A new anti-poverty program in Flint, Michigan, gives cash to new moms

When Alana Turner’s son, Ace, was a baby, she had to boil bottled water to give him a warm bath — the water from the tap was contaminated with lead. But more difficult, she recalls, was having to go back to work five weeks after giving birth.
“I just had to go back so quickly, and I always regret doing that, even though I had to,” Turner said. “It’s traumatic not only to you, but to the baby as well. And I was breastfeeding. So to be away from a newborn that you’re breastfeeding at five weeks old, it’s stressful.”
Four years later, and now expecting her second child, Turner is one of the people who will benefit from Rx Kids, a new program in Flint, Michigan, that “prescribes” cash payments to every pregnant person (or guardian) and infant in the city. The program gives a one-time $1,500 payment after 20 weeks of pregnancy, and $500 a month during the infant’s first year.
Alana Turner with her son, Ace, and fiancé Orlando Brown at Rx Kids’ January open enrollment event in Flint, Michigan. Photo by Douglas Pike/Rx Kids
There are no income requirements or restrictions on how participants spend the money. The goal of the program is to improve infant and maternal health outcomes and economic stability for the city’s youngest residents and their families.
Enrollment began Jan. 10, and the program hosted a big community launch party Feb. 14.
The program is a public-private partnership, funded in part by the state of Michigan through a novel use of the federal Temporary Assistance for Needy Families (TANF) grant, along with major support from the Charles Stewart Mott Foundation. It also involves a research partnership with Michigan State University, the University of Michigan, and Hurley Children’s Hospital. Other supporters include foundations, community organizations, city government, health insurance companies, and individual donors. More than $43 million has been raised so far, enough to run the program for at least three years. The goal is to raise $55 million to fund the program for five years.
Gov. Gretchen Whitmer also included $24 million in her budget proposal for fiscal year 2025 to expand a version of this program to several other cities across Michigan, on a slightly smaller scale — $1,500 before the birth of a child, and $500 a month for the first three months of life.
The program is “about a new vision of how we fundamentally should be caring for each other,” said Dr. Mona Hanna-Attisha, one of the program’s co-directors.
Dr. Mona Hanna-Attisha with baby Khim’Meir Taylor at Rx Kids’ Jan. 10 open enrollment celebration in Flint, Michigan. Photo by Douglas Pike/Rx Kids
About 1,200 children are born in the city of Flint every year. Almost 70 percent of Flint children grow up in poverty, five times the U.S. average, according to the University of Michigan Center for Poverty Solutions. Flint is one of the poorest places in the country, with a median household income of $35,451.
This city of about 80,000 people was once a vibrant automobile manufacturing center; General Motors was founded here in 1908. After years of deindustrialization, disinvestment, and “white flight,” Flint is better known today for the lead found in the city’s water supply in 2014, after an emergency financial manager appointed by then-Gov. Rick Snyder changed Flint’s water source without adding anticorrosive measures. Hanna-Attisha was one of the first people to sound the alarm on the issue.
Having a program for every child born in the city with no income requirements and with no strings attached is “sharing a message of trust in a city where there is no trust,” said Hanna-Attisha, the associate dean for public health at Michigan State University’s College of Human Medicine.
While there have been other cash assistance pilots and programs focused on maternal-infant health, including the Abundant Birth Project in California and the Bridge Project in New York, Hanna-Attisha said the new initiative in Flint stands out as the first universal citywide initiative, with the largest overall financial investment.
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The first year of a child’s life is generally when families struggle the most financially, Hanna-Attisha said, and it’s also critical for a child’s neurodevelopment.
“We do so much for our kids, especially since the water crisis,” she said. “But so much of it is Band-Aids. So much of it is after the fact.”
The opportunity, she added, is to start building a more steady foundation from the start.
While this kind of program is relatively new for the U.S., it is not new for other countries around the world. Many other countries have more paid parental leave, child benefits, and child cash allowances.
A recent review of nearly two dozen studies on cash transfer programs for families in Canada, published in the Canadian Journal of Public Health, found they can lead to healthier pregnancies, better birth weight, fewer premature births, more breastfeeding, better parental mental health, better food security, and better early cognitive development in infants.
“We have strong evidence that more resources when women are pregnant can lead to healthier births — meaning higher birthweight, better maternal health,” said Hilary Hoynes, professor of economics and public policy and director of the Berkeley Opportunity Lab at the University of California Berkeley.
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An analysis from the Institute for Women’s Policy Research said that cash transfer programs in the U.S. have increased significantly since 2018, and especially in the wake of the COVID-19 pandemic. Ninety guaranteed income programs were implemented between 2017 and early 2023, it found, across 30 states and the District of Columbia. At least half of these were focused on women or households with children, it noted, suggesting such programs “will touch the lives of many women across the U.S.”
“The U.S. spends less as a share of GDP on anti-poverty programs for families with children compared to other rich countries. That lower spending is consequential — we also have higher child poverty rates compared to other rich countries,” Hoynes said.
Most existing government social safety net programs in the U.S. respond in kind, like providing food and nutrition, or housing vouchers. Many are also conditional, for instance on jobs or work.
Hoynes’ own research on Supplemental Nutrition Assistance Program (SNAP) showed that legislative, media, and public attention on the program “is too focused on decisions of the mothers,” like whether assistance changes whether they work or how they shop, Hoynes said. Over the past 10 years, research has begun to shift from the behavior of the mother to how these programs affect the general well-being of the family in the short and long term. Recent research by Hoynes and others shows that more spending on SNAP in early childhood leads to improved education and labor market outcomes, reductions in contact with the criminal justice system, better health, and lower mortality.
“This shows that the social safety net is an investment in children with a return on investment,” Hoynes said. “These benefits need to be weighed against the costs of the program. For too long we have focused on costs and not enough on the benefits.”
The changes to the 2021 child tax credit during the COVID-19 pandemic expanded eligibility and increased the amount families could receive, but it also distributed benefits on a monthly basis, rather than in one lump sum. A 2022 University of Michigan study found that the 2021 expanded child tax credit decreased poverty and food insecurity, and helped reduce medical hardships and people’s inability to pay utility bills, and more. Evidence showed that people generally spent that money on things like food, rent, utilities, and enrichments for their children like school supplies and clothing. It did not affect people’s employment.
Research by UNICEF found that when countries adopt a family cash allowance policy, child poverty decreases dramatically. Universal cash benefits for children at 1 percent of GDP leads to a 20 percent decline in poverty across the entire population.
The expanded child tax credit was not renewed, and the child poverty rate more than doubled in 2022, a result of expiring programs and other pandemic-era initiatives, according to an analysis from the Center on Budget and Policy Priorities. The House of Representatives just passed an updated version for 2024, with bipartisan support.
Luke H. Shaefer (left to right), Dr. Mona Hanna-Attisha, and state Lieutenant Gov. Garlin Gilchrist celebrating the inclusion of Rx Kids funding in Gov. Gretchen Whitmer’s state budget that was signed into law last summer. Shaefer and Gilchrist hold up handprints from babies “endorsing” the Rx Kids program. Photo courtesy of Charles Stewart Mott Department of Public Health
“Rx Kids was in part inspired by the incredible success of the expanded child tax credit that brought child poverty to an all-time low,” said H. Luke Shaefer, professor of public policy and director of Poverty Solutions at the University of Michigan. “[It] showed what is possible. Rx Kids though adds important pieces, including by supporting pregnant moms in pregnancy, before a baby is born, and being immediately available to families upon the birth of a child when poverty spikes and so do expenses rather than the year following the birth of a child.”
Rx Kids also provides an opportunity to expand research on these types of programs, and on health more broadly, he said.
“We’ll look at the impact of Rx Kids on health care utilization, such as when pregnant moms start prenatal care and how often they go, health outcomes at birth, and health for moms and babies in the first year of life,” said Shaefer, a co-director of the program. “We also have a big look at impacts on child welfare involvement that peaks during the first year of life. We’ll be able to assess whether the program helps reduce out of home placements for neglect and abuse. We’ll also be able to look at questions about whether Rx Kids spurs civic participation through things like voting, and the impacts to the local economy.”
One month into the program, 300 families have enrolled and almost $400,000 in cash has been prescribed.
The idea has received broad support in Michigan from the local and national level.
“Investing in strong families is an investment in Flint’s future,” Flint Mayor Sheldon Neeley said in a statement. “Rx Kids will support mothers and children in Flint when they are most vulnerable. This blessing will lift families out of poverty and improve health outcomes.”
Critics of guaranteed income or cash assistance programs have often argued that they do little to incentivize work or other requirements that may help improve economic stability. Hanna-Attisha said the limited nature of this program — ending at 12 months of age — has alleviated some arguments about work and lifestyle choices.
Republican state Sen. Jim Runestad voted against the 2024 budget last year, which included Rx Kids. He told Bridge Michigan last summer that cash handouts without restrictions are “emotional programs” that “create dependence on the government” and that “to just willy-nilly hand checks out is irresponsible to the nth degree.”
Part of what makes Flint an ideal place for Rx Kids is that Flint is a small big city that already has a community-partnered academic infrastructure.
“Everything that we do in Flint is hand in hand with community,” said Hanna-Attisha, who is the founding director of the Pediatric Public Health Initiative, a Michigan State University and Hurley Children’s Hospital partnership. “We built this public health program here in Flint. And it was built in partnership with community. We asked the community, ‘What do you want us to work on?’” Rx Kids has a parents group, a kids group, and a new moms’ group.
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She added that the city has a “track record of transforming practice into policy.” Many of the changes that occurred after the Flint water crisis have also been implemented elsewhere across the country — lead pipes have been replaced, EPA lead and copper rules have been tightened, and a nutrition prescription program inspired a U.S. farm bill.
“There’s a lot of things that we have done here that have gone on to help kids in communities across the nation,” she said. “I want to do this for every kid in the country.”
Whitmer’s budget proposal for fiscal year 2025 would launch several more cash assistance programs like Rx Kids in cities across the state. The prenatal and infant support program would give pregnant people $1,500 before the child’s birth and then $500 for the first three months of the newborn’s life. The money can be used to buy food, toys, diapers, and anything else needed to care for the newborn. If approved by the state legislature, these new programs could potentially be ready to implement in the next fiscal year.
“In Michigan, we support new parents by having their back every step of the way,” Whitmer said in an emailed statement to the NewsHour. “By expanding the program to [several] more cities across the state, we will lower costs for new moms and ensure they and their babies can ‘make it’ in Michigan.”
In Flint, Hanna-Attisha sees firsthand how much new mothers struggle. “I was in clinic the other day and a newborn missed their first appointment,” Hanna-Attisha said. “Staff called, and the mom had to go back to work at four days of age.” Another new mother went back to work before her newborn was eight days old.
Alana Turner speaks at a Rx Kids event on Jan. 10. Photo by Douglas Pike/Rx Kids
For Turner, things look different now than they did four years ago. The lead pipes to her home have been replaced, and she is now 31 weeks pregnant, with her second child due in April. She currently works two jobs — as a property manager and at a call center. Turner said she hopes that the extra support from Rx Kids will allow her to gradually return to first one position and then the other, “instead of just jumping full force back into two positions and a new baby [with a] little one at home already. Maybe take a little bit of the chaos out of all of that. So there’s some breathing room.”
With some of the financial burden lifted from her shoulders, Turner is looking forward to being able to “take time to nurture my baby and really, mentally and physically, be present for her.”
“How much this means to us never changes. Everyone is just so excited,” said Turner, who is also in the program’s moms’ group. “I was just thrilled to know that someone cared enough about our community here in Flint to even organize this and put this together. From the ground up. I think this is how moms should be supported everywhere.”
Editor’s note: Gov. Whitmer’s office first indicated the Rx Kids program would expand to seven more cities in Michigan and that was reflected in this report. The office reached out to correct their mistake. “Seven” has been revised to “several” in the text and in Gov. Whitmer’s quote.