Over 3 million in 9 states could lose health coverage
9 states could end health coverage if funding for Medicaid expansion cut
With Donald Trump’s return to the White House and Republicans taking full control of Congress in 2025, the Affordable Care Act’s Medicaid expansion is back on the chopping block.
More than 3 million adults in nine states would be at immediate risk of losing their health coverage should the GOP reduce the extra federal Medicaid funding that’s enabled states to widen eligibility, according to KFF, a health information nonprofit that includes KFF Health News, and the Georgetown University Center for Children and Families. That’s because the states have trigger laws that would swiftly end their Medicaid expansions if federal funding falls.
The states are Arizona, Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah, and Virginia.
The 2010 Affordable Care Act encouraged states to expand Medicaid programs to cover more low-income Americans who didn’t get health insurance through their jobs. Forty states and the District of Columbia agreed, extending health insurance since 2014 to an estimated 21 million people and helping drive the U.S. uninsured rate to record lows.
In exchange, the federal government pays 90% of the cost to cover the expanded population. That’s far higher than the federal match for other Medicaid beneficiaries, which averages about 57% nationwide.
Related: N.C. Medicaid Expansion nears 500,000 enrollees
North Carolina recently expanded its Medicaid program and, surprise, it’s really popular.
According to a news release from North Carolina Governor Roy Cooper’s office, three-fourths of those eligible for expansion now have coverage.
Rural counties are leading the charge to enrollment. Over 12 percent of the adults in Edgecombe, Swain, and Robeson counties have Medicaid coverage.
Government-owned broadband can have mixed results
State and local governments may want to think twice before establishing government-owned broadband networks, findings from a new report suggest.
In recent years, the U.S. has seen a “dramatic surge” of publicly owned broadband networks across communities, according to the Institute for Local Self-Reliance. Nearly 50 networks have been built by municipalities since 2021, with the total number of public networks reaching at least 447.
The increase in government-owned broadband networks comes as states continue to determine how to allocate $42.5 billion in federal funding from the Broadband Equity Access and Deployment, or BEAD, program. BEAD funding, approved by Congress in 2021, can be doled out to private and public broadband providers, but a report from the Information Technology and Innovation Foundation released earlier this week suggests governments may want to hold off on using BEAD money to deploy public networks.
Related: Even if properly served with internet service providers, municipal broadband can aid economic development
Like Wilson and Salisbury, NC, Bristol, VA, and Danville, VA, Lafayette is a smaller municipality. This is the size that generally seeks a municipal broadband service. Lafayette is different since it is not underserved by private Internet service providers. The only other private providers in the city are Cox and AT&T.
The presence of private providers creates a competitive situation. Unlike the case of municipalities that offer service to fill a telecommunication vacuum, LUS Fiber must compete with Cox and AT&T on price and service. Of course, the effect goes both ways: the private ISPs have to compete with LUS Fiber. Mitchell (2012) reported that Cox Communications had allowed service in Lafayette to languish while it invested more heavily in other areas but made major upgrades after the creation of LUS Fiber.
The presence of private competitors also increases the probability of legal challenges for municipal broadband. Cox and AT&T fought the government through the state legislature and courts. As noted above, the FCC’s ruling in favor of municipal broadband was overturned in federal court. At present the legal issue is a matter of state law and court interpretation. About 20 states have laws that deter municipal broadband networks (Ramos 2015).
N.C. voters furious to learn candidates want to disqualify them
Meredith Brooke Bass, 44, grew up with Jefferson Griffin. A year ahead of him in school, she was best friends with one of his first cousins. Today, they’re still personal Facebook friends. But Bass didn’t vote for Griffin for North Carolina Supreme Court; she opted for Democrat Allison Riggs instead. Now, she is one of thousands of names on a list of voters who Griffin alleges may not have been eligible to do so.
Carolina Public Press reached out to 75 people on the list of voters facing election protests in Granville, Mecklenburg, Vance and Wake counties for “incomplete voter registrations.” Nine responded and agreed to comment.
Some of them said they had no idea their qualifications to vote were being challenged until CPP called.
Why protests are challenging a list of voters
At the end of election night, Griffin was thousands of votes ahead. But during the pre-canvass period, when provisional ballots and later-arriving absentee ballots are counted, Riggs pulled ahead by a few hundred votes.
After a machine recount, Riggs remained ahead by 734 votes. Counties are now beginning a second hand-to-eye recount in a sample of precincts in each county upon Griffin’s request.
In the meantime, Griffin has filed several hundred election protests that question whether more than 60,000 ballots cast in the election were improperly counted.
A few other Republican candidates in close races have filed similar protests against a list of voters in each of their respective counties.
OPINION: Pardons aren’t issued often enough
In 2014, an executive pardon changed my life. Years earlier, I had served a prison sentence for a crime I committed as a young man making bad choices. I vividly remember the phone call with an aide to New York Gov. Andrew Cuomo. He said that as soon as our conversation ended, an email would arrive granting me clemency. I had paid my debt, and the governor’s pardon was a new shot at life.
Clemency is a powerful tool possessed by our government’s executive branch, one that has been used to address injustices throughout our country’s history. It can take the form of a commutation, which reduces a criminal sentence, or a pardon, which effectively relieves the collateral consequences of a criminal conviction.
