Tag Archive: build back better

  1. Build Back Better: Improving Maternal & Infant Health Disparities 

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    President Joe Biden announced his Build Back Better Framework, a plan that introduces the most transformative investments in children and caregiving in generations. The Build Back Better Framework addresses climate change, expands affordable health care, and strengthens family economic security. December 7, 2021 marked the first-ever White House Maternal Day of Action.

    The United States of America has the highest maternal mortality rates in the developed world. Black women are more than three times as likely to die from pregnancy related complications than White women and Indigenous women are more than twice as likely, regardless of their income or education to die from pregnancy related complications. Pregnant women who reside in rural communities are approximately 60 percent more likely to die before, during, or following birth than women in urban communities.  

    According to data from the Virginia Office of Health Statistics, the rate of fetal death in Virginia in 2019 was 7.6 fetal deaths per every 1,000 live births, which is the lowest it has been since 2015. From 2016-2020, there were a total of 2,723 infant deaths in Virginia. The Center for Disease Control (CDC) estimates that the infant mortality rate in Virginia is 5.8 infant deaths per 1,000 live births. Despite lower numbers of fetal deaths, Virginia continues to struggle to decrease disparities for non-White women and infants.

    March of Dimes reported that from 2016-2018, the infant mortality rate for Black infants in Virginia was 9.5 per 1,000 live births as compared to White infants at 4.8 per 1,000 births. According to our Voices’ Racial Truth & Reconciliation Virginia equity impact statement, in 2018, Black women died two and a half times more often than White women. Additionally, non-White and non-Black women experience higher natural fetal death rates 1.5 times higher than their counterparts according to the Virginia Division of Health Statistics.

    Build Back Better (BBB) includes a historic investment of $3 billion dollars in maternal health. $175 million in funding is included in BBB to address social determinants of maternal health ranging from housing and nutrition to environmental conditions. Additionally, the Black Maternal Health Momnibus Act includes innovative payment models for non-clinical perinatal support, data collection and quality measure processes, and the investment in digital tools to improve outcomes.

    Once passed, the BBB Act’s policy investments could include:   

    Expanding Postpartum Medicaid Coverage: Currently, states are only required to provide 60 days postpartum coverage through their Medicaid programs, despite research that shows many deaths occur past the 60 days postpartum period. Build Back Better encourages states to pursue a path presented through the American Rescue Plan to provide 12 months of continuous postpartum coverage. If every state adopted the postpartum extension in BBB, the number of Americans gaining access to a full year postpartum coverage would double, extending coverage to approximately 720,000 people.

    Create a new designation of Birthing Friendly Hospital: The Center for Medicaid and Medicare Services plans to propose the “Birthing-Friendly” hospital designation, which would be awarded to hospitals that participate in collaborative programs to improve maternal outcomes and patient safety practices. This designation would be reflected on the “Care Compare” website so that consumers are able to choose the hospital with the most implemented best practices.

    Diversifying Perinatal Workforce: $295 million of funding in BBB is targeted to investing in a diverse perinatal workforce and better coordinated care. The funding proposed in Build Back Better would:

    • Provide over 92,000 perinatal nursing students with loans, scholarships, and programmatic support over a ten-year period.  
    • Additionally, it would provide approximately 30,000 doulas in training with loans, scholarships, and programmatic support over a ten-year period.  
    • Provide over 42,000+ individuals training in maternal mental health or substance use treatment with loans, scholarships, and programmatic support over a ten-year-period.

    Resources for Community-Based Organizations: Allows states to establish maternal health home to better coordinate health care for individuals before, during, and after birth. This also includes training to decrease biases. Build Back Better provides $75 million for community-based organizations working to promote maternal health equity.


    Each year, thousands of women are susceptible to the maternal health crises, which has worsened across two decades, even as rates improve among peer nations. The bill would make investments in improving racial disparities in maternal health outcomes through the investments in the Black Maternal Health Momnibus. Children need healthy parents and caregivers to thrive.

    We urge the Congress to swiftly act on BBB. Take action here to contact your representative and encourage them to support BBB.



