Diapers' cost can strain poor families' budgets; Tennessee becomes the first state to have Medicaid pay for them

Volunteers stack hundreds of diapers at the Nashville Diaper
Connection. (Photo by Mark Zalesk, The Tennessean)

Babies need plenty of naps and diapers. Naps are free, but diapers? Buying diapers at an average cost of $80 a month often stresses family budgets, but poor families in Tennessee may be getting some help. "Tennessee could soon be the first state in the nation to cover part of the cost of diapers for babies on the state's Medicaid program," reports Vivian Jones of The Tennessean. "With funding approved last month by the state legislature, TennCare is working to implement a benefit offering half of the diapers a baby needs for the first two years of life. The benefit is expected to be in place by January 2024. . . . Funding for the benefit comes from the $330 million in savings the state realized by restructuring how the state receives Medicaid funding from the federal government." (The impact won't be as great as it could be; Tennessee is one of the 10 states that has not expanded Medicaid to househols with incomes up to 138 percent of the federal poverty level.)

The need and expense of diapers are a shared pain for most parents. Danielle Cast, a single mom working two jobs, told Jones, "You need diapers all the time – you can't not have them. When you don't have them, and you need them, it's a heck of an emergency." Jones reports, "Casto is one of about 4,500 parents in Middle Tennessee served by the Nashville Diaper Connection – Tennessee's largest and oldest diaper bank." Despite help from such non-profits, more diapers are needed, Jones writes: "Unlike food, diapers are not targeted by any in-kind federal assistance program – no food stamps or WIC benefits cover them. About one in three families in Middle Tennessee struggle to provide the diapers their infants need. . . . Without enough diapers to keep a baby clean and dry, infants are at higher risk for diaper dermatitis and urinary tract infections. . . . Most daycare facilities require parents to provide a day's worth of diapers for their child – which poses a significant burden to families facing financial insecurity."

Casto told Jones that the new benefit "is going to be an extraordinary help. Lots of parents struggle with bills or their groceries – being able to have half your diapers already, it takes off half the burden, and it'll allow you to buy groceries that you might need, or gas that day, or medication for your children. . . . It's rough, especially the way that inflation has gone up recently – nobody planned for that. It's hard for parents to go and tell everyone how bad they're struggling – like, 'I don't have groceries' or 'I don't have diapers.' It's not something someone wants to brag about. It's uncomfortable, it's embarrassing – it's hard."

Doug Adair, founder of the Nashville Diaper Connection, told Jones, "It's a stupid, broken economic system: we want you to support your family, we want you to have a great job, and a solid career and go to school – but people really don't want to talk about diapers. . . . You can't buy diapers with food stamps. You can't buy diapers with WIC. You can't leave a day's worth of diapers [at daycare]? No daycare. No daycare? No work." Jones reports, "Adair said TennCare's new diaper benefit is something he's been hoping to see for a long time." Adair added, "It's essential. It's basic. It's empowering. It's a little burden off."