While many of the bill’s supporters claim that children and other vulnerable populations will not be harmed by the changes made in reconciliation, this is just not true. It is impossible to achieve the level of funding cuts set forth in the bill without causing direct and indirect impacts to the health and well-being of children and families. 

The House reconciliation bill singles out programs that disproportionately benefit children for cuts. Only 8.87% of total federal spending goes to kids, but the programs targeted by the bill devote a much larger share to children. For example, 20% of Medicaid funding goes to children, 100% of the funding in the Children’s Health Insurance Program (CHIP) goes to children and pregnant women, and 43% of SNAP dollars go to families with children. These three programs rank among the top 10 largest federal investments in children and are targeted for more than $1 trillion in cuts. 

These programs work alongside one another to support our nation’s kids. Any of the individual cuts included in this bill would be considered a loss for children, and when taken together, this bill is a disaster for kids. For example, 14 million children depend on both Medicaid and SNAP. This “double jeopardy” risks their access to both food and health insurance. In addition, enrollment in certain benefit programs makes it easier for children to receive other supports. For instance, SNAP recipients automatically qualify for free school meals and child care subsidies. If children are not enrolled in SNAP or Medicaid, they are also likely to experience reduced participation in these other programs that qualify for automatic eligibility. 

Medicaid, SNAP, and tax policy are essential to keeping kids fed, healthy, and cared for. As the House bill moves to the Senate, Congress still has an opportunity to choose babies over billionaires. First Focus Campaign for Children calls on lawmakers to protect children by stopping this bill. 

Child Health

Every child deserves a healthy start and the opportunity to thrive, but policies that undermine access to essential health care put the well-being, development, and future of millions of children at risk. The proposed budget reconciliation bill includes several provisions that would significantly alter Medicaid and CHIP, jeopardizing health care access for over 37 million children who rely on the programs. 

Moratorium on Rule that Simplifies Enrollment and Eligibility

The House bill would place a moratorium on the Centers for Medicare & Medicaid Services’ (CMS) “Streamlining Medicaid, CHIP, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes” rule, which was designed to reduce red tape and make it easier for eligible children to enroll and stay enrolled in Medicaid and CHIP. The rule also included important protections for CHIP by prohibiting states from imposing:

• Waiting periods: This is an outdated mechanism imposed on children after they voluntarily disenroll from a group health insurance plan, such as a parent’s employer-sponsored plan. When CHIP was established in 1997, states were required to make sure that CHIP did not substitute for group health insurance. One method that states used was to impose a period of time a child must remain uninsured before enrolling in CHIP. Many states ended waiting periods after the Affordable Care Act limited them to 90 days. However, as of February 2024, nine states still required children to remain uninsured for a period of time before they could sign on to CHIP. The final rule helped to ensure that no child eligible for CHIP will be forced to go without coverage, preventing critical gaps in their health care.

• Lock-out periods: Under the final rule, states are prohibited from imposing mandatory “lock-out” periods on children whose families cannot keep up with their state’s CHIP premium payments. Prior to the final rule, a dozen states used these lock-out periods to keep children from re-enrolling in CHIP for a certain period of time after they lost coverage due to non-payment of premiums. The child could be forced to go without coverage until the end of the lock-out period, even when the family could afford to pay the overdue premiums.

• Annual/Lifetime Benefit Caps: States have several options for how they implement CHIP. States can choose 1) to expand Medicaid coverage for children (funded with CHIP dollars; a.k.a M-CHIP); 2) design a separate CHIP; or 3) use a combination approach. Most states use a combination approach. For kids enrolled in M-CHIP, a state must follow Medicaid rules. For separate CHIPs, states have greater flexibility in designing benefit packages, a policy that has led some states to limit certain benefits and services, such as dental and mental health care, including imposing annual and lifetime caps. Medicaid does not allow annual or lifetime limits, and the Affordable Care Act extended these protections to other populations. The final rule meant that states could no longer impose these limits on specific benefits that children who are enrolled in separate CHIPs need.

Reducing Retroactive Coverage

Retroactive Medicaid coverage allows medical bills incurred up to 90 days before application approval to be covered. The House bill would reduce this vital coverage from 90 days to 30 days. Retroactive coverage is crucial for newborns, children with sudden illnesses, and families facing emergencies, ensuring they are not left with unaffordable medical debt while their application is processed. Without this protection, families will be forced to delay or forgo crucial medical care for their children due to cost concerns, leading to preventable hospitalizations and worsening chronic conditions.

