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THE CASE FOR SPENDING WAY MORE ON BABIES  
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Annie Lowrey
February 14, 2024
The Atlantic
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_ Rx Kids has started sending $1,500 to every pregnant person in
Flint, Michigan, and $500 a month for their child’s first year. It
is a “prescription” against poverty, says pediatrician
Hanna-Attisha. It's something the whole country should do. _

Child tax credit, Investopedia / Joules Garcia

 

Holding her infant patients, Dr. Mona Hanna-Attisha felt a deep sense
of frustration. “I’m doing everything I’m supposed to do as a
pediatrician,” she told me, describing counseling her patients’
parents about vaccines, a healthy diet, safe sleeping, and car seats.
But Hanna-Attisha practices in Flint, the poorest city in Michigan and
one in which more than half of children grow up in poverty. That
poverty means her patients are more likely to miss milestones and fail
to thrive, and more likely to grow up to have heart disease
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or to experience psychological distress
[[link removed]]. She felt like she
was only ever applying a “Band-Aid,” she said. Poverty’s “a
really big problem. I can’t fix that.”

Except it turns out that she can. Over the past half decade, four
dozen cities have piloted cash-transfer programs, giving
no-strings-attached money to residents. Hanna-Attisha watched with
shock as Congress did basically the same thing, passing an enormous,
albeit temporary, child allowance as part of a pandemic-relief
package, giving large monthly grants to parents in the last six months
of 2021. She decided to set up a local version in Flint. Working with
Luke Shaefer, a professor of social work at the University of
Michigan, she created Rx Kids, which last month started sending $1,500
to every pregnant person in the city and $500 a month for their
child’s first year. It is a “prescription” against poverty,
Hanna-Attisha told me.

It is also something the whole country should do. There’s a strong
case that Congress should be spending way more money on kids.
There’s a really, really strong case that it should be handing out
cash to babies.

The case for showering new parents with financial support is
particularly relevant now. The Supreme Court, in striking down _Roe
v. Wade_, has increased the number of children born to financially
distressed families
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states with no or severely limited access to abortion have
done little to support new parents
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And Congress is debating whether and how to expand the child tax
credit. Legislation that has passed the House would lift roughly half
a million children above the poverty line
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the temporary child allowance
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more than 3 million of them out of poverty
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the bill is stalled in the Senate.

As a general point, the United States, despite being the richest
society Earth has ever known, tolerates astonishingly high rates of
child poverty. Kids are two or three times as likely to grow up in
poverty in the United States as they are in most of our rich-country
peers [[link removed]]. That is a
direct consequence of the United States spending such a small share of
its GDP on family benefits
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as public child care, home visits, and payments to new parents—a
smaller share than all other OECD countries except Turkey, Costa Rica,
and Mexico. The country is also an outlier in lacking a comprehensive
paid-family-leave program and child care for kids 5 and under.

Problems of poverty are acute in Flint, where the median income is
half the statewide average. So too are health disparities; less than a
decade ago, thousands of families were exposed to dangerously high
levels of lead in the public water system
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a crisis that Hanna-Attisha studied
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attention to. Lawrence Reynolds, the former president of Mott’s
Children’s Health Center in Flint, described poverty and health as
deeply intertwined. New parents in the city, he told me, are forever
asking themselves: “Shall I spend my money on gas to get to work or
go to the doctor’s office or get the kids to school? Do I take a day
off without pay, because I’m in a sector of the economy where paid
time off is limited or nonexistent? Do I get a week of formula if
I’m not breastfeeding? Do I have the dollars ready to cover that?
Can I go to my prenatal visits?”

Having cash on hand helps parents answer those questions, reducing
stress and lowering the chance of skipped meals, missed appointments,
and lost opportunities. Shaefer told me he also saw Rx Kids as “an
invitation” into the health system and the broader system of
benefits aimed at low-income parents, such as Medicaid, the
earned-income tax credit, and food stamps. “People show up for cash.
They don’t show up for other stuff,” he told me. Welfare programs
are punitive and stigmatizing; disability benefits can be too
difficult and confusing to use. Rx Kids is just cash with no
conditions, its funds coming from private donors, COVID-relief
allocations, and state TANF (Temporary Assistance for Needy Families)
money. The application is simple
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or income requirements.

The evidence on cash-for-kids programs is compelling. Poverty in
childhood is associated not just with poverty in adulthood, but with
worse health outcomes, reduced educational attainment, and a shorter
life span. As a result, transfers pay big dividends, sometimes huge
dividends, in improved health and bolstered incomes. The evidence on
cash-for-babies is even more compelling
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“Poverty peaks right at childbirth and persists for that first year
of life,” Hanna-Attisha told me, because the majority of new parents
with no or little paid leave
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to reduce their work hours or drop out of the labor force. “That
most economically vulnerable time is the most neurodevelopmentally
important time,” she said, as a child’s brain doubles in size in
the first year of life.

The hope is that Rx Kids will improve “maternal morbidity and
mortality, prematurity, low birthweight, breastfeeding initiation, and
NICU admission,” Hanna-Attisha told me. But it will likely have
benefits far beyond that. And it should be implemented far beyond
Flint. Already, Michigan is pushing to make Rx Kids a universal
program across the state, first by expanding it to six additional
cities, including Detroit. “We will lower costs for new moms and
ensure they and their babies can make it in Michigan,” Governor
Gretchen Whitmer said in a statement. Legislators in Washington should
do something similar.

_Annie Lowrey [[link removed]] is a
staff writer at The Atlantic._

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* Child Tax Credit
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* Mona Hanna-Attisha
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* Flint
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* children
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