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Showing blog entries tagged as: Health Care


Brief: Washington state must ensure kids are on the path to a healthy life

Posted by Jennifer Tran at Apr 11, 2018 12:55 PM |
Filed under: Kids Count, Health Care, Equity

Washington state has made tremendous gains in recent years to make sure more kids and families have greater access to health insurance. In 2007, the Washington State Legislature passed the Cover All Kids law, creating affordable, comprehensive Apple Health for Kids coverage. Since then, the number of Washington children without health coverage has dropped to its lowest level on record. Yet despite reaching historically high rates of insurance coverage, racial gaps in health outcomes persist and must be addressed.

HealthyStartPhoto

For KIDS COUNT in Washington’s new “Getting All Kids Off to a Healthy Start” brief (a part of the State of Washington’s Kids 2018 series), we asked local health leader Michelle Sarju, “What would it take to make sure young kids have a healthy start?” She noted that it begins with the quality of care an expectant mother receives – because women with low incomes experience the worst features of our public systems, which includes our health care system. Mistreatment at the hands of medical providers is a disincentive to seek further care, says Sarju. “Who wants to show up to a doctor’s appointment to be treated poorly?”

Even when socioeconomic differences are erased, race still matters. Black women are three times as likely to die from pregnancy and childbirth-related causes as white women, according to the U.S. Department of Health and Human Services. “For African American and Native American women, midwifery and doula care are two of several evidence-based strategies for improving maternal-child health outcomes,” says Sarju. “If you have a well-trained and licensed provider, you have much better outcomes. Midwives and doulas are strategic resources.”

In Washington state, women of color have a greater likelihood of dying from pregnancy-related causes. And infants of color – particularly Black, American Indian, and Pacific Islander babies –experience higher rates of infant mortality and preterm births and are more likely to be born at a lower birthweight.

In order to make systemic improvements to address these poor outcomes, decision makers must thoroughly assess quality of care for women and families of color. Policymakers, community health leaders, health care practitioners, and other individuals who influence health care and public health systems should also take other necessary steps to implement the following recommendations to help improve health outcomes for mothers and young children:

  • Identify interventions to address the adverse effects of structural and institutional racism on health outcomes;
  • Promote culturally relevant forms of health care, such as midwifery; and
  • Prioritize socioeconomic supports that advance the well-being of families, including Apple Health coverage, Supplemental Nutrition Assistance Program (food stamps), Temporary Assistance for Needy Families, two-generation approaches to parent-child support like home visiting, and the full implementation of the state’s new paid sick and family leave laws.

Getting All Kids Off to a Healthy Start” is the second release in the State of Washington’s Kids 2018 series. See the first in our series here.

KCinWA

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President Trump’s budget won’t strengthen the economy. It will harm Washington state

By Misha Werschkul, executive director

President Trump’s 2019 budget does nothing to bolster the economic security of people with middle and low incomes – which is critical to create a thriving economy. Instead, his budget actually threatens the economic security of millions of Washingtonians who rely on federal programs to be able to pay for food on the table, a roof over their head, health care, and other basic needs. Further, it will have profound ripple effects on Washington's local economies. 

While this budget is largely symbolic, since the U.S. Congress just approved a two-year budget deal, these extreme proposals should not be ignored. They are an important signal of the president’s priorities. Many of the specific proposals included in the budget have been introduced before and could be incorporated in future budget proposals or stand-alone legislation this year.  

On the heels of the passage of harmful new federal tax breaks that benefit the wealthy and corporations to the detriment of people with low and middle incomes, President Trump laid out a recipe for increased poverty, homelessness, and inequality. Specifically:

  • He again calls for repealing the Affordable Care Act (ACA) and drastically cutting Medicaid, putting health insurance for millions of Washingtonians at risk.
  • He calls for huge cuts in nutrition, housing, and other basic assistance for millions of Americans below or close to the poverty line, most of whom work for low wages, are elderly or have disabilities, or care for young children. For example, the president cuts nearly 30 percent over 10 years from the Supplemental Nutrition Assistance Program, which currently helps put food on the table for more than 900,000 Washingtonians.
  • He proposes deep cuts to the non-defense discretionary budget that funds education, scientific research, job training, and other core government functions. This would result in massive and unsustainable cost shifts to state governments.  

Instead of pursuing the policies proposed by President Trump, federal leaders should take common-sense steps to support families and grow the economy. They can do this by investing in high-quality job training and apprenticeships; increasing access to safe, affordable, dependable child care and care for family members with disabilities; and advancing policies that create jobs and raise wages for working families. 