Penalizing States that Provide Coverage to Immigrants

The reconciliation package would penalize the federal matching rate (FMAP) for adults in Medicaid expansion states, reducing it from 90% to 80%, if the state provides financial assistance or “comprehensive health benefits” to residents ineligible for Medicaid due to immigration status. Currently, 14 states and the District of Columbia have chosen to use state dollars (not federal Medicaid funds) to extend some form of comprehensive health coverage to all children, regardless of immigration status. Two states also provide coverage to pregnant women regardless of immigration status.

This penalty effectively doubles the state’s cost of maintaining Medicaid expansion and also represents an unprecedented federal intrusion into state policy decisions about how to use state-only funds. This provision will force states to choose between maintaining coverage for immigrants, disproportionately children and pregnant women, and preserving federal Medicaid expansion funding. The provision would likely result in thousands of immigrant children losing access to preventive care, chronic disease management, and treatment for acute conditions. This loss of coverage could lead to worsened health outcomes, increased emergency department utilization, and higher long-term health care costs for families and the communities in which they live.

Moratorium on Provider Taxes

A provision to limit states’ flexibility to finance their Medicaid programs through provider taxes would have far-reaching consequences for pediatric care. These taxes on hospitals and other health care providers generate revenue that helps states support their Medicaid programs. Restricting state ability to use this financing mechanism would:

• Force cuts to services, eligibility, or provider payments that directly affect children.
• Create significant financial pressure on children’s hospitals and pediatric specialty providers that depend heavily on Medicaid.
• Threaten school-based health services that rely on support from Medicaid.
• Jeopardize mental health and developmental services for children, which are often financially vulnerable.
• Hit hardest in states with limited tax bases that rely on provider taxes to maintain their programs.

Children’s hospitals, community clinics, and pediatric specialists often operate on thin margins while serving a high proportion of Medicaid patients. Financial instability in these critical institutions would have immediate consequences for children’s access to care, including specialty care, particularly in underserved areas.

Banning Use of Federal Dollars for Gender-Affirming Care

The budget reconciliation bill includes a provision that would prohibit use of federal Medicaid/CHIP funding for gender affirming care for all individuals, including children and youth. This legislative move would have significant negative consequences for the health and well-being of transgender and gender-diverse youth.

Banning federal funding for gender affirming care means that transgender youth in families with low-incomes would lose access to guideline-directed, medically necessary health care interventions. These interventions may include puberty blockers, hormone therapy, and related mental health services, which are recognized by major medical organizations as critical components of care for gender dysphoria in youth. Without coverage, many families would be unable to afford these treatments out-of-pocket.

Research consistently shows that access to gender affirming care is associated with improved mental health, reduced rates of depression and anxiety, and lower risk of suicide among transgender youth. Denying this care can lead to increased psychological distress, feelings of rejection, and a higher incidence of self-harm and suicide attempts. 

Work Requirements

The House bill would require certain adults on Medicaid to work or participate in work-related activities for at least 80 hours per month, with some exemptions for parents and caregivers of small children. Despite these exemptions, imposing work requirements on Medicaid poses significant risks to children’s health. When parents or other adults in a child’s household lose Medicaid coverage due to work requirements — often because of complex paperwork or administrative hurdles — children are less likely to receive the care they need. This is because children’s health and development are closely tied to the health and stability of their parents and caregivers. Loss of coverage for adults can lead to increased family stress, reduced access to health care, and greater financial hardship, all of which negatively affect children’s well-being and development.

Additionally, work requirements create more bureaucratic barriers for families, leading to eligible children losing coverage due to missed paperwork or confusing processes. Past experience, such as in Arkansas, showed that thousands lost coverage for procedural reasons, not because they were actually ineligible. When children lose Medicaid, they lose access to essential services — including preventive care, mental health, and developmental screenings — that are critical for healthy growth, especially for those with special health needs.

Affordable Care Act Marketplace 

More than 2 million children are currently enrolled in Marketplace plans. The reconciliation package includes revisions to Marketplace policies, including special enrollment periods, income verification, auto re-enrollment, and other items that will increase costs for Marketplace enrollees or make it harder to stay covered, which will lead to more uninsured individuals, including children. 

