Kids, pregnant woman among those impacted by Rounds' budget

By Lynn Taylor Rick, Journal staff | Wednesday, December 03, 2008

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Health care coverage through current state programs will not be extended to an additional 2,000 children and 1,268 pregnant women as the governor clamps down on state spending.

It's a fact that has Betty Field alarmed.

"It's devastating. It's a blow to women and children," said Field, who runs the Volunteers of America Young Women Success Program in Rapid City.

Young Women Success assists pregnant women and young parents who are struggling. Getting adequate medical care is often a big part of that struggle.

"Medical care is always a huge issue," Field said. "We see it a lot. It's actually more common to work with some of these young women who have not had prenatal care than those who have."

Gov. Mike Rounds presented his budget Tuesday, offering a bleak look at the coming years and emphasizing a need to cut back. Rounds said that planned budget increases for Medical Assistance, a program for pregnant women, and the Children's Health Insurance Program, or CHIP, are two victims of the state's belt-tightening agenda.

Neither will get the increases expected; however, the programs will continue to cover the women and children they have in the past.

The Department of Social Services provides Medical Assistance to pregnant women who meet specific guidelines.

Very low-income pregnant women qualify for full medical coverage, but women whose family income is at or below 133 percent of the federal poverty guideline qualify only for pregnancy-related services.

The income guideline to quality for pregnancy services under Medical Assistance is $2,350 a month for a family of four, according to the state Department of Health.

The state initially intended to increase the guideline to 200 percent of the federal poverty level. The increase would have expanded care to 1,268 more pregnant women, at a cost of $2.3 million.

For South Dakota children, the state provides health insurance through CHIP. CHIP covers health care at little or no cost to uninsured kids whose family income is up to 200 percent of the federal poverty level. The income guideline for the CHIP program is $3,534 a month for a family of four.  

The state had planned to increase that to 250 percent, at a cost of $1.2 million. The increase would have provided medical insurance for an additional 2,000 South Dakota children younger than 18.

The stall in both health care coverage plans concerns those working in health care. 

"It's unfortunate, because for all kinds of reasons, ... I think that the state has an obligation to take care of pregnant women and their kids," Dr. Marvin Buehner, an obstetrician/gynecologist in Rapid City, said.

"We see women all the time who just don't have the funds to get health care," he said.

Dr. Amanda Diehl, a pediatrician with Community Health Center of the Black Hills, has the same concerns when it comes to children.

"It's always hard when we don't get funding for kids who need it," Diehl said.

Diehl said she often sees kids whose parents earn enough to disqualify them for programs such as CHIP but who don't make enough money to cover the costs of adequate health care for their children. The results are children who don't get adequate medical care. Occasionally, that means medical issues compound, eventually requiring treatment from health facilities that must then absorb all of the health care costs for an uninsured child.

"We just really need to take care of kids," she said.

Field agrees.

Although she understands the economic constraints the state is facing, she hopes that instead of completely eliminating the proposed increases, the state will only reduce them. It's a move she views as more economically sound, considering the potential expenses of critical care.

"Instead of a simple antibiotic, you're having a major systemic infection," she said. "Medical care gets more expensive the more you ignore it." 

Contact Lynn Taylor Rick at 394-8414 or lynn.taylorrick@rapidcityjournal.com.

Title: Gov. Rounds' budget address Date: December 2nd, 2008 Gov. Mike Rounds presented his proposed budget for 2010. Read who it will affect and how it will affect them. VIEW PRESENTATION »