For more analysis about this harmful budget proposal, see this statement from Bob Greenstein, president of the Center on Budget and Policy Priorities: "Trump budget offers stark vision."


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New report: An inclusive economy is essential for all Washingtonians, our economy, and the future progress of our state

Washington is poised for great economic progress. By many measures, a better future for all people in our state is within our grasp. And yet, economic growth is not reaching all Washingtonians. There are persistent and deep disparities based on race, ethnicity, nativity, class, and geography across every measure of economic progress. Progress is meaningful only if it’s felt by everyone and prosperity is shared by all Washingtonians. To create real progress, our state must have an inclusive economy in which everyone, especially people with low incomes and people of color, can participate in growth and benefit from it. Those are the primary findings of our “Building an Inclusive Economy” report (the first in our Progress in Washington 2018 series of reports).

Inclusive Economy carouselShared economic prosperity is one of the best measures of how our state and country are progressing, but economic growth has not been broadly shared in our state. Gains in income have been concentrated at the top while wages for low- and middle-income people have stagnated or declined. This rise in inequality is the result of many state and federal policy and budget decisions by legislators that have negatively impacted certain Washington state residents. Decades of regressive taxation, deregulation, privatization, cuts to the safety net, as well as the decline of collective bargaining have all played a role in rising inequality.

Washington state’s own upside-down tax code has contributed to the problem. Hardworking families in our state pay as much as seven times more than the wealthiest pay while corporations and the ultra-wealthy benefit from unnecessary tax breaks, making it hard for our state to have the revenue it needs to invest in the foundations that serve us all, such as great schools, quality health care, and other public priorities that make Washington a great place to live. Policymakers must fix our broken tax code. Doing so will allow our state budget to have sustainable sources of revenue to build an inclusive economy and to invest equitably in our communities in the short and long term.

Prosperity should be within reach of all Washingtonians
Making sure all Washingtonians have access to opportunity and resources is essential to ensuring prosperity is within reach of all residents. Across many indicators of economic progress, the data show that people with low incomes and people of color are starting off on unequal footing and are facing greater barriers in large part because of the impact of harmful historical housing, economic development, and financial policies. As Washington grows more racially and ethnically diverse, the future well-being of all of us hinges upon erasing the deep and pervasive racial imbalances that exist across these measures. By 2050, our state population will be majority people of color. Washington state’s young people are already at the forefront of this demographic transformation. Forty-three percent of children are kids of color.

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WA_Demog_1980to2050

In an inclusive economy, all Washingtonians – regardless of race, ethnicity, nativity, income, or community of residence – would be able to access quality jobs and have financial security and stability. Our education system would be preparing students and workers for good jobs and jobs of the future. And all Washingtonians would be able to live healthy lives in vibrant communities so they can better connect to and participate in the economy. However, data trends highlighted in our report indicate economic prosperity is out or reach for many residents in three key areas – economic security; education and job readiness; and healthy people and communities. For example:

  • Economic security: Although economic growth holds the promise of prosperity for working people across the state, rising employment has not reached all communities. While unemployment in Washington state has overall dipped to 4.5 percent, for many communities of color – such as Pacific Islanders, American Indians, and Blacks – unemployment rates remain at or near 10 percent. There are geographic differences as well: the unemployment rate has remained high in many rural counties. In Ferry County, the unemployment rate is the highest in the state at 9.1 percent, and in Pacific and Wahkiakum counties, unemployment remains at just above 6 percent.
  • Education and job readiness: While the state’s Department of Early Learning’s goal is for 90 percent of kids to start kindergarten with the skills they need to succeed, currently only 47 percent of kindergartners are meeting that threshold, and there are significant differences by income and race. Only 33 percent of kids with low incomes, 27 percent of Pacific Islander kids, 30 percent of Latino kids, and 32 percent of American Indian kids were kindergarten ready in 2016.
  • Healthy people and communities: In Washington state, many low-income communities, communities of color, and rural communities experience worse health outcomes when it comes to chronic diseases, life expectancy, obesity, and more. Thirteen percent of households in Washington struggle with food insecurity – the inability to have three meals on the table every day as a result of lack of resources. Among 10th graders, Pacific Islander, Latino, and Black students have the highest likelihood of living in families that had to reduce meal sizes or skip meals compared to overall state average.

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Food_Insecurity_10th_graders

Note about data: Disaggregated data is presented to provide a preliminary understanding of disparities by race, ethnicity, and nativity. On its own, the data throughout the report tells a limited story about the population it represents. We encourage users of this data to engage with communities of color to develop a more accurate and meaningful understanding than the data allows.