A last-minute change to the House bill will provide funding for special payments called cost-sharing reductions (CSRs), which help lower out-of-pocket costs like deductibles and copays for people with low incomes who buy what are known as Silver plans in the Marketplace. In the past, the government stopped paying these CSRs, but insurers still had to offer the reductions, so they raised the prices of Silver plans to make up the difference—a move known as “Silver Loading.” This actually helped some families get more financial help to pay their premiums for other types of Marketplace plans (e.g., Bronze or Gold). Now that the government will start paying CSRs again, insurers won’t need to “Silver Load,” but this change will have the consequence of raising health insurance premiums for families insured through the Marketplace, making it harder for them to afford coverage and possibly leaving them uninsured.

Potentially even more impactful on Marketplace coverage is what the reconciliation bill fails to do. Under the Affordable Care Act, individuals and families can receive advance premium tax credits (APTCs), based on their income, to help lower their monthly premium cost for purchasing a plan on the Marketplace. The American Rescue Plan Act (ARPA) made “enhancements” to the APTCs, providing even more assistance to lower the cost of premiums. The House bill fails to extend the enhanced APTC levels, which expire at the end of 2025. While the base level of APTCs remain in statute, the additional assistance provided under ARPA significantly improved costs for families enrolling in Marketplace coverage, helping millions more individuals, including children, becoming insured. Since 2020, enrollment in the Marketplace more than doubled from 11 million individuals to over 24 million in 2025. By allowing the enhanced level of APTCs to expire, the Congressional Budget Office estimates that over 4 million people will lose their health insurance.

Nutrition

As the nation’s largest federal food assistance program, the Supplemental Nutrition Assistance Program (SNAP) is the first line of defense against hunger and food insecurity for low-income children. More than 15 million children — representing close to 40% of the program’s participants — rely on SNAP for consistent, healthy meals. In 2023, SNAP lifted more than 1.3 million children out of poverty, and countless studies show that SNAP participation improves food security, health, educational, and long-term economic outcomes for children. First Focus Campaign for Children is deeply concerned that the changes contained in the budget reconciliation bill will increase the number of children who experience hunger or food insecurity. 

Transfer of Cost to States

The federal government has historically fully funded the food benefit costs of SNAP. In this bill, Congress backs away from that commitment and mandates that states cover at least 5% of the food benefit cost. While 5% may seem like a low percentage, this translates to billions of dollars for some states. Moreover, states could be required to pay much more than 5%, with Congress proposing increased responsibility to states based on error rates within the program. In some instances, this provision could lead to states being responsible for up to 25% of the cost. Because error rates are calculated annually, states could fall into different categories of funding responsibility from year-to-year. In addition to the food benefit cost transfer, the budget reconciliation bill also restructures the funding balance so that states will be responsible for 75% of the administrative costs. Currently, the federal and state governments share administrative costs 50%-50%. 

These cost transfers place many states in an unfeasible position. The potential variability of a state’s cost share also makes it extremely difficult for states to plan for program continuation or prepare budgets for future years. Analysts anticipate that, if confirmed, these transfers will force states to reduce benefits, limit eligibility, or, in some cases, even end their SNAP programs. These pressures would lead to a reality where the government assists hungry children in some states and leaves them behind in others. 

Work Requirements

Currently, SNAP exempts households with children from work requirements. The House bill would exempt only families with children under the age of 7. Proponents of the provision reason that children over the age of 7 are in school during the day, allowing guardians to work. This change shows a complete misunderstanding of school schedules, ignoring summer and seasonal breaks and the fact that the hours of a school day are shorter than conventional work hours. It also represents a disregard for the costs and challenges of finding after-school child care. But most concerning, this provision communicates a willingness to risk the health and well-being of children over the age of 7. Adults who care for dependent children with disabilities also are not exempt from work requirements under this bill. Work requirements in SNAP are especially dangerous as they reduce the household’s overall benefits leading to less money for groceries and ultimately diminishing the amount of food the household has for children. Estimates place at least 4 million children living in households at risk of losing some or all of their benefits as a result of the new work requirements. 

