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.

Finding appropriate placements for youths entering Ohio's child welfare system has become increasingly difficult.

Rachel Reedy, outreach and member engagement manager for the County Commissioners Association of Ohio, said the complex needs of children in the system, ranging from behavioral and mental health care to justice involvement, require specialized placements, which can drive up costs.

"Across the state, we have just heard more and more about the challenges in finding affordable, accessible and appropriate placements for our youths coming into our child welfare system," Reedy reported.

The challenges are compounded by rising costs, even as fewer children are entering care. County commissioners play a critical role in funding child welfare through a combination of federal, state and local dollars, including property tax levies in some areas.

A lack of trained professionals is another significant obstacle. Reedy elaborated on the capacity challenges within the system.

"We need workforce supports as well," Reedy urged. "When you do not have enough workforce in the system and facilities available, that leads to these capacity challenges, which, in a sense, drives up the cost."

She highlighted initiatives at the state level, such as efforts to encourage students to pursue careers in social work and human services. However, the solutions take time, underscoring the urgency for collaboration at all levels. Reedy added addressing the challenges requires a united effort from local communities, state leaders and lawmakers to ensure every child receives the care they need.


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In his 1963 "I Have a Dream" speech, Dr. Martin Luther King Jr. condemned the poverty hindering Black Americans' rights and decades later, a new report found children of color still bear the weight of poverty.

The analysis by the Economic Policy Institute showed in 2023, Black, Hispanic, American Indian and Alaska Native children were three times more likely than their white peers to live in poverty. In Missouri, there's a nearly 17% child poverty rate, just above the national average revealing risks to children's overall well-being.

Ismael Cid-Martinez, economist at the Economic Policy Institute and the report's co-author, said a major cause centers around employment disparities.

"Black workers are more likely than their non-Hispanic white peers to be unemployed," Cid-Martinez reported. "Then when they do obtain some form of employment in the labor market, they're likely to earn less than their peers."

The report also revealed Asian children are twice as likely as their white peers to live in poverty. Cid-Martinez stressed a key solution is implementing policies to ensure the social safety net effectively addresses the material needs of families.

According to the report, the expanded Child Tax Credit cut poverty for children of color by half from 2019 to 2021, lifting more than 700,000 Black children and 1 million Hispanic children out of poverty. However, the gains largely vanished when lawmakers did not extend the tax credit.

Cid-Martinez emphasized stronger unions in the labor market would help.

"Unions help ensure that working parents have jobs where they have the necessary benefits and the flexibility of hours that they need to provide care for children," Cid-Martinez noted.

Recent data showed Black Missourians face a 13.1% unemployment rate, nearly five times higher than white residents. Cid-Martinez added poverty figures reflect economic progress, highlighting King's dream of economic equality remains unfulfilled.


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New York legislation could help working families in the state cope with rising prices.

The Working Families Tax Credit would combine a patchwork of tax credits, the current Empire State Child Credit, the Earned Income Tax Credit and several others. The bill would also raise the maximum tax credit to $1,600 with a $100r minimum credit per child, regardless of family income.

Sen. Andrew Gounardes, D-Sunset Park, the bill's sponsor, said financing the credit will not cost much in the state's budget.

"There are a number of loopholes that exist in the state tax code we can look to close to pay for this," Gounardes pointed out. "But there's no reason why New York should continue to have three of the 'top 10 worst states for child poverty,' given the vast amounts of money we spend in our state every single year clearly are not achieving the results we need it to achieve."

He noted feedback on the bill has been positive from lawmakers and New Yorkers but it is the third time this proposal has been introduced. Gounardes explained competing budget priorities are the primary challenge to getting it passed and stressed he is confident.

The attempt to pass the measure comes as Gov. Kathy Hochul announced plans to expand the state's Child Tax Credit. Hers would raise the credit to $1,000 annually per child under age 4 and $500-dollars for children ages 4-16.

Gounardes supports Hochul's plan and said a Working Families Tax Credit would put even more money in families' pockets.

"Kids, even though it might be more expensive when they're younger, they don't stop needing things," Gounardes pointed out. "They don't stop needing school clothes, school supplies; they don't stop eating, they don't stop needing heat and a roof over their head. So, I think the governor's proposal is a great start to a conversation about what will it take to support families who are struggling the most."

A 2023 University of Washington report found almost two of five households in New York cannot afford basic needs and more than 2 million New York households struggle to get by solely on their earnings.


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