A program on a mission to eliminate deep infant poverty by giving cash payments to pregnant moms and babies in Flint is expected to expand to cities across Michigan.
Rx Kids, regarded by officials as a first-of-its-kind initiative in the country, provides moms with $1,500 mid-pregnancy for essentials like food, prenatal care, cribs or other needs. Then, after birth, families get $500 a month for the first year of the infant's life, for $7,500 in total. The no-strings attached program, which does not have income restrictions for eligibility, launched in January.
Now, thanks to $20 million in a recently approved state budget, the program is tentatively slated to grow beyond Flint to five counties in the eastern Upper Peninsula, including Alger, Chippewa, Luce, Mackinac and Schoolcraft; the cities of Kalamazoo, Saginaw, Dearborn, Highland Park, River Rouge and parts of Detroit. The budget was sent to Gov. Gretchen Whitmer, who is expected to sign it, the Free Press reported last week.
If Rx Kids is able to raise the needed philanthropic dollars, programs could go live in other cities as early as January.
"Rx Kids is a prescription for health, hope and opportunity," said Dr. Mona Hanna, director of Rx Kids and associate dean of public health at the Michigan State University College of Human Medicine. Hanna, a pediatrician who spotted high lead levels among children in Flint and was among the key people to expose the water crisis, said she had wished for a "prescription" to take away poverty for her patients.
In Flint, where nearly 78% of children under 5 live in poverty, Rx Kids has so far distributed more than $2 million in cash to 828 families. About 60% of the families have an annual household income of less than $10,000, Hanna said. With the dollars in hand, families are able to pay their rent, utilities, food and diapers. They can put the money into savings.
"This is generational, historic work," she said.
Cash can alleviate poverty
There's evidence that cash benefits for children can lift them out of poverty.
Rx Kids co-director H. Luke Shaefer pointed to the pandemic-era expanded Child Tax Credit, which provided $250 to $300 per month for each eligible child. The payments reached more than 61 million children and nearly cut child poverty in half in 2021, compared with the year before, according to Columbia University's Center on Poverty and Social Policy. After the benefits ended, child poverty rose sharply in 2022. January of that year saw 3.7 million more kids in poverty compared with December 2021.
"For that brief, shining moment, we lifted millions of children out of poverty. We saw food hardship among families with children fall to the lowest level that we've ever recorded. We saw the credit scores of families hit their all-time high," Shaefer, who is a professor of public policy at the University of Michigan and director of the Poverty Solutions initiative, said. "And then we reversed course and weren't able to extend that past the one year and we saw child poverty spike — the highest one-year increase in history. We saw food hardship increase and just the financial security of families doing worse."
Shaefer said Rx Kids, a child cash benefits initiative, falls within the same family of programs as universal basic income, recurring cash payments that are not targeted, and guaranteed basic income, which provide no-strings-attached cash payments that are often geared toward people with the greatest needs. The latter two are largely untested, he said, but multiple countries have some type of child cash transfer program.
"Investments in children pay dividends over the long term. Also, families with children are often sort of the most economically vulnerable," Shaefer said.
Program to expand but needs philanthropic funds
Lawmakers approved $20 million in funding from the federal Temporary Assistance for Needy Families (TANF) program for Rx Kids.
The five-year Flint program relies on a combination of public dollars, including TANF, alongside philanthropic contributions, from funders like Charles Stewart Mott Foundation. The program is slated to expand to other parts of the state, but organizers need philanthropic matches to make it available to moms in those municipalities, regardless of their income.
"There's a private part that is necessary," Hanna said. "We will not launch this only for low-income people. It must be a universal program."
Dearborn, for instance, would get about $3 million in state TANF funding that could support the first four cash payments for lower income families. To extend to the full 12 months and to make it open for all moms and babies in a given area — like the Flint program — Rx Kids would need to raise another $9.5 million. An alternative option would be to make it a perinatal program — providing the first four payments for families regardless of income. The perinatal version of the program would require nearly $2 million for Dearborn.
In the case of Detroit, of the $20 million allocation, the city would get about $10 million in TANF, Hanna said, covering about 3,000 babies a year. To make it similar to the one in Flint, Rx Kids needs to raise an additional $32 million but $7 million to launch a perinatal program. For Detroit, Rx Kids will be looking at areas of greatest need, likely based on highest poverty rates by ZIP code. A spokesperson for the Detroit Health Department said it is not involved with the Rx Kids program at this time.
About 49% of children under the age of 5 in Detroit live below the poverty line, according to 2022 Census estimates. In River Rouge, the child poverty rate is nearly 68%.
In Wayne County, 52% of households in 2022 earned more than the federal poverty level but still struggled to make ends meet. In other words, they fall within the United Way's ALICE threshold, meaning they aren't technically living in poverty but don't earn enough to afford the basics where they reside.
Dr. Abdul El-Sayed, director of Wayne County’s Department of Health, Human, and Veterans Services, said the county is eager to make the program a reality.
"Stable housing or good healthy food or a safe living environment or transit opportunities — addressing those issues are critical to giving every child that best first start at their life," El-Sayed said. "And so, when you think about what it is that the government and philanthropy, even society, can do to make sure that everybody has an equal shot at a dignified life, it's making sure that, at that transition of life, that the resources that people need are available, and cash is the single best way to do that."
Ali Abazeed, founding director of the Dearborn Department of Public Health, said there's no better intervention than investing in the period before and after pregnancy. He pointed to how the birth of a child increases the risk of poverty, especially for first-time mothers.
"Giving people cash — especially when they're dealing with this thing that causes a spike in poverty, both before and after the birth of the child — that's redefining the social contract, that's redefining what we do for one another, that's redefining how we support one another and our residents," Abazeed said.
Abazeed said the city plans to allocate $1 million in federal funding to the program, and is talking to local and state partners for further investments.
"We have quite the lift ahead of us," he said, but is confident the program will launch for Dearborn residents.
Over on the southwest side of the state, the Kalamazoo Community Foundation has committed $500,000 so far and is pursuing local government and philanthropic funds for a full 12-month program. Exploring an Rx Kids initiative is among the top priorities for the Kalamazoo City Commission as part of the city's 2025 budget, but funding has not yet been determined, according to a spokesperson for the city of Kalamazoo.
"Rx Kids will ensure that our newborn residents are born into a thriving community, where their family's income level does not adversely impact their life's trajectory,” Grace Lubwama, CEO of the Kalamazoo Community Foundation, said in a statement.
Rx Kids is exploring what the program could look like outside of Michigan, too. Hanna said there is interest in both red and blue states that have unspent TANF dollars.
"We started this in Flint, but the intent was never to end in Flint," Hanna said.
Contact Nushrat Rahman: nrahman@freepress.com. Follow her on X: @NushratR.