Thrifty Food Plan 

The Thrifty Food Plan is the national standard by which the government determines the cost of buying food to maintain a healthy diet and subsequently sets SNAP benefit amounts based on that calculation. The plan was adjusted by the Department of Agriculture (USDA) in 2021 to modernize the standards and take into account the latest nutritional guidelines and food prices. This evaluation led to a slight benefit increase for SNAP recipients, with most households receiving an increase of $12-14 a month. The 2021 adjustment is credited with lifting 1 million children out of poverty. The House budget reconciliation bill would cancel future benefit adjustments, jeopardizing families’ ability to afford the basic necessities and components of a healthy diet. As grocery prices continue to rise, Congress should be taking steps to protect SNAP users from this fluctuation, not jeopardizing child nutrition further by ending future adjustments. 

Cascading Effect onto School Meals

Although the budget reconciliation bill does not specifically mention school meals, its provisions will directly impact the way schools address child hunger. Children who participate in SNAP currently are automatically enrolled in free school meals. If states are forced to limit the number of children covered by SNAP, students could lose their enrollment in free school meals due to administrative burdens, even if they are still qualified. In addition, fewer schools are expected to participate in the Community Eligibility Provision (CEP), which allows them to provide free school meals to the entire student body, if states have to limit their SNAP participation. The two programs are intertwined, with CEP reimbursement rates linked to the percentage of students that a school has enrolled in SNAP. Children cannot afford to lose the nutrition support they receive through schools at any time, but to not have safeguards for school meal enrollment at a time when SNAP cuts are endangering food at home is especially cruel. 

Economic Security

The tax code offers one of the most powerful tools for improving the lives of children, with the Child Tax Credit (CTC) and the Earned Income Tax Credit (EITC) among the top 10 programs contributing to federal investments in kids. In 2023, the CTC and EITC combined lifted 3.4 million children out of poverty. That number would have been even greater — as high as 7 million children — if lawmakers had renewed the historic 2021 improvements to the CTC, according to Columbia University’s Center on Poverty and Social Policy. 

The House reconciliation bill goes in the opposite direction. The bill would make permanent tax cuts benefiting the ultra- wealthy, including a boost to the estate tax exemption and the increase in the business passthrough deduction while also extending the weakened alternative minimum tax. The measure also would revive a trio of business deductions and together all these tax policies account for over 60% of the measure’s overall $3.8 trillion estimate of lost revenue through 2025-2034.

The tax provisions in the reconciliation bill represent a massive giveaway to the richest Americans. Under the bill, in 2026, the bottom 20% of earners (annual income below $27,000) would receive only 1% of tax savings (about $140) while the top 1% of earners (annual income above $900,000) would receive 21% of the tax breaks, amounting to an average tax break of nearly $70,000. The fact that the wealthiest will get permanent tax cuts while families with the lowest incomes will have their taxes increase over time — and will lose access to basic needs programs — threatens the future of millions of kids.

In addition, although the CTC maximum is increased from $2,000 to $2,500, the reconciliation bill simultaneously leaves behind 20 million children whose parents make too little to qualify for the full CTC. It also disqualifies 4.5 million U.S. citizen babies and children because their parents don’t have a Social Security number. Millions of other children will be hurt by changes to the EITC. Despite an overwhelming body of literature documenting that expanding the CTC is one of the best ways to help families with rising costs, this bill sharply limits who can access the credit and how much of it they can claim. 

A more unequal CTC

This budget bill prevents 20 million of the nation’s poorest kids from receiving the full credit — 2.5 million more low-income kids than previously. Right now, 17 million kids — one-in-four — are excluded from the full $2,000 CTC because their family income is too low. Instead of righting this wrong, the reconciliation provisions would increase the maximum CTC from $2,000 to $2,500 but leave in place the inequitable cap on the credit’s refundable portion. Meanwhile, families earning up to $400,000 would qualify for a larger credit. This change will widen the gap between families who are well-off and those who are struggling to provide basic, everyday needs for their children.

Children who will be disproportionately “left behind” by this bill are: babies and toddlers; children in larger families; rural children; children of color; and children in single-parent households. The bill punishes babies and mothers who lose income with a reduced credit when mothers earnings decrease during pregnancy, childbirth, and postpartum, when a child and family are vicitms of a natural disaster, when a child loses a parent due to death, when a parent reduces work to provide caregiving, or when a parent loses a job. For children and families who need the CTC the most, they get the least.