These and other trends highlighted in the report point to the fact that much work remains to be done for policymakers and all of us to advance shared prosperity and progress for generations to come. Our state budget and tax code are powerful tools to make this happen and to build an inclusive economy. In the upcoming 2018 legislative session and beyond, policymakers can choose to advance shared prosperity by making sure our state budget and policies increase economic security, promote racial equity, ensure all kids have access to great schools, and build thriving communities for everyone.

Stay tuned for the next publications in the Progress in Washington series, which will explore policy solutions that address the barriers to opportunities described in the “Building an Inclusive Economy” report.

“Building an Inclusive Economy” is the first report in our Progress in Washington 2018 series. The report is intended to offer a framework for understanding the challenges before us. To reach the goal of an inclusive Washington state economy with shared prosperity for everyone, we need to know where we are, where we need to be, and how we can get there.

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New Census Numbers: To Build Thriving Communities, Invest in Removing Barriers to Economic Security

New data released by the U.S. Census Bureau shows that there is some good news when it comes to poverty rates and access to health care in our state. At the same time, the data shows that many Washingtonians – in particular, some communities of color, women, and people with disabilities – still face barriers to economic security. The numbers make it clear that to build thriving communities, our policymakers must invest in priorities that remove obstacles to prosperity for Washingtonians.

First the good news: Last year, the poverty rate in Washington state declined slightly to 11.3 percent from 12.2 percent in 2015. And between 2013 and 2016, the rate of people with health insurance increased to 94 percent from 86 percent.

The fact that fewer Washingtonians are living in poverty is likely due to economic growth and a low unemployment rate. And the insurance rate is more evidence that the Affordable Care Act has been extremely effective in ensuring more people can afford to have access to a doctor and preventive health services.

Yet the numbers also reveal that despite economic growth, far too many residents of Washington face barriers to economic security, especially people of color, women, and people with disabilities. In fact, the poverty rate for some communities of color in Washington is nearly two to three times that of whites. Systemic barriers are impacting many people’s ability to put food on the table and pay for their housing. For example:

  • Twenty-seven percent of American Indian/Alaska Natives, 23 percent of Blacks, 20 percent of Native Hawaiian/Pacific Islanders, and 19 percent of Latinos live in poverty.
  • Among full-time workers, women earned 75 percent of what men earned in 2016.
  • One in four working age Washingtonians with a disability live below the federal poverty line, compared to one in ten adults without disabilities. 


Further, when looking at the data over a longer time period, they show those facing the greatest hardship are not reaping the benefits of economic growth. In fact, more people in Washington are living in deep poverty – below 50 percent of the federal poverty line, which is less than $10,080 a year for a family of three in 2016 – than in 2006. The number of Washingtonians living in deep poverty grew by 17 percent between over the last decade (See figure below).

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Washingtonians in Deep Poverty

Our economy and our communities will be stronger when everyone is able to not only to make ends meet, but also to have a better future – and when lawmakers act to undo systemic and institutional barriers that prevent people from having equal access to opportunity.

While it is good news that there is declining poverty overall and greater rates of health insurance coverage in our state, the new Census numbers nevertheless underscore that too many people are still facing financial hardship. In order to build thriving communities, lawmakers in our state need to make investments that enable all our residents to thrive. Further, federal policymakers must protect essential health care coverage – pushing back against continued efforts to repeal the Affordable Care Act – and they must protect programs that ensure that when people hit hard times, they don’t go without the basics.

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KIDS COUNT Report: Washington Continues to See Historic Progress in Kids’ Health Care Access

Posted by Jennifer Tran at Jun 13, 2017 09:25 AM |

The number of Washington state children with health insurance has risen to historic highs, with 39 of every 40 kids in the state now covered by health insurance. Further, disparities in access to health care have been reduced across nearly all racial and ethnic groups. This according to the 2017 KIDS COUNT Data Book released by the Annie E. Casey Foundation and the KIDS COUNT Data Center. Given this monumental progress toward strengthening the long-term health and well-being of Washington’s kids, our representatives in Washington, D.C. must reject harmful federal policy proposals that would send kids’ health backward.

WA_KCDB_2017_Health_Insurance_Soundbite

Washington state's Cover All Kids law, passed in 2007, combined with the 2014 implementation of the Affordable Care Act (ACA) have helped reduce the number of uninsured Washington children by more than half, to 3 percent today from 6 percent in 2011. This improvement underscores how smart federal investments to expand Washington state’s Apple Health for Kids has significantly enabled more kids to see a doctor or get necessary medicines when they’re sick.

