BILLINGS, Mont. -- The number of Montana children without health coverage has gone up by 25%, according to a new report which said the increase came during stronger economic times.

The findings from the Georgetown University Center for Children and Families cover a three-year period, from 2016 to 2019.

Montana had an estimated 15,000 uninsured children last year, compared to 12,000 in 2016.

Xanna Burg, KIDS COUNT coordinator for Montana, said because the data is pre-pandemic, they don't know how many more families have lost coverage.

But she added there's real concern the number is growing.

"We do know that families are struggling," Burg emphasized. "You know people are losing their jobs and with it, the health insurance that came with those jobs."

The report cites constant changes to the Affordable Care Act and more red tape in various states as possible factors for rate spikes.

Montana has accepted a Medicaid expansion in recent years, but there have also been efforts to attach a work requirement for eligibility.

Joan Alker, executive director of the Georgetown Center for Children and Families, said while there have been attempts to dismantle the Affordable Care Act, including funding cuts for outreach and enrollment, that doesn't mean states shouldn't be doing all they can to help families qualify for assistance programs.

"States do have enormous power here," Alker explained. "However, they can't entirely outrun the federal context. We're going to have to see a renewed commitment at all levels of government, federal and state, to turn this situation around."

Meanwhile, Burg said one of the glaring concerns in Montana is that nearly 22% of American Indian children don't have coverage. She cites chronic underfunding of the Indian Health Service (IHS) program.

"The IHS has been severely underfunded for a long time," Burg contended. "It receives only half the amount per-person that Medicaid receives. "

Statewide, Montana's rate of uninsured children was more than 6% in 2019, higher than the national average of 5.7%.

ALBUQUERQUE, N.M. - Pandemic fallout still has U.S. states clawing their way back to normalcy, and New Mexico believes its decision to provide more child care assistance will help families and the economy recover faster.

An expansion that basically doubles eligibility for child care financial assistance was announced by the governor last month. It sets aside about $320 million from the American Rescue Plan for child care assistance, and overhauls how day care and preschool providers are reimbursed.

Amber Wallin - deputy director with the group New Mexico Voices for Children - said it's a game-changer for the state's youngest children, and the workers who care for them.

"This is going to mean that about 20,000 more families will now see crucial relief in affording the enormous costs of high-quality child care," said Wallin.

As of July 1, families who earn up to 350% of the federal poverty level - that's about $93,000 a year for a family of four, up from $54,000 - are now eligible for child care aid.

Teachers and school staff in Albuquerque return to classrooms this Wednesday, with students set to begin classes the following Wednesday.

New Mexico's allocation of federal pandemic-relief money to help middle-class families pay for child care is the largest of any state in the nation, according to research by the Associated Press.

Wallin noted that families of color were especially hard-hit by school closures and other economic impacts from the pandemic and now, should have more peace of mind.

"They're able to better afford housing needs and ensure they can buy their kids back-to-school clothes," said Wallin. "But also it's helping them go back to work, afford necessities and helping our economy get back on track as well."

In November 2022, New Mexico voters will be asked to approve a constitutional amendment to increase withdrawals from the Land Grand Permanent Fund. Much of the revenue would fund childhood services, with the rest directed to K-12 public schools.

APPLETON, Wis. - The pandemic paused many facets of life, and a new report says wellness checkups for children were among them. With school resuming this fall, Wisconsin families are urged to get caught up on preventive care.

According to the Georgetown University Center for Children and Families, new findings suggest there was a 27% decline in the United States in pediatric office visits in 2020. Dr. Sharon Rink, an Appleton-based pediatrician at ThedaCare Physicians-Darboy, said now's the time for kids to reconnect with their family physician to ensure their growth and development wasn't hindered.

"With younger children, it's just to make sure that their speech is progressing, that their gross motor is progressing," she said. "With older teens, it's just a good time to regroup: 'How is your family doing?'"

She said those conversations can help kids rid themselves of unhealthy habits they may have developed, such as too much screen time. While health experts say there are rare cases in which standard immunizations aren't called for, they urge following up on missed shots that are required for most children as they grow.

The report said 11 million routine vaccinations were missed during the pandemic. Dr. Lee Beers, president of the American Academy of Pediatrics, noted the importance of staying on track.

"If too few people in a community are vaccinated against a particular disease, it means that we might see an outbreak of that disease; we've seen this before, with measles and with pertussis," she said. "And so it's so important to make sure that your child is vaccinated, not just to protect themselves, but also to protect everyone around them."

Rink said keeping kids healthy allows them to stay in the classroom, adding that they don't want to miss any more in-person learning, as so many did during COVID lockdowns.

"The devastation from the last year-and-a-half has been terrible in terms of mental health, physical health, academic progress," she said.

For families who avoided doctor visits out of safety concerns, Rink said offices still are carrying out protocols to prevent the spread of COVID. For those who have suffered financially because of the crisis, she recommended reaching out to county human service departments to learn more about resources for wellness visits.

HELENA, Mont. - A Montana campaign is renewing its efforts to help identify developmental delays in young children.

The Centers for Disease Control and Prevention's "Learn the Signs. Act Early" program is aimed at parents and people who work with children from birth to age 5. As part of that effort, Act Early Montana has launched a website to provide free resources to help folks recognize developmental disabilities.

Marcy Hanson, a registered nurse and the Montana Act Early ambassador, said most developmental delays or disorders aren't identified until kids reach school.

"What we know is early identification and intervention is really the best for overall health outcomes," she said. "So, the goal is to get these resources in parents' hands before they hit those early school-age years, so that we can get them the resources and the tools they need."

Because of COVID-19, she said, Montana Act Early has seen a dip in referral to services and wellness visits for children. With restrictions easing, the group hopes to ramp up services and outreach again. Hanson noted that one in four kids from birth to age 5 is at moderate or high risk for developmental, behavioral or social delays.

One in six children between ages 3 and 17 has a developmental disability that can affect how they play, learn, speak, act or move, according to the CDC. Hanson shared some of the milestones they look for in young children.

"Is your child meeting eye contact when you talk with them, when you interact with them? We also look for things like hearing, and feeding themselves, and walking and babbling and rolling over," she said, "all of those fun little milestones that kiddos progress through."

Hanson said the CDC provides a milestone tracker app that can be useful for parents and folks who work with young children, such as child care, education and health-care providers.