Congress will not be producing a budget blueprint this year, as the two houses will not come to an agreement on funding levels. The Senate has announced that it will abide by the spending limits in last summer’s debt ceiling bill (Budget Control Act or BCA) and call it a day. Meanwhile, the House has taken a step further, not only adopting a budget that calls for more spending cuts than the BCA, but also going through its own reconciliation process to achieve those lower spending targets. While the prospects for a reconciliation bill in the Senate are unclear, the House proposals give an alarming picture of where priorities lie on that side of the Hill. The bottom line is that vulnerable children and families will lose out to tax cuts and shoulder the burden of deficit reduction.
A refresher on reconciliation: When both Houses of Congress agree on a budget that includes new spending targets for programs with mandatory funding, they include “reconciliation instructions” to Committees to pass legislation that will adjust mandated spending to those new targets. Because there will be no real joint budget resolution this year, there will be no real reconciliation process. The House process shows what they would do to alter priorities in the federal budget. The plan is presumably to package the handiwork of the various committees into one big bill and pass it through the House, after which it could stall in the Senate.
While several committees have been acting on these instructions, three are particularly important to programs serving young children and their families.
Agriculture Committee Cuts the Supplemental Nutrition Assistance Program (SNAP): This Committee was first to act and had to meet the House-approved budget requirement to produce $33 billion in savings over the next decade. On April 18th, the Committee approved a proposal that would take the entire amount from cuts to SNAP, formerly known as food stamps. The cuts would reduce or eliminate benefits for all SNAP households, including the poorest. According to the Center on Budget and Policy Priorities (CBPP), some 2 million individuals would lose SNAP entirely. The remaining 44 million individuals who receive SNAP would see their benefits cut. The proposal would increase poverty and hardship and could affect the economy adversely. CBPP shows that in 2010, SNAP lifted about 4 million people out of poverty, including about 2 million children. The proposed cut in SNAP benefits would push some households into poverty and deepen the extent of poverty for millions of others.
Committee on Ways and Means Cuts Social Services: The House budget instructed this Committee, which oversees major social services programs, to find $53 billion in savings. The committee eliminated the Social Services Block Grant, which helps over 11 million kids through funding to states for services such as child abuse prevention and intervention, foster care, child protective services and child care.Its bill, approved on April 18, also would deny access to the child tax credit to parents who pay federal income taxes using an Individual Taxpayer Identification Number instead of a Social Security number. This provision is aimed mainly at American-born children whose parents are low-income working immigrants. The Center for American Progress shows that this change would take $1,800 away from the families of 5.5 million children in working families with incomes below the poverty level.
Energy and Commerce seeks to roll back health care reform: The Energy and Commerce Committee was instructed to find $3.8 billion in savings this year, and $96.8 billion over 10 years. This action doesn’t include the budget’s proposal to actually block grant Medicaid. To achieve this goal, they have targeted the health care overhaul. Their measure, approved on April 25, would eliminate the Prevention and Public Health Fund, the nation’s first mandatory funding stream dedicated to enhancing community-based preventive health programs. For example, one 2010 initiative related to children included nutrition, physical activity, and screen time standards in child care settings, and broader obesity prevention in early childhood programs.
The measure would repeal the maintenance of effort (MOE) requirements on states for Medicaid and the Children’s Health Insurance Program, allowing states to apply more restrictive eligibility standards for programs (thus allowing states to drop hundreds of thousands of children from Medicaid and CHIP). It also would reduce the federal Medicaid match, shifting more program costs to the states.
Appropriations Levels Differ in House and Senate: The final piece of the budgetary puzzle is discretionary spending, which must be approved by the Appropriations Committees every year. The BCA agreement, reached after much debate and brinksmanship over sending the country into credit default, set limits for multiple years, reducing discretionary spending by $900 billion over 10 years. The Senate is using the 2013 overall limit for its Appropriations bills, but the House budget reduced that limit by an additional $19 billion, thereby pretty much assuring there will be no resolution of final funding levels until after the November election. Adding to concerns is the fact the House bill that funds the Departments of Health and Human Services and Education would receive one of the largest cuts, coming in at $7.7 billion less than in the Senate. Most of the programs that help support infants and toddlers are in this bill.
One rationale for all these cuts is to forestall the across-the-board cut, or sequester, built into the BCA if Congress failed to come up with additional savings. Those cuts were split between defense and domestic spending. The cuts laid out by the House Committees would help shift the burden of the cuts away from defense and more heavily on domestic programs. At this point, the Senate isn’t likely to go along with the cuts or the shift, setting up another big issue until after the election. Yet, just having these proposals moving through one House of Congress is an alarming development.
But the House budget doesn’t direct all of its savings toward deficit reduction. It also envisions major new tax cuts as well as the extension of all of the Bush-era tax rates which expire at the end of 2012. These tax issues complete the triad of unresolved budget questions that will be on the table for a lame duck session of Congress. To paraphrase Bette Davis, strap your babies tightly into their car seats, it’s going to be a bumpy ride.
April 2012
3 posts
A couple of weeks ago, the Baby Monitor reported the introduction of a bill, the Rebuild America Act (S. 2252) authored by Senator Tom Harkin (D-IA). This sweeping legislation would support families who are striving to work and build a future for their children—families commonly referred to as the “middle class” as well as those who aspire to join them. Tucked into this large bill is a pretty significant statement, not only about child care’s role in allowing families to work, but also about infants’ and toddlers’ needs for high quality services.
The Rebuild America Act covers a broad range of issues that affect the prosperity of our nation and the economic engine that working families provide. Its strategies include investing to create jobs through rebuilding schools, supporting teachers, and increasing manufacturing power; creating financial stability and a better future for middle class families as well as seniors; and restoring fairness to the tax code and ensuring fiscal responsibility.
A prominent feature is a substantial investment in child care—and not just any child care, but care that meets high levels of quality. The proposed bill would pump $5 billion a year for 10 years into an enhanced “CCDBG Plus” program provided to states through a formula. Ten percent of those funds would be directed at improving the child care workforce; another 10 percent would support quality improvements. The remainder would be used to fund high-quality early care and learning services, with recognition of parents who work non-traditional hours and children with special needs. Services under the Rebuild America Act would have to meet the Head Start/Early Head Start program performance standards, the top tier of a state’s Quality Rating and Improvement System, or be accredited by a national accrediting body.
But here’s the big news for babies: two-thirds of the funds for services are directed at high quality programs for infants and toddlers. Senator Harkin’s efforts on behalf of quality services for very young children will not be unfamiliar to those who have followed the Early Head Start program as it has grown over the years. The child care proposal in this new bill carries that commitment further.
As ZERO TO THREE Executive Director Matthew Melmed said in a letter to Senator Harkin prior to the bill’s introduction, “By directing such a significant proportion of funds to services for very young children, this bill makes a powerful statement that the earliest years are an important time for public investment and that society has a strong interest in ensuring that families can provide positive developmental experiences for their infants and toddlers.”
To be clear, all ages of children need a continuum of high quality early childhood experiences. Yet the biggest gaps are for infants and toddlers, the most likely to be in lower quality care. Senator Harkin’s bill takes to heart three things we know: First, babies’ earliest experiences form the foundation for all learning that follows. Second, with 60% of U.S. mothers with infants working, a significant portion of these early experiences unfold in a child care setting. And third, parents of infants and toddlers—especially at the lower rungs of the economic ladder—often can’t find good quality care at any price, much less care they can afford.
The need for more, better, and financially feasible child care for young children is a major piece of the economic puzzle for families now and for their children in the future, when they will form the backbone of the American workforce. Senator Harkin’s overall bill comes with a high price tag, and its prospects in the current stringent budgetary environment are daunting. Still, as Melmed’s letter said, even “in these times of economic insecurity and budgetary distress, it is important that we not lose sight of the priorities necessary to meeting our current challenges while laying the foundations of a vigorous future for our nation.”
For babies, it is a vital step just to have a champion so clearly put down a marker for their essential needs as their parents go off to work. While it is a way from introducing a bill to realizing change—in this case having more high quality services in place—it is important to start. After all, no vision is ever realized if someone doesn’t first give it voice.
Last week, two years after the law’s passage, the Supreme Court heard oral arguments on the constitutionality of four elements of the Affordable Care Act (ACA):
- Monday, the first day of arguments, simply sought to decide whether the case could be heard at all before certain provisions of the ACA have been implemented. (The Anti-Injunction Act of 1867 states that a tax cannot be challenged in court until it has been charged. The charges in question under the ACA will not go into effect until 2014, leading some to question whether arguments on the constitutionality of the ACA could be heard until then.)