The CTC proposal also strips eligibility from 4.5 million American children because they live in households with mixed immigration status.. The poverty rate among U.S. citizen children in mixed-status families is 31.5% — more than three times that of citizen children in households where all members are citizens. The 2017 Tax Cuts and Jobs Act (TCJA), passed during the first Trump Administration, began denying the CTC to 1 million kids who did not have Social Security numbers.. Under the proposed tax provisions currently being considered, an additional 4.5 million kids, who have social security numbers, are US citizens or lawful permanent residents, and live with a parent without a social security number, would lose access to the credit, forcing many low-income families into, or deeper into, poverty. 

Hurdles to the EITC

The reconciliation bill also erects hurdles to the EITC, which has a long history of bipartisan support and a proven track record of lifting up working families. Research shows that families mostly use the credit to pay for basic needs such as groceries, rent, clothing, and school supplies. In 2023, the EITC kept 4 million people out of poverty as the poverty rate for children jumped to nearly 10 million from 3.8 million in 2021. Evidence has shown that the credit also produces significant lifetime benefits, such as better education outcomes, improved health, and higher lifetime earnings and a more secure retirement. 

Barriers to credit for health care premiums 

The Advance Premium Tax Credit (APTC) is a refundable tax credit available to families purchasing health care through the Affordable Care Act’s health insurance Marketplace, helping lower their monthly premium costs. In 2024, consumers eligible for a tax credit experienced an average yearly premium savings of approximately $700 due to enhanced premium tax credits, yet lawmakers did not extend them in the bill. A record 93% of Marketplace enrollees, or 19.3 million people, receive APTCs. Failure to renew this enhanced tax credit will raise health care costs for many families with children.

Education

Lawmakers have included in the reconciliation bill a version of the “Educational Choice for Children Act,” which would create a federal private school voucher program. School vouchers hurt students and schools by diverting public funds to private schools, discriminating freely against students, and not improving academic outcomes. School voucher programs are disproportionately harmful for students with disabilities. Voters continue to oppose private school voucher schemes: Every time one has come up for a vote, Republican, Democratic, and Independent voters have soundly rejected them.

While legislators claim vouchers help kids, they actually just benefit the wealthy. The bill provides an opportunity to avoid capital gains taxes by allowing donations of “marketable securities.” This provision would allow individuals to donate their appreciated corporate stocks and avoid paying capital gains tax on the appreciation, while also receiving a federal tax credit for the full market value of the donation. According to the Institute on Taxation and Economic Policy, this provision could lead to a “120 percent match or more for upper-income families” and disproportionately benefit wealthy Americans, while decreasing funding in state and federal budgets. In addition to the lost capital gains revenue, this would spend $5 billion a year in taxpayer funds, totaling $20 billion over a four-year period.

Environment

The reconciliation bill would claw back up to $16 million in grants from the Inflation Reduction Act to reduce air pollution and monitor and improve indoor air quality in schools. This provision would disproportionately affect children and schools in low-income, disadvantaged, and tribal communities who routinely report higher instances of asthma, lead poisoning, and obesity. 

Children are uniquely vulnerable to pollutants as they breathe more air in relation to their body weight than adults. A mountain of evidence suggests that properly managing indoor air quality in schools leads to better academic performance and attendance, protects children from airborne illnesses like COVID-19, and makes school buildings last longer while saving money. Estimates show that 57 million people attend or work in schools across the country and the reconciliation bill would put the air they breathe at risk. 

The post How the House-Passed Budget Reconciliation Bill Would Negatively Impact Children appeared first on First Focus on Children.

Project 2025, the granular “playbook” assembled by the ultra-conservative Heritage Foundation for the next Republican administration, outlines a plan to gut environmental regulations and programs that currently protect underserved communities and, in particular, children. 

In its attack on the U.S. Environmental Protection Agency (EPA), Project 2025 would reduce restrictions on pollutants, eliminate environmental justice programs, and consequently ignore children. Many of the proposals would put business before science and suggest replacing senior scientists with business-savvy executives or members of Congress regardless of their scientific background.  

First Focus on Children has long advocated for environmental and climate policies that protect children and their right to a healthy future. Our goal is to advance environmental justice and ensure that children, whose developing brains and bodies are more susceptible to environmental contaminants, are appropriately accounted for in all decision making. Specifically, we have urged lawmakers to support legislation that protects children from pesticides and toxins, especially lead. We have supported laws and regulations that shield marginalized communities and invest in combatting climate change and its impact on children’s health.  

