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The Good, the Missing, and the Imperfect: 2023 Federal Spending Bill

(January 20, 2023) At the end of 2022, President Biden signed the fiscal year 2023 federal spending bill into law. This omnibus bill provides key appropriations to federal agencies and contains crucial provisions that support the education, health, and wellness of our nation’s most vulnerable children, youth, and families. However, there were also some notable compromises in this area that will require further advocacy and outreach.

Elements of the bill that support children’s health, nutrition, and wellness include:

  • $6 billion in funding for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), including an extension of enhanced fruit and vegetable (CVB) benefits through the end of the fiscal year.
  • The Pregnant Workers Fairness Act (PWFA) and the PUMP for Nursing Mothers Act, which cover gaps in labor accommodations for pregnant individuals and expand the right to private places to pump, respectively.
  • The option for states to participate in a permanent Summer EBT program, which provides summer grocery benefits for children in low-income families starting in summer of 2024. These benefits will provide eligible families with $40 per month during the summer to supplement the additional grocery cost the family incurs when school meals are not available.
  • Several “wins” for home visiting for pregnant people and parents of young children, including the reauthorization of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program through 2027. This includes an initial increase of $100 million and incremental increases eventually reaching a total of $500 million, and allows for virtual home visits beyond the unwinding of the public health emergency (PHE).
  • Funding and authorization for the CHIP program were extended by two years to 2029. In a key win for advocates, states are now required to provide children with 12 months of continuous eligibility when they enroll in Medicaid or CHIP. This flexibility was previously available to all children enrolled in CHIP, but only for children up to age 4 in Medicaid. Twelve months of continuous coverage provide the opportunity to increase preventive care and reduce gaps in other health care needs.
  • The option for states to provide 12 months of Medicaid postpartum coverage, which previously had a five-year expiration.

Some other key provisions were either left out completely or have complicating elements that could negatively impact children and families. The spending bill includes another temporary extension of the enhanced WIC CVB Benefits, which will expire at the end of the fiscal year with no further action. Also, Congress did not make virtual visits for WIC participants permanent in the bill, which creates a significant need for advocacy. WIC participants across the nation and Pennsylvania have expressed the great need for the flexibility that telehealth provides. As of now, this enhanced benefit could expire as early as mid-July 2023.

The permanent summer EBT program addresses food insecurity that school-age children experience in the summer. Unfortunately, to pay for this, the pandemic-related supplemental food assistance program will now end in February 2023, instead of alongside the PHE. This program provided eligible families with extra SNAP payments to account for increased grocery costs from pandemic-era economic conditions.

The bill also set in motion discussions related to the unwinding of the PHE, which will have a major impact on health supports. This will end continuous coverage for Medicaid that is tied directly to the PHE, which will require Medicaid recipients to reapply. This will likely cause millions of individuals to lose coverage due to paperwork or procedural barriers. The key to anticipating this challenge will be ensuring Medicaid and CHIP families update all contact information with their providers to allow seamless notification about re-enrollment in Medicaid. We will continue to seek opportunities to get this important message out to families as we approach March 2023.

In addition to children’s health and wellness, education programs were also highlighted in the Federal omnibus bill, including increases to career and technical education and Title 1 funding.

Many opportunities to elevate the needs of children come with these policy changes, especially as the legislative session moves forward. Allies for Children continue to explore ways to advocate strategically and make a positive impact for children in our region. If you have questions about the advocacy outlook at the federal and state levels, check out our Executive Director’s recent blog post.

Cristina Codario, Allies for Children Health Policy Director