- On Tuesday, the Justices heard arguments around the key question: is the individual mandate constitutional? In other words, they discussed whether Congress can require people to purchase insurance.
- And on Wednesday, they considered two final questions: If the individual mandate is repealed, can the rest of the Act stand without it? Or would all benefits for children and families, such as those featured below, be lost as well? This question is referred to as “severability.” And, is the expansion of Medicaid to a broader population constitutional? This issue is frequently referred to as “expansion.”
Throughout the week, the Policy Baby Blog covered the story while exploring the law’s impacts on infants, toddlers, and families. Now Americans will have to wait three months for the Justices’ verdicts, expected by the end of June.
In the meantime, advocates for infants and toddlers can continue to educate the public about the ACA’s benefits for infants, toddlers, and families. Here is just a handful that we’ve been exploring at the Baby Blog over the past two weeks:
The ACA expands health care coverage to more children.
Today, Medicaid is the largest source of health care coverage for children in America, and starting in 2014, the ACA will expand Medicaid to include more families in need. (Due in large part to Medicaid, the national rate of uninsured low-income children of all ages fell from 28% in 1998 to 10.4% in 2010; and the ACA will lower that number further.) Medicaid is critical to ensuring that the youngest children have access to high quality, affordable, and consistent health care. And research demonstrates that Medicaid’s impact on the health outcomes of very young children is especially pronounced. Here are a few things you should know about babies, Medicaid, and the ACA:
- Medicaid currently pays for 40% of births in America.
- Medicaid is the largest source of health care coverage for children with special health care needs, and starting in 2014, the ACA will expand Medicaid to include more families in need.
- Children make up more than half of all Medicaid beneficiaries but only 20% of Medicaid costs.
- Because of the ACA, 17 million kids with pre-existing conditions can no longer be denied health coverage.
The ACA provides preventive care that is critical to healthy development.
In the past two years, an additional 14 million children have already benefitted from preventive services without their families having to pay a co-pay or premiums under their insurance plans. That means access to well-child visits, immunizations, regular screenings, and other services as laid out by the U.S. Preventive Services Task Force. These services are critical to young children’s healthy development, and all too often babies grow up without them. In 2010, 25% of two-year-olds in the U.S. have not received crucial immunizations, and in 2009 more than 10% of children age four and younger had not received a well-child visit in the past year. (That number jumps to almost 60% for uninsured children.) These unacceptable numbers are and will continue to be addressed by the preventive care provisions of the ACA.
- Every dollar spent on vaccinations for children saves $16 down the line.
- Childhood conditions like obesity, asthma, developmental delays, and mental health disorders can be successfully prevented or treated when identified early. Left untreated, however, they necessitate costly medical treatment in the future.
The ACA provides preventive care to women and mothers.
Section 1302 of the ACA includes maternity and newborn care in its list of Essential Health Benefits – services to be covered by Medicaid and other plans by 2014. In addition, Section 2713 requires that all non-grandfathered health plans cover preventive health care services – including preconception care, well woman visits, and perinatal care – with no cost-sharing. That means that, as the law is implemented, millions of women will gain access to these preventive health care services for themselves and their babies.
- Mothers’ physical and mental health – as well as their lifestyle choices and environmental exposures – are central to babies’ pre- and postnatal development.
The ACA provides new federal funds for home visiting services.
The ACA’s home visiting services will give at-risk parents and children improved access to family preservation services that seek to decrease child maltreatment and families’ child welfare involvement.
- By helping parents to understand and address their children’s physical, social-emotional, and cognitive development needs, home visiting cultivates families’ protective factors, nurtures parent-child attachment, and helps to ensure that parents have the resources necessary to caring for their children.
- Home visiting is a particularly critical tool in serving infants and toddlers, who are difficult or impossible to reach through other programs.
For more detailed information about the ACA’s impacts on infants and toddlers, read our posts, Happy Birthday to the Affordable Care Act (3/19/12), The ACA Toddles Toward Mothers, (3/23/12), Updates on the Supreme Court Oral Arguments on the Affordable Care Act (3/28/12), and Dispatch from the Supreme Court (3/28/12).
