1AM Medicaid Hearing Ahoy
Plus Child Welfare Wonk's big moves...
Welcome, Wonks!
Wonk on a Pod: In a week of continued Medicaid news, I hopped on The Imprint’s podcast with John Kelly to talk Medicaid’s role in child welfare policy.
Featured Child Welfare Wonk Partner:
ChildFocus connects people, programs and policy to support non-profits, philanthropy and government as unrelenting champions for children, youth and families.
First up, we’ve got huge Child Welfare Wonk updates.
Behind the Build: Big Moves from CWW
While we started as a one-man Substack, Child Welfare Wonk is not just a newsletter, and it’s not just Zach Laris. We’re growing into a full on policy intelligence platform.
This newsletter is the flier for what we’re building for you. We use data and strategic insights into policymaking to illuminate the real story under the topline story.
That means we don’t just explain what’s happening. We frame it with data and context to see what it means now. And we forecast what’s next, so you can think ahead.
We have two exciting developments about that growth, which show what we mean.
CWW Scoops Data GOAT
Child Welfare Wonk is thrilled to share that we’ve added Robin Ghertner as our Founding Director of Strategic Policy Intelligence.
Robin was most recently the Director of Data and Technical Analysis in HHS’ Office of the Assistant Secretary for Planning and Evaluation.
He brings 20 years of expertise in research, policy analysis, and direct service in social services, including child welfare.
His work is the forefront of public health and child welfare policy, digging into the opioid crisis, prevention services, how poverty affects neglect, disparities, and more.
He directed major federal investments improving child welfare data infrastructure, like the first multi-state data system linking child welfare and Medicaid records.1
And, he’s a renaissance man; an active dad of three whose music career may be the only thing to someday eclipse his data and policy legacy.
Robin’s Role at CWW: As Founding Director of Strategic Policy Intelligence, Robin is building the engine of our intelligence system.
He’s designing a comprehensive system that makes it easy to understand the past, interpret the present, and peer into the policy future.
No more downloading a file and doing a one-off analysis. We’ll have a comprehensive setup that ties many sets of data together, to run simple and seamless analyses.
Expect to start seeing more new and cool data visualizations, deeper analyses, and more. Founding partners get even deeper data and richer intel to drive their decisions.
New Voices Coming to CWW
We’re also excited to say we’re adding contributors, building a deep bench of phenomenal writers and experts in policy and policymaking.2
In the coming weeks we will be adding team members who are finding, analyzing, and writing about key issues you will want to know about.
Expect sharp new insights essential for your work, including new original analyses and provocative data-driven series that look behind trends to show you deeper meaning.
We’re not here to summarize the news, but to show you why it matters, what it means, and what comes next. Our growing team will take it to the next level.
Founder & President Zach Laris now spends more time leading strategic forecasting and deeper analysis. This team is what makes that possible.
Onward!
Policy News: 1AM Medicaid Hearing
At 1AM on May 21st (yep, you read that right, 1AM…) the U.S. House Rules Committee meets to consider the House reconciliation bill,3 which includes major Medicaid cuts.
Reminder on Reconciliation: Our reconciliation overview explains how this fast-track simple-majority legislative process works.
It matters for child welfare since it could include funding cuts and policy changes for:
Medicaid;
the Social Services Block Grant (SSBG); and
Temporary Assistance for Needy Families.
State of Play: We forecasted last week’s markups, which advanced after marathon hearings. The bill cuts and changes Medicaid, and leaves alone SSBG & TANF.
Then, late Friday, the bill failed a key test vote, leading to a weekend of negotiations.
Policy Latest: Last week’s votes left SSBG and TANF untouched, and kept the major cuts and changes to Medicaid, which include4:
Total Health Spending Cut of $714B (including Medicaid)
Work Verification & Cost Sharing
Limits State Financing Mechanisms
Cuts to Funds for States Over Immigrant Coverage
Turbulence Ahead?: Friday’s test vote failed because conservative Members argue the cuts to Medicaid and other programs are too small and should go bigger.
The markups succeeded because more moderate Members successfully blocked both far larger cuts and deeper structural changes to the program.
On May 18th, the House Budget Committee approved the bill by 17-16, with four Republican Members voting “present” instead of in support.
Power Play: Back to the Rules Committee. It matters because it is air traffic control for getting bills on the floor… and extracting concessions before they get there.
On the Rules Committee are Reps. Chip Roy (R-TX) and Ralph Norman (R-SC), key voices of the “go big or go home” school of Medicaid cuts and deficit reduction.
They were among those voting “present” and will have outsize influence on the bill’s shape before it gets to the House floor.
Balancing Act: The tensions remain the same throughout this exercise; concessions in either direction risk losing as many votes as they secure.
Each stage of this process has repackaged and punted on those tensions, rather than resolving them. Passing the House will be a big lift, and the Senate will be yet another.
This is nowhere near over. We’ll keep tracking the turbulence for you.
Policy Context: Debt Downgrade
Amidst all this budget reconciliation news, you may have heard that credit rating agency Moody’s downgraded U.S. debt. What’s that mean for child and family policy?
What Moody’s Does: Moody’s is a private credit rating agency. They look at the debt of companies and countries and rate how risky it is to buy.
What Happened: On May 16 Moody’s downgraded the U.S. credit rating, citing a decade of rising government debt that is increasingly interest payments.
What it Means: The U.S. government still has highly rated debt, but it’s one more sign that the finance world is looking askance at U.S. fiscal policy.
It also is not lost on policymakers that this came during reconciliation talks, as noted in critical statements like this one from Ways and Means Chair Jason Smith (R-MO).
Why it Matters: If you feel bored and like this doesn’t matter for you, stop scrolling.
Debt ratings drive borrowing costs for the U.S. government. Higher borrowing costs means more pressure on spending, and a greater likelihood of cuts later.
In addition, reductions in funds for states also risk downgrades of state debt. That too creates pressure on state budgets, which leads to tough choices and tradeoffs.
What to Watch: You don’t need a green eyeshade to see that Treasury and municipal bonds are indicators of how easy it is to spend public resources.
If we see borrowing costs rise, expect spending to tighten. That could lead to budget shortfalls and pressure on programs like Medicaid, child welfare, and income security.
Datapalooza: AFDASH
The Adoption and Foster Care Analysis and Reporting System (AFCARS) just upgraded to a data dashboard.
AFCARS provides insight into demographics and other important characteristics related to children who enter the child welfare system.
It has long been a series of annual PDF reports, alongside downloadable excel files.
What’s New: ACF issued the new FY2023 data as an interactive dashboard.
Why it Matters: It’s now much easier to look through AFCARS data by state, topic, or population. These are key data for policymaking and resource allocation decisions.
Thanks for reading, Wonks!
Which is now available from the National Data Archive on Child Abuse and Neglect.
Speaking of, if you’re interested in contributing, reach out to Zach@ChildWelfareWonk.com
That’s the updated bill heading to the Rules Committee. If you really want to Wonk Out, here’s the redline version that shows all the changes that it includes.
See last week’s edition for more breakdown on what these include and mean