Set to make history, Tennessee will offer free diapers to Medicaid families, making it the first state in the US to do so. This effort, just approved by federal officials, is set to begin in August. Following closely, Delaware gained similar government approval to expand a trial program that provides free diapers and wipes to postpartum parents for the first three months after birth. These programs represent an important step toward addressing the growing public health challenge of diaper needs among low-income households.
Addressing diaper need: an emerging public health concern
Public health advocates have long emphasized the difficulties that low-income families confront in purchasing enough diapers. Inadequate diaper supply can pose serious health concerns to newborns, including diaper rash and urinary tract infections, and have far-reaching social and economic consequences for their parents. According to the Centers for Medicare and Medicaid Services (CMS), babies typically need eight to ten diapers per day, which equates to around 300 diapers each month. Toddlers, on the other hand, require approximately 150 diapers monthly.
“Diaper rash is one of the most common medical conditions for infants and toddlers, and changing diapers frequently is the mainstay of recommendations to prevent this condition,” CMS noted in their May 17 approval letter to Tennessee.
A transformative diaper program in Tennessee
TennCare, Tennessee’s Medicaid program, will soon provide families with up to 100 diapers each month for children under the age of two, available at TennCare pharmacies. This campaign is part of a larger effort to help needy families spearheaded by Republican Governor Bill Lee. Tennessee lawmakers agreed in 2023 to allocate $30 million in TennCare cash for the free diaper program.
“Strong families are central to strong communities, and Tennessee is leading the nation in prioritizing resources for families in need,” said Governor Lee. “We are the first state in the nation to cover the cost of diapers for mothers in the first two years of a child’s life, and we hope this is a model for others.”
Delaware’s pilot program extension
In Delaware, a similar program offers postpartum mothers up to 80 diapers and one box of baby wipes every week for the first twelve weeks following birth. With CMS approval, this pilot program will be extended for an additional five years. The Delaware Health and Social Services stressed the program’s dual benefits, stating that an adequate diaper supply not only minimizes newborn health issues but also reduces maternal stress and depression.
“Access to sufficient diapers offers health benefits to the parent, as well, as diaper need is associated with maternal depression and stress,” explained Martha Lodge, a spokesperson for the Delaware Health and Social Services.
Expanding access to Medicaid
Along with the diaper benefit, Tennessee obtained authority to raise TennCare’s income limit for parents to 100 percent of the federal poverty level. Previously, income eligibility was limited to certain monthly amounts. Under the revised standards, a parent in a three-person home can now earn up to $2,000 per month, up from $1,600. According to the Sycamore Institute, a Tennessee think tank, this adjustment provides Tennessee with the highest income eligibility for parents and caregivers of the ten states that have not significantly expanded Medicaid eligibility under the Affordable Care Act (ACA).
A contrast in federal funding decisions
Tennessee’s aggressive attitude on free diapers contrasts sharply with some of its other federal funding selections. Tennessee decided earlier this year to participate in a federal program that provides low-income families $40 per child per month for food during the school year for one year, intending to withdraw in 2025.
A model for the nation?
As Tennessee and Delaware implement these policies, they set a precedent that may encourage other states to explore similar steps. These initiatives focus not just on giving critical supplies to newborns, but also on improving the general well-being of families. States that address diaper demand can help reduce baby health issues, relieve parental stress, and promote stronger communities.
These initiatives emphasize the necessity of state-led efforts to address public health issues, as well as the possibility for innovative programs to enhance the lives of vulnerable communities. Policymakers and public health advocates around the country will surely be keeping a close eye on how these projects progress.