  2. Building Back Better for Kids and Families- Update 11.5.21

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    As Congress is poised to act on the social infrastructure agenda known as Build Back Better, we wanted to give a better sense of the transformational impact this legislation will have on kids and families. The goal of Build Back Better is to address the inequities that existed before the pandemic and have been exacerbated by the pandemic. The policies are intentionally designed to target economically disadvantaged children, children of color, and women to provide the resources that have previously been unavailable or unaffordable. These policies will also deliver immediate relief to families by continuing the monthly Child Tax Credit payment for the lowest income families and improves conditions in the long-term by providing more equitable access to child care and prenatal care.

    UPDATE 11.5.21- House of Representatives Vote

    Today the House of Representatives will vote on the Bipartisan Infrastructure package and the Build Back Better Act. The Senate has already approved the Infrastructure bill so it will head to the President. The Senate has been given a deadline to approve Build Back Better before Thanksgiving and the contents could change to reach an agreement between the House and Senate. Particularly at risk in the Senate are the paid family leave provisions.    

    Our hope for Build Back Better was that it would provide the three things we heard from families throughout the pandemic that they needed most—child care assistance, flexible cash assistance through the Child Tax Credit, and paid family medical leave. House negotiations and incredible advocates have made it possible to put four weeks of paid family leave back into the bill. It will be critical to continue to speak up to ensure it stays in the Senate version.

    There are many provisions of the Build Back Better plan. Here are some key highlights for children and families:

    Extension of the enhanced Child Tax Credit for one year:

    The new framework keeps the higher payment amounts and fully refundable payments in place for another year. This will allow for the families who previously earned too little to qualify for the benefit to receive assistance and for “little DREAMers” to qualify.  This expansion will impact Black and Latinx children significantly as more than half of the children who were previously excluded for earning too little were children of color. The flexible cash assistance provided through the Child Tax Credit will continue to help families cover basic necessities like food and child care.

    Transformational investments to make child care and preschool more affordable and accessible:

    Congress’s $400 billion investment in child care and preschool will dramatically impact a system that is struggling to recover from the impact of the pandemic and help get mothers back into the workforce. The comprehensive proposal addresses the child care supply and affordability angle from all sides—it reduces parent costs to no more than 7% of income, provides resources to increase early educators compensation, and builds on a mixed-delivery system of public, private, and Head Start programs. With funding specifically for 3’s & 4’s in preschool, this significant investment provides an opportunity to improve the child care assistance policies around the needs of infants and toddlers.

    Child and maternal health improvements to address racial disparities:

    While Virginia lawmakers have already approved the extension of Medicaid eligibility for 12 months postpartum, Build Back Better makes this extension a requirement for states. It also includes all of the provision of the Black Maternal Health Momnibus package, which would support training and diversification of the perinatal workforce, maternal health quality improvements, better data systems to track and identify causes of maternal mortality, investments in historically Black colleges and universities to conduct research into maternal health disparities, and grants to support implicit bias training for frontline health care professionals.

    For children, the legislation would require Virginia to provide 12 months of continuous eligibility for Medicaid and FAMIS. Currently about 5% of children enrolled in Medicaid/FAMIS lose their coverage during the year. It also makes the federal funding for the Children’s Health Insurance Program (known as FAMIS in VA) permanent.

    Improvements to nutrition access will keep children from going hungry:

    Build Back better would provide better nutrition access to students by expanding the Summer EBT program allowing eligible families to receive additional assistance to purchase meals during the summer months or while schools are closed. The proposal also strengthens the Community Eligibility Provision that allows schools to opt in to provide free meals to the entire school enrollment.

    House version provides four weeks of paid family medical leave:

    Parents need paid family medical leave after the birth of their children, when kids are sick, to care for other families and to provide for their own health. The U.S. is alone among wealthy nations for not providing a paid family leave program. The House proposal would create a program to offer every worker access to a national paid family medical leave program. Creating a universal program will impact more parents of color working in jobs who currently do not offer paid leave. And importantly, it will give more new parents time off to care for their newborns and for mothers to recover from giving birth.

    More to come…

    While more details are forthcoming, the bill also includes investments in trauma-informed care peer support specialists. here are also provisions on immigration reform and affordable higher education that we are monitoring. It’s now up to Congress to act on or improve on this bill. Watch this space for more detailed information on the proposals. Stay tuned on our blog and sign up for emails to get the latest updates.