–96 to 73.6% by 2021–22.

That progress did not happen by accident — it happened because the Department of Education tracks whether states actually comply with the law. Remove the agency whose job is to hold states accountable, hand the function to a department with no education enforcement capacity, and the obvious risk is that compliance — already weak — quietly erodes.

Funding. The Administration claims this cuts bureaucracy. It does the opposite. States and districts will now have to coordinate with multiple agencies and learn new payment systems, and we have already seen what that produces. When K–12 programs create duplicative authority in the Department of Labor, DOL’s grant system didn’t even recognize state education agencies’ bank accounts. Rural school leaders received their funding two months late. For students who depend on IDEA dollars for the services they are legally owed, a payment delay isn’t a paperwork glitch — it’s a child going without.

This Objection Is Bipartisan

It would be easy to wave away the alarm over this move as routine opposition to a Republican administration. It isn’t. The most consequential resistance is coming from inside the Senate committee that oversees both departments — and from a Republican chairman.

Senator Bill Cassidy of Louisiana, a physician and the Republican chairman of the Senate’s Health, Education, Labor, and Pensions (HELP) Committee, broke with the administration and put it on the record.

“I agree that that should not be moved to HHS,” he told a June 17 committee meeting, adding that if special education had to be relocated at all, he would rather it go to the Labor Department than to RFK Jr.’s agency. And he didn’t stop at registering an objection: Cassidy promised Sen. Tim Kaine (D-VA) a committee vote next month on a measure to bar HHS from administering the Office of Special Education and Rehabilitative Services. With moderate Republicans like Lisa Murkowski of Alaska and Susan Collins of Maine also on the panel, that is not an idle threat.

Kaine, who said he believes members of both parties can support the measure, called the special education office the “core” of the Education Department — the piece lawmakers across the aisle care about most. Kaine also captured the lawlessness of the broader project in a single line, charging that the administration has treated the Department of Education “as if it’s a going-out-of-business sale of a discount furniture outlet.”

And this is not the first bipartisan warning. When Congress passed the fiscal 2026 budget, appropriators from both parties used the accompanying report to question both the wisdom and the legality of these interagency agreements. The bipartisan Appropriators wrote they were:

…concerned that fragmenting responsibilities for education programs across multiple agencies will create inefficiencies, result in additional costs to the American taxpayer, and cause delays and administrative challenges in Federal funding reaching States, school districts, and schools.

That was not an advocacy talking point. That was the committee that controls the money, predicting on the record the very problems now unfolding.

The Administration is gambling that it can break the Department of Education apart faster than Congress can organize to stop it. The early, cross-party resistance suggests that bet is far from safe.

The Bottom Line

This is what “organized abandonment” looks like in practice: strip the agency that holds the expertise, scatter its functions to departments that don’t, and let the resulting dysfunction do the work that Congress refused to authorize.

No press release calling this a “partnership” changes the fact that 8 million children with disabilities have just been handed to an agency that does not know how to teach them, and that the offices built to protect their rights are being pulled apart and gutted.

IDEA is a promise this country made 50 years ago: that a child’s disability would never again be a reason to deny them an education. Keeping that promise requires keeping IDEA where the expertise, the accountability, and the civil rights enforcement actually live — at the Department of Education.

Congress should say so, loudly — as a bipartisan group of senators has already begun to — and reverse this before the damage hardens into permanence.

Fifty years ago, Congress made a promise that disability would never again be a reason to exclude a child from a meaningful education. That promise depends on expertise, accountability, and enforceable rights – not bureaucratic shell games that scatter responsibility across government.

Children with disabilities only get one childhood and one education. Congress should stop this dreadful experiment before another generation pays the price.

Share

Subscribe now

Leave a comment

Share Kids Can't Wait