Project 2025 directly and specifically attacks EPA’s environmental justice mission and programs. For decades, industry giants have intentionally targeted low-income communities and communities of color — called “frontline” communities — for pollution and hazardous waste on the theory that their lack of resources would make them less likely to resist new power plants, landfills, waste dumping, and other hazards. Children in these communities routinely report higher instances of asthma, lead poisoning, and obesity, all health issues linked to environmental injustice. Project 2025 would gut the regulations and programs aimed at protecting these communities.  

Children are uniquely vulnerable to pollutants and therefore especially sensitive to environmental injustice. They drink more water, eat more food, and breathe more air in relation to their body weight than adults. They also routinely put their hands in their mouths and play outside, increasing their chances of exposure. The damage resulting from exposure to pollutants can also include neurodevelopmental issues and other complications that can follow them for a lifetime. 

EPA’s Environmental Justice programs aim to mitigate this damage by directing funds to frontline communities. Many of these programs provide grants directly to communities and non-profits working on the ground to clean up abandoned pollution sites (known as brownfields), reduce pollution in local waterways, cut back emissions and protect the air, land, and water in these communities.  

Specifically, Project 2025 would: 

Eliminate the Office of Environmental Justice and External Civil Rights (OEJECR)

Project 2025 makes destroying EPA’s Environmental Justice programs one of its top priorities. The Biden Administration created OEJECR in 2022 to advance environmental justice and enforce civil rights laws in communities that the agency historically has overlooked. The office has been instrumental in providing technical support and implementing the $3 billion in climate and environmental justice block grants provided by the Inflation Reduction Act, which have directly supported states, tribes, municipalities, and community-based organizations in their work to create healthier communities. The office also works to incorporate environmental justice into each sector of EPA’s work, ensuring that programs and rules specifically uplift and protect frontline communities. Eliminating this office means that EPA will struggle to meaningfully prioritize environmental justice. 

Eliminate the Office of Children’s Health Protection (OCHP)

Project 2025 would disband the stand-alone Office of Children’s Health Protection (OCHP) and redistribute its functions across the agency. OCHP specifically focuses on the impact that rules, policies, research, and enforcement have on children’s environmental health. This move would ensure that no single office is working to protect children, diluting — and likely dissolving altogether — the agency’s awareness of and focus on children’s health.  

Eliminating Race from Consideration in the programs that remain

Racial disparities, especially among children, are one of the key drivers of environmental health inequities. Communities of color have historically been targeted as areas for releasing pollution and waste, as companies knew that the government was less likely to protect them. After the Administration eliminates OEJECR, Project 2025 suggests that any environmental justice initiatives remaining in EPA’s other programs should not consider race when making decisions. The proposal cites the seemingly unrelated Students for Fair Admissions v. University of North Carolina Supreme Court case, decided earlier this year, as grounds for a race-neutral approach to distributing environmental justice funds. The Court found that UNC violated the 14th Amendment by considering race in their admissions process. Project 2025 now claims that considering race in the distribution of environmental justice funds could do the same. Yet, race has been one of the key determinants in environmental injustice. Failure to consider it when correcting these issues will only create deeper inequities for children of color.  

First Focus on Children remains dedicated to advancing environmental justice for all children. The environments our children learn, grow, and play in shape their health for a lifetime. An equity-based approach to tackling environmental and climate pollution is critical to ensure children who have been left behind for decades get a chance at a healthy and fulfilling life. The next administration can and should protect our children by protecting their land, air, and water.  

The post How Project 2025 would gut environmental protections and poison the nation’s children   appeared first on First Focus on Children.

An estimated 500,000 U.S. children under age 6 currently have dangerous blood lead levels (BLLs). While Flint — with its tinged tap water and aging infrastructure — is well-known as risk for lead exposure, the problem is far more widespread. One study found that between 2018-2020 56% of the U.S. population relied on water systems contaminated by lead. Black children and children in low-income households have higher levels of lead in their blood than their white and/or wealthier peers.

Lead exposure has severe health ramifications and can cause lifelong complications for children. Children drink more water per pound of body weight than adults, making them more susceptible to smaller levels of lead. Infants are perhaps most at risk of consuming lead in drinking water, as those who consume formula may receive up to 60% of their lead exposure via water (as compared to 20% for the average person). Children exposed to even low levels of lead may develop neurological and brain disorders, behavioral health issues, or may even succumb to comas or death. 