As the chart below shows, these policies have also advanced health equity by connecting more Black, Latino, and Asian and Pacific Islander (API) children with the coverage they need to thrive. Today, only 2 percent of Black and API and 3 percent of Latino children are without health insurance. With the exception of American Indian children, coverage gaps among children of different races and ethnicities have narrowed since 2011. Ten percent of American Indian kids remain uninsured in Washington state.

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Uninsurance rates by race/ethnicity updated 12June2017

Unfortunately, this progress toward covering more kids is threatened by federal policy proposals that would make huge cuts to health care for people with low incomes. The proposal to “repeal and replace” the ACA with the American Health Care Act passed the U.S. House of Representatives and is now being negotiated by the U.S. Senate. It would effectively end the Medicaid expansion that led so many more children from families with low incomes to get health insurance through Apple Health for Kids in Washington. Furthermore, the president’s proposed budget would also slash Medicaid funding to the state nearly in half by 2027.

We all have a responsibility to ensure all of Washington’s kids have the opportunity to have a healthy start in life. At a time when far too many Washington families are just one personal crisis away from a financial catastrophe, it is vital that families can afford basic preventative health care for their children and can take them to a doctor when they need to. State and federal lawmakers must protect the health and economic security of kids and families against harmful budget proposals. They must safeguard the great progress our state has made in covering more children and closing racial and ethnic gaps in health coverage.

To read more about how Washington’s kids rank nationally in economic well-being, education, health, and family and community, read the full 2017 KIDS COUNT Data Book, the one-page KIDS COUNT Washington state 2017 profile, and our KIDS COUNT in Washington press release.

Five Ways Trump’s Budget Proposal Would Harm Washington State

By Julie Watts, deputy director
 
The Trump administration’s federal budget proposal hurts the very people the administration purported to help and leaves our states on the hook to make up the difference. The budget calls for big increases in military spending and pays for it through deep cuts to programs that help strengthen the economic security of everyday Americans. These cuts are on top of those already being proposed to health care through the repeal of the Affordable Care Act.

 

President Trump has promised to be a champion of people left behind by the economy. However, his budget takes aim at the very programs that serve them. In fact, all of the cuts come from the Non-Defense Discretionary spending area of the federal budget. This part of the budget funds key priorities like job training, education, affordable housing, and basic supports for children, families, and the aging. It also includes funding for border security, veterans' benefits, and the FBI, but since Congress is unlikely to cut these areas, programs that help workers and families would be particularly hard hit. 

Trump’s budget proposal, entitled “America First: A Budget Blueprint for Making America Great Again,” would not, in fact, help the communities in our nation and in our state thrive. Here are five ways Trump’s budget proposals would hurt Washington state and its residents:

1. Shifting costs to our state government and making it harder to balance the state budget: Federal grants make up almost one third of the Washington state budget. (See chart below.) They pay for things like education, human services, the environment, and statewide emergency response. The budget proposal would cut federal grants to states, which would leave our state on the hook for $458.6 million per biennium to maintain these services. (That is not even taking into consideration the $2.5 billion our state would have to cover if the proposed repeal of the Affordable Care Act and cuts to Medicaid go through). 

Federal grants to WA pie chart_2017

2. Making it harder for people to make ends meet: President Trump’s proposed budget would eliminate the Low Income Energy Assistance Program, which helps people who don’t have enough money to pay their light and energy bills to keep the lights and heat/cooling on. This program – which largely serves people with low incomes and the elderly – would provide $113 million to the state in the 2017-2019 biennium. Trump’s budget would also eliminate the Weatherization Assistance Program, which provides roughly $8.6 million per biennium to the state to help people with lower incomes weatherize their homes to save on energy bills.

3. Making it harder for parents to care for their kids: Many working families rely on before- and after-school programs to not only provide educational and enrichment opportunities for their kids, but also to ensure that kids are well-cared for while they work. Trump’s budget proposal would eliminate the 21st Century Community Learning Centers program. This program would provide $36.1 million for before- and after-school programs in Washington state in the next biennium. Eliminating the program could mean nearly 18,000 state children would lose educational, recreational, and enrichment programs outside school hours.

4. Making it harder to get a living-wage job: Whether you are a young person just starting out or you’ve been laid off and are back in the market, job-seeking is a daunting task. The Workforce Innovation and Opportunity Act (WIOA) provides support to help eligible job seekers get education, training, and support services to succeed in the job market. WIOA grants to Washington totaled $137.5 million between 2015 and 2016. The Trump budget proposes cutting WIOA grants to states by 35 percent, which would mean the state would either need to come up with an additional $48.1 million in funds to cover the federal losses or serve 59,000 fewer people with job search and training support in the next biennium. 

