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.
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Advocates for working families in New York say they want less talk and more action to improve child care in the state.
Gov. Kathy Hochul has proposed a child-care construction fund and a task force to address the issue - which advocates say will make a dent in the child-care shortage, but doesn't do enough.
Estimates show New Yorkers spend a grand total of $14 billion a year on child care, or about $22,000 per year, per child. High child-care costs also are cited as a major reason young families leave the state.
Rebecca Bailin, executive director of New Yorkers United for Childcare, said universal child care is possible if the state will fund plans to implement it.
"That child care would be free, easy to apply, nearby and accessible to all families," she said. "There's no reason, with a budget of $237 billion, she cannot start to implement universal public child care now."
Bailin said a lack of political will has been the biggest hurdle for universal public child care, since 74% of New Yorkers say they want it. Feedback from some state lawmakers is positive, although enacting a universal plan could cost $12 billion a year - 6% of the state's current budget.
A Cornell University poll found high child-care costs are one reason some people can't join the workforce, while other reasons are lack of accessible child care that keeps people from working.
Bailin said a universal public system could counteract these economic harms.
"It's a $10 to $13 return on investment for every dollar spent," she said. "Making New York an affordable place for families will help to stop the exodus of families, make it possible for us to grow our workforce and our tax base."
Although New York offers child-care programs, some families earn too much to qualify for them, or have issues with immigration status that keep parents from reaching out. Bailin said expanding New York's Child Tax Credit and Working Families Tax Credit could help the system, as well as investing in the child-care workforce.
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January is National Mentoring Month and in Minnesota, program leaders report waiting lists for kids to be matched up with an adult willing to spend some valuable time with them.
Calls are being renewed for volunteers. Community-based mentoring programs connect youths who do not have many role models in their lives with adults for a range of activities. It could include attending sporting events, museums, or doing arts and crafts together.
Jill Hinners, executive director of Mentor North in Duluth, said it is all about helping children develop new skills and confidence.
"We definitely see kids that are introverts, shy, anxious," Hinners explained. "Where maybe they just have a little bit of difficulty putting themselves out there to form a large network of friends."
She suggested a mentor might put them more at ease in making connections as they grow. Her group pointed to research showing mentored kids are 22% more likely to have felt a strong sense of belonging. Hinners noted even though Minnesota has a good track record for volunteer work, her office reports a waitlist of between 50 and 60 kids.
Other data show kids who have a mentor are 55% more likely to enroll in college and are 78% more likely to volunteer regularly. Hinners stressed the outcomes can be traced back to a sense of belonging.
"We want youths to feel that they are developing their voice," Hinners emphasized. "To be able to make themselves heard in their community and courageous enough to take leadership positions in their community."
Hinners pointed out even though they have a backlog, volunteer levels have rebounded from a pandemic dip. She added they are trying to be more accommodating in certain ways, including making sure kids with disabilities have a good experience.
Adults who want to become mentors are put through a screening process before they are matched with a youth who has similar interests.
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Nearly 9,000 families are on the wait list for the Oregon Employment Related Day Care program, and family advocates are calling on lawmakers to ramp up funding to meet the growing need. Child-care prices in Oregon can exceed college tuition and have outpaced growth in household incomes, according to research by Oregon State University.
Dana Hepper, director of policy and advocacy with the Children's Institute, said most families, even if they don't qualify for the ERDC, cannot afford child care.
"And most child-care providers do not make living wages. So we can't rely on just parents paying tuition to solve this child-care crisis," she insisted.
Hepper added that the state needs to spend at least $500-million more on the ERDC program this year. This would serve the families that are on the wait list, as well as those who have vouchers for the program but cannot find a child-care provider.
All but one county in Oregon is considered a child-care desert for infants and toddlers, according to Hepper. A child-care desert is defined as having only one licensed child-care slot for every three or more children. She added that there has been more funding for preschools, such as Head Start and Multnomah County's "Preschool For All" which has expanded access. But even if they are not deserts, Hepper added, every county in the state has a shortage of preschool care.
"I think there's a dearth of child-care because there's a lack of public investment in child-care. And the data bears that out," she continued.
Hepper highlights Gilliam County as the only Oregon county that is not a desert for infant child care because it has invested public funds. She added that the ERDC program alone will not solve the child-care crisis; the state also suffers from a shortage of child-care workers.
"We need strategies that support the workforce and invest in pathways to enter this workforce with the skills that you need," she concluded.
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