President Joe Biden's pardon of his son Hunter has drawn bipartisan criticism as an example of favoritism and improper use of clemency powers, as also happened when Donald Trump pardoned his son-in-law's father and Bill Clinton pardoned his half-brother. Nevertheless, pardons applied conscientiously and fairly are an opportunity to right past wrongs and remove barriers to successful re-entry.
Governors are given clemency power to demonstrate leniency and acknowledge that past government actions may have been too heavy handed. In the Federalist Papers, Alexander Hamilton argued that clemency is a critical safeguard against a system capable of imposing excessive punishment.
State news compiled by MultiState
- California – Lawmakers returned to Sacramento to kick off the 2025-26 regular session on Monday, and to convene a special session on funding legal challenges to the incoming Trump Administration. After the swearing-in of new members, Gov. Gavin Newsom (D) wants the legislature to approve at least $25 million for the litigation efforts. California officials filed over 120 lawsuits against the first Trump Administration's immigration and environmental policies. Read more.
- Colorado – Secretary of State Jena Griswold (D) ordered a mandatory recount of votes in House District 16 on Tuesday, which could determine whether Democrats hold a supermajority in the House next year. Republican Rebecca Keltie leads incumbent Democratic Rep. Steph Vigil by just six votes, triggering a recount. Read more.
- Illinois – Despite strenuous objections from Republicans, House and Senate Democratic leaders confirmed last week that lawmakers will reconvene Jan. 2 for a week of lame duck session in the new year before the new, 2025-26 General Assembly convenes Jan. 8. The agenda has yet to be revealed for the lame duck, which Republicans insist should be reserved for emergencies. Read more.
- Maine – The legislature convenes its 2025 legislative session Wednesday with the swearing-in of new members, leadership elections, and the adoption of rules to guide the new session. Rep. Ryan Fecteau (D) is expected to be reinstalled as speaker after previously serving as speaker from 2021-22, and would like to change the rules to force committee meetings to start on time, which he thinks will reduce the number of session days. Read more.
- Michigan – Lawmakers return Tuesday for a lame-duck session with Democrats expected to address minimum wage and paid sick time before Republicans take over the House next session. The GOP won a 58-52 majority in the House in last month's elections, although the Senate, which was not up for election this year, remains in Democratic hands. Read more.
- Nebraska – Gov. Jim Pillen (R) released a preview Sunday of his legislative priorities for the 2025 session. To no one's surprise, property tax reductions remain one of his top goals after a weeks-long special session in August on the issue came up short of the 50% tax cut he was seeking. Pillen's priorities for the new session also include preventing transgender athletes from competing in women's sports, banning the sale of lab-grown meat, and changing the state's method of allocating electoral college votes. Read more.
- Oregon – Gov. Tina Kotek (D) called a special session for Dec. 12 in order to pay for the cost of fighting wildfires this year. The governor is asking lawmakers to appropriate $218 million to cover the emergency response tab for the 2024 wildfire season, which burned 1.9 million acres – more than three times the previous 10-year average. Read more.
- South Dakota – Gov. Kristi Noem (R) will give what is likely her final budget address Tuesday before she goes through confirmation hearings as President-elect Trump’s nominee for Homeland Security secretary. Declining sales tax revenue and increased expenses are expected to lead to a period of fiscal austerity in South Dakota beginning in 2025, marking a departure from recent years' expansion fueled by federal stimulus funds. Read more.
- Washington – Democrats re-elected Rep. Laurie Jinkins (D) last week to serve as House Speaker for her sixth session. Democrats picked up a district to hold 59 of the 98 seats. Republicans also re-elected Rep. Drew Stokesbary (R) to serve as Minority Leader. Read more.
Stakeholders push Texas legislature to bolster maternal health care system
Twenty five years ago, the Texas Legislature passed a sweeping set of reforms to resuscitate the state’s collapsing rural health care system.
Now, health care providers, advocates and local leaders are proposing similarly aggressive action to pull the rural maternity care system back from the brink. The Rural Texas Maternal Health Rescue Plan is a package of proposals they’re hoping lawmakers will champion in this upcoming session.
Almost half of all Texas counties offer no maternity care services, and more than a quarter of rural mothers live more than 30 minutes away from the nearest provider. Living in a “maternity care desert” contributes to delayed prenatal care, increased pregnancy complications and worse delivery outcomes. Women living in rural areas are more likely to die from pregnancy or childbirth-related causes, and infant mortality is also higher.
But despite these sobering statistics, more rural hospitals are closing their labor and delivery units, leaving patients to travel long distances or deliver in under-equipped emergency rooms. Most of those that do still deliver babies lose money in the process, due to low Medicaid payments and too few deliveries to break even on round-the-clock staffing.
“We’re reaching a tipping point where people are frequently more than an hour from routine prenatal care, and more than an hour from a delivering hospital when their water breaks,” said John Henderson, president of the Texas Organization of Rural and Community Hospitals. “There’s no way we’re going to get the kind of quality or outcomes we want as a state when that’s the reality.”
The Texas A&M Rural and Community Health Institute convened more than 40 groups, representing rural hospitals, health care providers, medical schools, advocacy groups and nonprofits, to create this rescue plan. They’ve identified steps the Legislature could take this session, including increasing Medicaid payment rates, incentivizing health care providers to work in rural areas and improving overall women’s health care access.
Comments ()