As South Dakota voters prepare to consider a proposed Medicaid expansion, emerging research suggests giving these programs a bigger reach can lead to reduced rates of child maltreatment.

Through a grant from the Centers for Disease Control and Prevention, the findings were compiled by researchers at the Moore Center for the Prevention of Child Sexual Abuse at Johns Hopkins University.

Elizabeth Letourneau, director of the Center, said they looked at data in states with expanded programs, compared with states without. She reported on average, they found a 13%-16 % reduction in child neglect rates in expansion states.

"And financial instability is perhaps the most serious risk factor for neglect of children," Letourneau explained. "And so, there's less medical debt, there's less trying to figure out, 'Do I buy this prescription medicine or do I put food on the table for my family?' "

She pointed out they also found positive trends in reducing physical abuse. The Center cautioned the trend was not as statistically significant, but noted there is evidence of hope. Under the Affordable Care Act, the federal government provides funding to help states expand their Medicaid programs. Twelve states have yet to do so. The question will appear on South Dakota ballots in the November election.

Letourneau added while there are a variety of prevention programs to help families on an individual basis, broader policies should not be overlooked in seeking solutions.

"If those policies happen to have the impact of driving down and preventing violence against children, you're just going to get a much, much bigger bang for your buck," Letourneau contended.

The federal government covers 90% of Medicaid expansion costs, and extra incentives were added during the pandemic. There is opposition from some Republican policymakers, who still give pause at having to find room in the state budget for the remaining share. Except for Wyoming, all the states bordering South Dakota have expanded Medicaid.

Groups working to fight hunger in Iowa say proposed cuts to SNAP benefits would fall squarely on the state's kids, who rely on them for food and other needs.

State lawmakers are considering a measure that would limit what items SNAP recipients could buy.

House File 970 would limit SNAP money to buying so-called "healthy" foods - grains, dairy, meat, eggs, fruits and vegetables, or other items considered necessary for good health.

Food Bank of Iowa's Senior Manager of Food Acquisition and Advocacy Emily Shearer said the change could have a dramatic effect on the one in six Iowa kids who face hunger.

"If there are cuts to SNAP, children will be impacted, seniors will be impacted, those with disabilities will be impacted," said Shearer. "So, the majority of people on SNAP that are able to work are working - it's just not enough to make ends meet."

Backers of the bill say they're guarding against abuse of the program.

If it is approved, the Iowa Department of Health and Human Services would have to request a waiver from the U.S. Department of Agriculture to override the current list of foods and beverages SNAP recipients can currently buy.

A 2016 USDA study found there are very few differences in the buying habits of families using SNAP and those who don't.

Shearer said it's been hard to counter the false claims that low-income Iowans have less healthy eating and buying habits, or that they use their SNAP benefits to buy unhealthy items.

"Nobody's buying tobacco and alcohol with their SNAP benefits. They're just not," Shearer insisted. "But with SNAP restrictions the way they're written currently, they're so vague - there's discussion that something like pasta sauce, or soup or jelly, are those going to be restricted? I don't think anyone would define those as 'junk food.'"

The USDA reports about 130,000 Iowans received SNAP benefits in 2024.

Each legislative session, Oregon's Joint Ways & Means Committee holds a statewide roadshow to hear from residents about their priorities. At the Salem stop April 16, supporters of the Food for All Oregonians bill are urging people to speak up. A coalition of over 180 organizations says bipartisan momentum is growing behind the bill, which would extend food benefits to all of the state's kids, regardless of their immigration status.

Ali King, a member of the Our Children Oregon coalition, said policy experts, parents, and other supporters of the bill have a clear message.

"We've all seen firsthand how our worsening hunger crisis impacts our children and state and it's unacceptable that one in six Oregon children don't have enough to eat," she declared.

King says Food for All Oregonians is one of the top priorities for her organization's 'Children's Agenda,' a package of legislation dedicated to improving the well-being of Oregon's children, youth, and families. The bill is currently in the Ways and Means committee.

A previous version of Food for All Oregonians would have extended food benefits to older adults as well as children. Opponents take issue with providing food benefits to people who are undocumented. King says, though the bill is linked to immigration status, it is not only about immigration.

"We can't allow Oregon's innocent children to become the collateral damage of partisan politics. It's really important that regardless of your views on immigration, we recognize that no one deserves to go hungry," she continued.

Food for All Oregonians would establish a new program in the Department of Human Services to provide food benefits to children up to 6 years old who would otherwise qualify for SNAP but for their immigration status. The estimated cost for this biennium is about $7.5 million. Coalition members say they will continue to work until all Oregonians have access to the food benefits they need.


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More than 7,500 Indiana children were removed from their homes last year because of abuse and neglect. According to The Indiana Youth Institute's 2024 Kids Count Data Book, that number represents a 26% increase from 2022.

Indiana's Child Abuse and Neglect Law includes persistent hunger and ongoing fatigue as symptoms of behavioral abuse.

Jeff Wittman, Prevent Child Abuse Indiana director, said child abuse resulting in bruises, broken bones and some lacerations may be easier to see than less obvious -- and potentially more serious -- forms of abuse.

"But the things that go unnoticed or harder to see are changes in behavior. So it's incumbent upon adults and those in roles of caregiving and authority and things like that, to be aware of children, to know them well enough where you can see changes in behaviors," he said.

Indiana's code lists additional signs of sexual abuse of minors as the child having sexual knowledge well beyond their age, imitating sexual behavior and a preoccupation with their bodies.

Wittman said the agency will occasionally receive calls from concerned citizens who have witnessed an incident or a child's actions and sense that something isn't quite right. He said people are familiar with the phrase 'when you see something, say something,' and are more proactive about picking up a phone and calling the agency. He said, as a society, "This is really where we need to be" to help an abused or neglected child."

"If we see situations that bring to mind or cause us to be concerned, where children might not be getting their basic needs met, or they seem to always be hungry and never have, enough food or maybe they are, crying all the time, or they're running away from their parents," he added.

Wittman explained that Indiana is a mandated reporting state, which means every adult at least 18 years of age has a legal obligation to report child abuse and neglect cases.

To report child abuse and neglect, call the hotline at 1-800-800-5556.