SIOUX FALLS, S.D. -- Despite a pre-pandemic period of economic stability, the number of South Dakota children lacking health coverage spiked between 2016 and 2019.

And amid the COVID-19 crisis, a new report raises concerns about the situation worsening.

The latest findings from the Georgetown University Center for Children and Families show South Dakota's rate of uninsured children skyrocketed by more than 60%, the largest increase in the nation.

Xanna Burg, KIDS COUNT coordinator for South Dakota, said because this 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 asserted. "You know people are losing their jobs and with it, the health insurance that came with those jobs. "

Prior to the increase, the rate of uninsured children in South Dakota had fallen to its lowest level.

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

The data comes as some groups call for a Medicaid expansion in South Dakota. Petitions will soon be circulated for a ballot question in 2022.

Joan Alker, executive director of the Georgetown Center for Children and Families, pointed to the Trump administration's efforts to dismantle the Affordable Care Act.

She said a key factor has been eliminating most of the funding for outreach and "navigators" to help people enroll.

"Families have been getting negative messages that coverage is going away at the same time that community-based resources to help them find public coverage have shrunk," Alker contended.

Burg said that's why a Medicaid expansion, and enhanced outreach from the state for initiatives like the Children's Health Insurance Program, might help stem the tide of children and families going without coverage.

"South Dakota should double down on outreach to families who are eligible but not enrolled in Medicaid or CHIP, particularly during the pandemic when we know more families are struggling," Burg urged.

The report's authors say states have a lot of power to help reverse the situation.

According to the Centers for Medicare and Medicaid Services, South Dakota hasn't adopted any of the targeted strategies designed to boost enrollment in Medicaid and the Children's Health Insurance Program.

During this week's presidential debate, Vice President Kamala Harris proposed reviving the Child Tax Credit, which was part of the American Rescue Plan Act.

Harris says she'd raise the credit to $6,000 for newborns, renewing focus on its impact for Ohio families. However, the U.S. Senate recently rejected House Resolution 7024, which aimed to expand the Child Tax Credit.

Analysts have said the proposal could have lifted 400,000 children out of poverty, including thousands in Ohio.

Lauren Reliford, public policy director for the Children's Defense Fund, cited a "lack of political will" as the main barrier to expanding the credit.

"But at this point, childhood poverty is a policy choice," she said. "The folks that have the power to do it know and have seen the evidence - and they haven't done it."

A Child Tax Credit expansion initially passed in the House with bipartisan support, including all but one Ohio representative. However, critics of the expansion have voiced concerns about the cost to taxpayers and potential misuse. These factors contributed to its rejection in the Senate, despite widespread support from family advocacy groups.

Reliford also pointed to the broader impacts of poverty on children and the long-term consequences of inaction.

"Poverty is a toxic stress," she said. "Children see their parents being stressed, and they take that on, too. And so, why are we allowing these children to grow up in spaces and places without the necessary resources they need?"

The Child Tax Credit has been credited with significantly reducing childhood poverty during the pandemic, but its future remains uncertain as the debate continues in Washington.

A national program to connect children and families with the outdoors is at risk of ending without help from Congress.

The Every Kid Outdoors program provides fourth graders and their families the opportunity to appreciate nature and wildlife without breaking the bank.

Julia Hurwit, Outdoors Alliance for Kids campaign manager for the Sierra Club, said the program encourages children to seek out an active and healthy outdoor lifestyle, leading to a sustained relationship with the natural world by offering a free, one-year pass.

"This includes things like national parks, national historical sites, national marine sanctuaries," Hurwit outlined. "This pass begins on September first every year for the current class of fourth graders and gives them access to those places."

This month and continuing through Oct. 5, the Outdoor Alliance for Kids is organizing a range of events and actions to spread awareness and advocate for Congress to pass the Every Kid Outdoors Reauthorization Act. It would secure $25 million in permanent funding and extend the program to fifth graders.

The Sierra Club believes the wellness of current and future generations, the economy and the health of communities and the planet depend on people having a personal, direct and lifelong relationship with nature.

Hurwit added it helps if kids are introduced to the great outdoors early in life.

"Every year, it's about 200,000 fourth graders who are able to access this pass," Hurwit pointed out. "You can get a voucher for free online, and then you turn it into a physical parks pass in certain locations across the country, including most national parks and federal lands."

She noted much of the Sierra Club's belief in the importance of the Outdoor Alliance program is based on studies.

"When a kid goes to a national park or goes to public lands for the first time with their own family and with multi generations, it really encourages them to continue going because they're seeing someone they really look up to," Hurwit explained.

Iowa has released an interactive website to help parents find real-time child care options for their kids.

Iowa Child Care Connect, which the state has nicknamed "C3," uses crowdsourcing technology, helping people use up-to-the-minute data to find child care where and when they need it.

Sheila Hansen, senior policy advocate for the nonprofit Common Good Iowa, said C3 is a vast improvement over what the state had before.

"It was kind of clunky and it wasn't really very fast," Hansen recounted. "Hopefully this will be a vast improvement upon that and families will be able to just go in there and immediately find openings in their area."

The site also offers information on subsidies the providers accept along with current real-time openings and quality ratings. Hansen argued the state should focus on improving pay and working conditions for child care workers.

She acknowledged while the technology is a step forward, Common Good Iowa and other advocates said the state does not need more brick-and-mortar child care centers. It needs more staff, which has been the real challenge.

"That's because they're just unable to find the people who want to work in child care because the pay is so low or the benefits aren't there," Hansen explained.

The Iowa Department of Health and Human Services requires child care providers to complete various training requirements and update their certification every two years.


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