5. Making it harder to get affordable housing: Washington state is in the midst of a homelessness crisis. Homelessness increased 15 percent in 2015 and again by 7 percent in 2016. The Trump budget slates the HOME Investment Partnerships Program,  a federal grant program to states to build affordable housing, for elimination. This program provides Washington state with about $38.1 million per biennium to issue to developers to build affordable housing units. Washington also stands to lose funding for Housing Choice Vouchers. These vouchers are an important tool in combating homelessness and providing people with low incomes with assistance to get housing in the rental market. In 2015, more than 50,000 Washington families had a roof over their heads thanks to this important program. Trump proposes to fund the vouchers at $1.7 billion below the amount necessary to maintain the current number of vouchers nationwide. That could mean big cuts to the number of households getting rental assistance in Washington.

And this is barely scratching the surface in terms of the cuts that the Trump budget is proposing.

President Trump’s budget proposal may have a difficult time clearing Congress. However, it represents a stark vision of what it would look like if Congress chooses to pursue a budget along similar lines: dramatic increases in military spending paid for with deep cuts to services and programs that help states support families, individuals, and workers. And again, this whole budget proposal is in addition to the dramatic cuts Washington state could be facing with the potential loss of ACA and Medicaid. 

 

The Future We Want: The Washington State Budget & Policy Center Announces Our 2017-2019 Legislative Agenda

Great schools, strong communities, healthy families: these are the things Washingtonians care about. Everyone wants this to be a state where kids can meet their full potential, where everyone can breathe clean air and drink clean water, and where everyone can succeed.

In the face of big changes on the national landscape, now more than ever it is important that state policymakers work to ensure the future of Washington as a place where all people can lead safe, happy, and healthy lives. The decisions they make now will influence the well-being of people in Washington for years to come.

How do we create a better future for our state? The Washington State Budget & Policy Center’s 2017-2019 Legislative Agenda offers a framework for how policymakers can ensure that every child, every family, every individual, and every community in our state can thrive.

Starting in January, state policymakers must take action to deliver a world-class basic education to every child. This will require cleaning up the tax code and avoiding distractions that take attention away from efforts to make sure every kid in Washington state has access to great schools. It is imperative that policymakers accomplish this task while also dedicating resources to priorities that make Washington a great place to live, from early learning to long-term care, from school breakfast for kids to night classes for their parents.

We know that basic education will dominate the conversation this legislative session. We also know that kids can’t succeed if their parents are struggling to meet their basic needs, if their neighborhoods aren’t safe, and if their communities aren’t healthy. That is why our Legislative Agenda is focused on building a better Washington through the six key areas laid out in our Progress Index: world-class education; economic security, healthy people and environment; community development and trust; good jobs; and revenue. The recommendations within our agenda also aim to promote policies that advance racial equity. The Budget & Policy Center Legislative Agenda offers specific recommendations for how lawmakers can:

  • Build economic security by addressing intergenerational poverty, strengthening support for families, and making sure everyone can afford a roof over their head and food on the table.
  • Create a world-class education system that provides kids with high-quality teachers, gives them a great start through early learning, and offers equitable access to higher education.
  • Ensure everyone has access to affordable health care, as well as mental health and public health services; make sure that everyone lives in an environment with clean air, water, and land.
  • Develop strong communities and racial equity while addressing barriers to re-entry and ensuring access to civil legal assistance; ensure that there’s greater transparency about our state’s tax breaks.
  • Promote great jobs that stimulate economic growth and development, and advance opportunities for all workers to have paid time off to be with their families.
  • Clean up the state’s tax code so that our state has the resources it needs to support a high quality of life for everyone.

Throughout the legislative session, which begins January 9, and beyond, the Budget & Policy Center will work with partner organizations, community leaders, and grassroots advocates to advance the priorities laid out in this agenda. Our research and analysis will continue to show policymakers why it is critical to invest in the progress of our state and its people – especially in the face of proposed federal policies that threaten to move us backward rather than forward. 


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HIGHLIGHTS

Thank you for attending Budget Matters

Our Budget Matters 2018 policy conference took place on November 13 at Seattle Center. john a. powell from the Haas Institute for a Fair and Inclusive Society and Gov. Jay Inslee were the keynotes. Stay tuned for the TVW coverage.  

Our policy priorities

Washington state should be a place where all our residents have strong communities, great schools, and the chance for a bright future. Our 2017-2019 Legislative Agenda outlines the priorities we are working to advance.

Testimonies in Olympia

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Watch our 2018 legislative session testimonies on TVW: