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Imagine developing a powerful medicine that could dramatically reduce human suffering, and then denying it to those who need it most.

Unfortunately, something like that could happen, with legislation now under consideration in Washington. The “medicine” is the expanded child tax credit that was passed as part of the American Rescue Plan and that went into effect in July and could expire at the end of the year, unless action is taken.

The child tax credit covers nearly all American children, including about 346,000 in West Virginia. And that’s a good thing. When the first installment of the refundable credit went out for the first time on July 15, the Census Bureau found that food insecurity in households with children immediately dropped by about 25%.

Probably the greatest thing about the child tax credit is its broad reach. By covering so many families, it could do for kids what Social Security did for elderly Americans. Before Social Security became a thing, poverty rates were high for older Americans. In 1969, for example, more than a third of older Americans experienced poverty. By the end of the century, the rate had dropped to less than 10%.

Without Social Security today, the poverty rate for the elderly would climb to nearly 40%, but it also makes life easier for millions of families living above the poverty line. That’s one reason why it’s so popular.

The child tax credit can do the same for our children. It has the potential not only to help working families but also to reduce child poverty by nearly half. However, that will happen only if it is extended and if it doesn’t exclude those families living in deepest poverty.

It’s kind of like the flip side of the old story about asking a bank robber why he robbed banks. He answered, “That’s where the money is.” If you want to reduce child poverty and the lifelong damage it can do, you need to go where the money isn’t.

Any measure that would impose income requirements to qualify for an extended child tax credit would undo its most beneficial effects by leaving out those with little or no income.

One population that could be hit hard by income and employment requirements is households with grandparents and other seniors raising children. According to the Census Bureau, in 2019 — before the COVID-19 recession — West Virginia was among the top five states where grandparents were responsible for taking care of children. We’re mostly talking about retirees, although anyone who has raised children knows that is work.

According to a news report from Clarksburg’s WBOY, “More than half of grandparents in West Virginia who live with their grandchildren who are 18 or younger are responsible for them, according to the 2019 U.S. Census numbers, making West Virginia the second in the nation for grandparents raising grandchildren.” The numbers have gone up since then.

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According to the West Virginia Department of Health and Human Resources, slightly over half of state children in foster care are in a formal or informal kinship/relative home, with much of the weight carried by seniors.

Another group that could miss out is people with disabilities or those who care for them, a group that overlaps to some degree with seniors. In 2019, about one in five West Virginians (nearly 350,000) had some type of disability. For people over age 65, the figure is about 40%. In 2017, 37% of working-age West Virginians with disabilities, i.e., those most likely to have children, lived in poverty.

Then there are parents and kids in domestic violence situations, which have been described as “intimate terrorism.” Among a host of bad things, this can keep people from meeting income and employment requirements for reasons of either power and control or personal and family safety.

According to Futures Without Violence, a national nonprofit advocacy group, “About one in four women experience intimate partner violence over their lifetime and reported some related impact.” Women between the ages of 18 and 24, prime childbearing years, suffer the highest rates of intimate partner violence.

The group also notes: “Increased financial security also gives survivors of domestic violence more options for safety for themselves and their children, such as living independently from an abusive partner.” Too often, people stay with abusive partners because they lack financial resources to support themselves and their children. Fully 74% of women in those situations reported staying in an abusive environment because they lacked financial resources according to a 2012 survey.

The Resource Center on Domestic Violence: Child Protection and Custody reports: “One researcher has estimated conservatively that at least 10 to 20% of children are exposed to intimate partner violence annually, with as many as one-third exposed at some point during childhood or adolescence.”

Nobody wins by denying benefits to people who are too terrorized to hold a job.

Aside from those situations, there also are people simply with very low incomes, those who have lost work because of the pandemic and seasonal workers in industries like tourism, one of our few growing economic sectors.

The beauty of the child tax credit is that it benefits a wide range of families with children. That needs to stay. But we shouldn’t leave anyone behind, especially those who would gain the most.

Rick Wilson works for the American Friends Service Committee and is a Gazette-Mail contributing columnist.

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