Children’s Healthwatch Letter on Lift the Cap on Kids Massachusetts

Dear Senate President Spilka and Speaker Deleo,

Children’s HealthWatch commends the state Legislature for its efforts to repeal the Temporary Assistance for Families with Dependent Children (TAFDC) family cap. Children’s Healthwatch’s network of pediatricians, public health researchers, and child health policy experts seeks to improve the health and well-being of young children by informing policies that address and alleviate family economic hardships in cost-effective ways. We support the repeal because ending the cap will improve the health of the Commonwealth’s most vulnerable young children, significantly reduce healthcare costs, and save taxpayers substantial amounts of money.

Our research shows that maintaining the TAFDC family cap puts the health and development of thousands of the Commonwealth’s youngest children at risk by unnecessarily exposing them and their families to hardships that harm all their health. Children’s HealthWatch has found that families of infants, toddlers, and preschoolers subject to the TAFDC family cap reported higher rates of food insecurity. In addition, young children in families affected by the family cap rule were more likely to be in fair or poor health, and at risk for developmental delays and compromised school readiness when compared to those in TAFDC households not subject to the family cap[i]. Thus, our data indicates that repealing the family cap rule will reduce food insecurity and improve the health and development of many young children in Massachusetts,[ii] likely diminishing preventable costs to the state’s health care and educational systems.

We are grateful for the Legislature’s leadership in supporting Lifting the Cap on Kids and we will continue to show our support on this very important issue.



Megan Sandel MD, MPH

Co-Lead Principal Investigator, Children’s


Boston, MA


John Cook, PhD, MAEd

Principal Investigator, Children’s HealthWatch

Boston, MA


Deborah A. Frank, MD

Principal Investigator and Founder, Children’s HealthWatch

Boston, MA


Stephanie Ettinger de Cuba, MPH

Executive Director, Children’s HealthWatch

[i] Ettinger de Cuba S and Bovell-Ammon A. Why Pediatricians Urge TAFDC Family Cap Repeal. Children’s HealthWatch, 2017. Available at:

[ii] Poblacion A, Testimony: Before the Committee on Children, Families and Person with Disabilities. Children’s HealthWatch, 2017. Available at: