Tennessee, Delaware offer free diapers with Medicaid

Two states first to participate in effort backed by the feds.

NASHVILLE, TENN. — Tennessee will soon become the first state in the country to offer free diapers to families enrolled in the state’s Medicaid program after receiving federal approval, state officials have confirmed.

Similarly, the Centers for Medicare and Medicaid Services has also approved extending a pilot program in Delaware that provides free diapers and wipes to postpartum parents for the first three months after giving birth.

The recent approvals in both Delaware and Tennessee come as public health advocates say that families are increasingly struggling to afford enough diapers for their children — not only putting babies at risk of infection and rashes, but also forcing parents to miss work or school because they can’t afford enough diapers required at many child care centers.

On average, newborn babies can require eight to 10 diapers a day, or around 300 a month. Toddlers can use around 150 diapers a month.

“For infants and toddlers, a key benefit to adequate diaper supply is preventing diaper dermatitis, otherwise known as diaper rash, and urinary tract infections,” CMS wrote in its approval letter to Tennessee on May 17. “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.”

According to TennCare,

Tennessee’s Medicaid program, families can receive up to 100 diapers per month for children under 2 starting in August — available at TennCare pharmacies.

The request stemmed from an initiative backed by Republican Gov. Bill Lee in 2023 to support families. Lawmakers approved $30 million in TennCare funding for the diapers.

“Strong families are central to strong communities, and Tennessee is leading the nation in prioritizing resources for families in need,” Lee said Wednesday.

“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.”

In Delaware, individuals can receive up to 80 diapers and one pack of baby wipes per week in the first 12 weeks postpartum.

CMS agreed the state could use Medicaid funding to extend the program another five years.

“Access to sufficient diapers offers health benefits to the parent, as well, as diaper need is associated with maternal depression and stress,” said Martha Lodge, Delaware Health and Social Services spokesperson .

Along with the diaper benefit, CMS approved increasing TennCare’s income limit for parents to 100% of poverty.

Previously, Tennessee’s income eligibility was set at specific monthly amounts rather than being connected to the federal poverty level.

This has meant a parent in a household of three used to face an income limit of about $1,600 a month.

Under the new changes, the income limit jumps to about $2,000 a month. Tennessee’s new diaper benefit stands out as the state has gained attention for becoming increasingly willing to reject federal funding that offers valuable resources to families and struggling individuals.

Earlier this year, Tennessee confirmed that it would only participate for one year in a federal program that gives low-income families $40 per child per month to pay for food while school is out — choosing to opt out in 2025 because Lee’s administration argued that other food programs existed.

Public health advocates say they were stunned when the state announced in January that it was rebuffing roughly $9 million in federal funding designed to prevent and treat HIV.

Instead, health officials chose to fund the HIV-prevention program with state dollars. Doing so allowed Tennessee to bypass federal requirements and refuse to fund Planned Parenthood.

‘Strong families are central to strong communities, and Tennessee is leading the nation in prioritizing resources for families in need. 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.’

Gov. Bill Lee, Tennessee

ASSOCIATED PRESS