The Lead and Copper Rule Improvements mark a historic effort to identify and replace all lead pipes in the country in just 10 years. The recently finalized rule requires that all child care facilities and elementary schools be tested for lead in their drinking water, given that young children are especially at risk of the effects of lead exposure and are most likely to develop lifelong conditions as a result. Additionally, the rule will trigger enforcement at 10 parts per billion (ppb) instead of 15 ppb, resulting in government intervention and public notices at a lower lead threshold. While the American Academy of Pediatrics notes that there is no safe level of lead exposure for children this change will help more communities get the assistance they need. 

The process will be long and arduous but will have potentially lifesaving results for communities across the country, especially those that have been historically underserved and are more likely to rely on lead service pipes. The EPA estimates that the new rule has the potential to prevent 900,000 infants from being born underweight, prevent ADHD in 2,600 children, and reduce IQ loss in children by 200,000 points. The investments that this effort makes in lead pipes will not only benefit our national infrastructure, they will improve the physical, behavioral, and mental health of our children.

The post EPA Finalizes Rule to Eliminate Lead Pipes appeared first on First Focus on Children.

Images of Flint Michigan’s water are hard to forget. For months in 2016, residents drank from taps running gasoline-colored liquid and water bottles filled with murky sludge, but one contaminant grabbed the headlines: lead. Blood lead levels (BLLs) among Flint’s children doubled citywide and even tripled in certain neighborhoods just months after the crisis began. These children suffered from rashes, behavioral issues, and learning delays, which could potentially follow them for life.

As Flint pediatrician Dr. Mona Hanna-Attisha said, “Lead is one of the most damning things you can do to a child in their entire life-course trajectory.” However, America’s lead problem isn’t isolated to just one town. An estimated 500,000 children have dangerous levels of lead in their blood, which can lead to serious health complications. But, as in Michigan, contaminated water may be one of the most prominent sources.

Lead seeps into our drinking water via lead pipes, which corrode over time and release lead particles into passing water. These pipes are most prevalent in older homes and buildings, which often are occupied by low-income families or families of color, a situation that has created a decades-old disparity in BLLs. Across the country, Black children and children in low-income households have higher levels of lead in their blood than their white and/or wealthier peers. 

Aging school buildings often serve as a significant source of lead exposure for children. An estimated 400,000 schools and child care centers may have elevated levels of lead in their water. There’s currently no mandated lead testing for school buildings, and schools know that if they find lead, they have to fix it — so more than half just don’t test at all. Among schools that have tested,  more than one-third found elevated lead levels in their water. 

The health ramifications of lead exposure are severe and can cause lifelong complications. Children drink more water per pound of body weight than adults, making them more susceptible to smaller levels of lead. Additionally, lower blood levels of lead cause greater impacts on children than in fully-developed adults. Infants are perhaps at the most risk of consuming lead in drinking water, as those who consume formula may receive up to 60% of their lead exposure via water (as compared to 20% for the average person).

Children exposed to even low levels of lead may develop stomach aches, headaches, and digestive disruptions. They may experience slower development and neurological damage that can lead to clumsiness, drowsiness, and convulsions. Elevated BLLs are associated with attentional issues, decreased academic performance, and behavioral challenges. In the most severe case, it can lead to coma or death.

The ramifications of lead exposure follow children for a lifetime and severe lead poisoning may lead to lasting behavioral and intellectual disabilities. The academic challenges that they face may lead to poorer economic outcomes in adulthood. Research shows that children who were exposed to lead are more likely to have lower socioeconomic statuses than their parents in adulthood. On all fronts, lead exposure sets children up for failure.

So, how do we get the lead out? We can start by replacing our lead pipes. The Environmental Protection Agency recently proposed a rule that will require all community water systems to replace their lead pipes by 2037, starting with communities that have been disproportionately impacted by lead exposure. If finalized, the rule could eliminate one of the biggest sources of lead exposure for kids. Read our comment to learn more.

The Biden-Harris Administration provided $350 billion in the American Rescue Plan for schools and child care centers to replace lead piping. The Bipartisan Infrastructure Law also provides billions for states, tribes, and local governments to begin to update their water systems. It’s up to those governments to take up those funds and begin these projects to protect their children’s health.

The post Getting the Lead Out: Keeping Kids Safe from Lead Pipes appeared first on First Focus on Children.

Health Consequences of Heavy Metal Consumption

Long-term consumption of baby foods contaminated with heavy metals, such as arsenic, lead, and cadmium, may impair the health and development of infants. Exposure to arsenic may cause harm to children’s central nervous system and neurodevelopment; specifically, children may experience poor motor skills, impacted verbal capabilities, and weaker memory. Consumption of arsenic is linked to higher risk of bronchiectasis, impaired liver function, cognitive deficits, skin conditions, and skin cancer. Lead has also been linked to cognitive deficits, and a prospective study has shown that cognitive impairment due to lead may persist from childhood into adulthood. Lead exposure may also cause stunted growth, delayed development and puberty, and behavioral issues. Cadmium has been found to lead to lower IQ scores and higher prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD).

Contamination of Food Products

Heavy metals can contaminate food products at many steps of the food production process. Some heavy metals are introduced through fertilizers and insecticides, while other heavy metals occur naturally in soil and are absorbed by plants. Runoff from roads, factories, and dumping grounds can also pollute water sources used for crops. In addition to the agricultural process, heavy metals can be introduced into food products through fortified vitamins and minerals that are added during the manufacturing process.

Impact on Children

While heavy metals in food are also harmful to adults, babies, and children are especially vulnerable to these toxins. Due to their smaller body weight and size, a small dose of any toxin can harm an infant. The presence of toxic heavy metals in baby food thus puts them at high risk of experiencing health consequences. Babies and toddlers are also at higher risk of harm due to consumption of heavy metals because their metabolic pathways are still developing, meaning their ability to metabolize toxins is weaker than that of an adult. Babies are still developing their organ systems, too, making them more vulnerable to heavy metals which tend to accumulate in the body.

Recent Reports and Developments

The presence of heavy metals in baby foods is a persistent issue. In 2021, the House 

Subcommittee on Economic and Consumer Policy released two reports detailing the presence of harmful levels of toxic metals in baby foods sold by seven of the largest baby food producers in the United States.The first report found that some companies sold baby foods despite testing for high levels of heavy metals, only tested food ingredients and not final products, or did not test for certain heavy metals. The second report found that other baby food companies had poor monitoring regulations, did not follow their own testing standards, or did not announce a recall of certain products despite testing for high levels of heavy metals. Earlier this year, a test by Bloomberg Law found that all but one of 33 baby food products contained at least two of three heavy metals: lead, arsenic, and cadmium. 

In response to this problem, the Food and Drug Administration (FDA) has developed the “Closer to Zero: Reducing Childhood Exposure to Contaminants from Foods” program. This program aims to lower dietary exposure to toxins to the lowest amount possible through research and analysis, regulation, consultation, and proposed limits for heavy metals in some baby foods. These limits are not enforceable, but the FDA may use the limits and other factors as the basis for enforcement action in specific cases. The FDA has also released draft guidance with action levels for lead present in food and is planning to publish action levels for arsenic, cadmium, and mercury after further research. However, these action levels are not legally enforceable.

Policy Recommendations

To protect the health and well-being of the nation’s infants and babies, First Focus on Children urges the FDA:

• Set legally enforceable limits for heavy metals in baby foods. Enforcement of FDA limits will ensure that heavy metal contamination of food products is kept at lower levels.
• Require farms to conduct soil testing and to use contaminated fields only for crops that do not absorb metals: Soil testing and alternative usage of contaminated fields will reduce the production of crops with heavy metals. Crops that do not pick up heavy metals, such as beans, can be grown in contaminated fields, and thus reduce the amount of food with heavy metals available for commercial use and consumption.
• Require food companies to test their ingredients and products and to enact a recall if testing reveals that their products surpass FDA limits: Food companies can test crops for heavy metals, buy crops from regions with lower contamination levels, and test food products after they have been processed. More frequent testing at several steps of the food production process can help to reduce heavy metal concentration in baby foods. Requiring recalls will reduce the amount of contaminated baby foods available in the market.

 While the FDA has made progress toward limiting heavy metals in baby food, dangerous levels of toxic heavy metals continue to contaminate many popular baby food products. Policymakers must continue working to develop enforceable limits and stricter testing protocols to protect the health, well-being, and development of infants and young children.

Contact Information 

Authored by Kaitlin Vu. For general nutrition inquiries, contact Abbie Malloy, Director of Health, Environmental, and Nutrition Policy at abbiem@wordpressmu-1207585-4417844.cloudwaysapps.com.

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