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.

Tens of thousands of children in Pennsylvania are still missing out on essential health care coverage, according to a new report.

The "State of Children's Health" report revealed Pennsylvania has the fifth-highest number of uninsured children in the nation.

Becky Ludwick, vice president of public policy at Pennsylvania Partnerships for Children, said factors like race, where you live and family income play big roles in whether children have health insurance. And while the number of uninsured kids has stayed relatively steady, a stable uninsured rate does not signal there has been progress.

"There's still a little over 5% of kids who don't have health insurance in the state of Pennsylvania," Ludwick pointed out. "What that translates into, in terms of the number of kids is, we are seeing that 147,000 Pennsylvania children do not have coverage."

In Pennsylvania, younger children are more likely to be uninsured than school-aged children. Ludwick added one possible solution is the Department of Human Services' recent federal approval of continuous Medicaid coverage for kids up to age 6.

Ludwick noted the Medicaid "unwinding" process, to re-qualify families for coverage after the pandemic public-health emergency officially ended, did not significantly increase the number of uninsured children in the state. But her organization initially worried about a greater disruption when renewals resumed.

"Fortunately, what the numbers yielded were that eight out of 10 kids that went through the Medicaid unwinding process were either able to keep their Medicaid coverage, or they were able to transfer coverage over to CHIP, or to plans through PENNIE," Ludwick outlined.

Ludwick added nearly half of Pennsylvania's children depend on Medicaid, the Children's Health Insurance Program or plans from PENNIE, the state's insurance marketplace, for their health insurance, emphasizing the critical importance of these programs not only to children but to parents and policymakers.

Whooping cough, or pertussis, is making a comeback and a Tennessee medical expert stressed the preventable, highly contagious bacterial infection requires urgent attention.

The Centers for Disease Control and Prevention reported, year-to-date, Tennessee has recorded more than 200 cases, while more than 25,000 cases have been reported nationwide.

Dr. Anthony Flores, professor of pediatrics and director of pediatric infectious diseases at Vanderbilt University Medical Center, said rising cases are largely due to vaccine hesitancy, and taking action now is essential to combat the serious illness.

"I think of our severe cases that we're seeing here in Tennessee, and nationwide as well, almost all of those severe hospitalized cases are in unvaccinated children," Flores explained. "I think the lower vaccination rate, kind of the periodicity with which we see whooping cough come back and surges, are contributing to the current numbers we're seeing."

Flores noted typical symptoms include a runny nose and low-grade fever, although fever is less prominent. The cough can develop and persist for weeks, becoming particularly bothersome in older children and adults. The name "whooping cough" comes from the severe coughing fits, which cause difficulty breathing, followed by a "whoop" sound as the afflicted person gasps for air.

Flores pointed out in newborns, especially before they begin receiving their initial vaccinations at 2, 4, and 6 months, their protection relies solely on the antibodies passed to them by the mother during pregnancy.

"In pregnant women, it's actually recommended that if they haven't received a booster, that they receive a booster in their third trimester, and that's again to pass on those antibodies to the newborn baby," Flores emphasized. "But then what can protect them from severe disease?"

Flores recommended children receive the whooping cough vaccine as part of their routine immunizations. He added as they grow, they get booster shots, and adults receive a different formulation called Tdap every 10 years to maintain immunity. He added it is important to follow a schedule to prevent waning immunity over time.


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CLARIFICATION: We updated language to clarify the timing for when the study's authors began tracking certain outcome measures for children within the foster care system. (9:30 a.m. CST, Nov. 22, 2024)

This Saturday is National Adoption Day and the latest findings showed Minnesota has made progress in helping kids in the foster care system secure a better future.

Aaron Sojourner, labor economist at the W.E. Upjohn Institute for Employment Research, helped lead a study of reforms Minnesota approved in 2015. He said states often provide financial support to children in foster care but support ends when a child is adopted or placed in a kin guardianship.

Minnesota decided to continue payments to households who take a child in permanently. Sojourner pointed out three years after foster cases started, positive outcomes became clear.

"The kids were scoring much higher on standardized achievement tests," Sojourner reported. "They were experiencing less turnover in schools and school instability."

He noted the incentives also boosted the chances of kids age 6 and older exiting the foster care system and moving into permanent home settings by 29%. Sojourner added while the results are encouraging, it is just one aspect of the child welfare landscape. Other research has shown racial disparities in Minnesota's foster care system, especially when looking at reducing entry rates.

Sojourner stressed if state lawmakers revisit the extended monthly payments in budget talks, they will need to realize the long-term payoff from these investments.

"The state is paying more money now but they're going to reap the benefits down the road," Sojourner contended. "In terms of increased earnings and employment."

His team's study said prolonged exposure to foster care is tied to poor transitions into adulthood, including homelessness.


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