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Leading Children’s Health and Medical Groups Respond to South Carolina Waiver

12/12/2019 Work requirements are proven to be ineffective and can cause parents to lose coverage

Washington, DC—The American Academy of Pediatrics, Children's Defense Fund, First Focus on Children, Georgetown University Center for Children and Families, March of Dimes and the National Association of Pediatric Nurse Practitioners issue the following joint statement in response to the approval of South Carolina's Section 1115 waiver:

"Our organizations represent children, pregnant women, families, children's health care providers and advocates across the country, and we speak with one voice today in opposition to barriers preventing families from getting the health care coverage they need.

"With this approval, South Carolina becomes the first state in the nation to exclusively impose the harmful policy of work requirements on low-income parents with children.

"Medicaid work reporting requirements just don't work. The requirements are burdensome for individuals, do not lead to increases in employment, and instead cause people to lose their health insurance coverage. We are disheartened and alarmed that the Administration has once again approved a policy that has been proven to lead to fewer people getting the care they need.

"Right now, we are facing an alarming increase in the number of uninsured children across the country. Instead of working to address it, the Administration is allowing more barriers to coverage that will worsen this trend. Children are more likely to be covered when their parents are covered. South Carolina's waiver could help children and families by expanding Medicaid eligibility for low income parents. Unfortunately, at the same time it purports to help these families, South Carolina will impose work reporting requirements on these families, likely taking away the very coverage it has just promised.

"The approval of the South Carolina Medicaid waiver does nothing to help parents living in or near poverty to overcome the barriers they face in obtaining jobs, such as providing affordable, quality childcare and job training, but instead adds red tape burdens that will fall squarely on parents' shoulders. Children rely on healthy parents and caregivers to help them meet their health and developmental needs, and this waiver will make it harder for parents to be there for their children.  

"The bottom line is that the South Carolina waiver will harm children and their parents, which is why our organizations are speaking out against it. We urge the Administration to instead pursue policies that keep Medicaid strong." 


About the American Academy of Pediatrics

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds.

About the Children's Defense Fund

The Children's Defense Fund (CDF) is a 501(c)(3) nonprofit child advocacy organization that has worked relentlessly for more than 40 years to ensure a level playing field for all children. We provide a strong, effective and independent voice for all the children of America who cannot vote, lobby or speak for themselves. We pay particular attention to the needs of poor children, children of color and those with disabilities. CDF educates the nation about the needs of children and encourages preventive investments before they get sick, drop out of school, get into trouble or suffer family breakdown.

About First Focus on Children

First Focus on Children is a bipartisan advocacy organization dedicated to making children and families the priority in federal policy and budget decisions. First Focus on Children leads a comprehensive advocacy strategy, with its hands-on experience with federal policymaking and a commitment to seeking policy solutions.

About the Georgetown University Center for Children & Families
The Georgetown University Center for Children & Families (CCF), part of the Health Policy Institute at the McCourt School of Public Policy, is an independent, nonpartisan policy and research center with a mission to expand and improve high-quality, affordable health coverage. 

About March of Dimes

March of Dimes leads the fight for the health of all moms and babies. We support research, lead programs and provide education and advocacy so that every baby can have the best possible start. Building on a successful 80-year legacy of impact and innovation, we empower every mom and every family.

Visit or for more information. Visit for comfort and support. Find us on Facebook and follow us on Instagram and Twitter.

About the National Association of Pediatric Nurse Practitioners

The National Association of Pediatric Nurse Practitioners (NAPNAP) is the nation's only professional association for pediatric nurse practitioners (PNPs) and their fellow pediatric-focused advanced practice registered nurses (APRNs) who are dedicated to improving the quality of health care for infants, children, adolescents and young adults. Representing more than 9,000 healthcare practitioners with 19 special interest groups and 50 chapters, NAPNAP has been advocating for children's health since 1973 and was the first NP society in the U.S. Our mission is to empower pediatric-focused PNPs and their interprofessional partners to enhance child and family health through leadership, advocacy, professional practice, education and research.