What Could Medicaid Expansion Mean to Your State?

If given the opportunity to save money and also help their residents be healthier, should state governments take it?

When the Supreme Court ruled on the Affordable Care Act earlier this summer, it decided that states could choose whether to expand their Medicaid program to more uninsured people. You might be curious how this choice could impact your state and community.

Medicaid is a partnership between individual states and the federal government to provide health care for uninsured people living in poverty. Costs are split between state and federal governments, depending on the income levels of the state. The average federal share of Medicaid cost is 57 percent. About 50 percent of Medicaid participants are children. Low-income elderly, people with disabilities, and pregnant women make up the rest.

Medicaid is especially important for rural communities for several reasons. Incomes in rural places are lower than urban counterparts, and fewer workers have employer-provided health insurance. We also have more elderly in our communities, many of whom need long-term care in nursing homes.

Did you know that right now, 40 percent of all costs for long-term care come from Medicaid? This will only grow in rural communities as our population ages.

There are a few important points to consider about the Medicaid expansion. One is that the federal government covers the vast majority of the cost increase. In fact, the first 3 years of the expansion is 100 percent covered at no cost to states.

Another point is that right now, states pay substantial costs because of uninsured patients. If you go to the doctor but can’t pay, state governments pay some of that cost. Taken together, states would spend an estimated $18 billion in the next 10 years on care that patients can’t pay if they don’t adopt the Medicaid expansion. Expanding Medicaid will reduce the number of uninsured patients by as many as 14.3 million by 2022. That saves us about $10 billion.

According to a recent report by the Kaiser Family Foundation, some states would actually save money by expanding Medicaid. Others could see their costs increase by up to 11 percent. About half the states would see Medicaid costs increase by less than 5 percent. Rural states, because of our aging population and lower incomes, could see substantial benefits.

Reducing the number of uninsured rural Americans is good for all of us. Expanding Medicaid is a good way to do this with a minimal cost to states.

You can find out more in our report, Medicaid and Rural America. Read more about What Could Medicaid Expansion Mean to Your State?

  • Rural Health

Time to “Get Real” with Washington

“It’s time for us to have an adult conversation with folks in rural America,” said Secretary of Agriculture Vilsack in a recent speech. “Rural America with a shrinking population is becoming less and less relevant to the politics of this country, and we had better recognize that, and we better begin to reverse it.”

The secretary made some valid points. But we think it goes both ways. It’s also time for rural folks to have an adult conversation with those who are supposed to represent them. The politics of Washington are also becoming less and less relevant to our real problems.

Secretary Vilsack is right in suggesting a proactive approach that attracts young people to rural America. He is right when he says the opposite approach—fighting an imaginary proposal to regulate farm dust—is a poor use of our energy.

We appreciate the secretary’s work to beef up support for organic farming, which expands opportunities for smaller farms. And we support his efforts for local foods, though the benefits are limited in the most rural parts of America far from metropolitan markets.

But in many respects the debate in Washington is missing the real issues in rural America. The big farm bill fight in Washington is over the exact form of farm payment. But the perfect program won’t help rural America if we don’t have family farmers left to use it. And as long as Washington continues to provide unlimited farm and crop insurance subsidies to the biggest farms, it will keep subsidizing mega farms to drive their neighbors out of business.>

That is the farm issue that matters most. It will shape farm life and farm communities for generations to come. President Obama won the pivotal 2008 Iowa caucuses in part by promising to cap mega farm subsidies. But the administration, like most elected officials, now rarely addresses the issue. Until we get that right, we’ll keep losing family farms and bleeding the lifeblood out of rural communities.

Our small towns are also fighting for their lives. There is real hope. There are promising entrepreneurial opportunities that work in small towns. As the secretary rightly stresses, broadband provides small rural enterprises new opportunities to sell to national and international markets.

But federal investments in rural business and community developing are shrinking – falling by half over the last decade (inflation adjusted). We have to invest in our future, if we are going to have a future.

But you rarely hear a peep about the issue in the farm bill debate. It’s time for the debate in Washington to get relevant to the challenges confronting rural people working to create a future in family farming and small communities. Read more about Time to “Get Real” with Washington

  • Farm Policy

Get Your Advocacy On!

A new year brings new opportunities, as well as challenges. At the Center for Rural Affairs, you know we’re dedicated to creating genuine opportunity for rural people and communities. By successfully engaging lots of you in the public policy decisions that impact your lives and your communities, the odds of success skyrocket.

Over the next several months, it’s especially critical for Nebraskans to engage in decisions being made in the legislature. There will likely be bold proposals introduced that we believe will harm rural Nebraskans and their communities.

October’s newsletter shared our perspective on a proposal to eliminate the state income tax and replace the revenue by abolishing an array of sales tax exemptions. It would impose heavy costs on most Nebraskans to benefit a small percentage of the richest people in the state. And it would immediately cut 56 percent of Nebraska’s general fund revenues. Another concern is an attempt to cut funding that helps create and strengthen small rural businesses.

Strong grassroots voices can sway the upcoming debates. So we’re planning a series of advocacy trainings across the state. We’ll engage new constituencies along the way by partnering with Nebraska’s Community Action Agencies. Through these trainings, participants will learn how to work with policymakers, build relationships and influence their thinking; work with the media to tell your story; and much more.

And we must also engage in upcoming federal policy debates. With a new Congress, newly elected members of the Senate and House of Representatives arrive in Washington. These men and women are ripe for relationship-building right out of the gate. It’s a perfect opportunity for you to influence their decision making.

Please let me know if you have any questions. I can’t wait to get started! Read more about Get Your Advocacy On!

  • Farm Policy

Your Opinion: Clean Energy and Rural America

Your thoughts are important to us. They shape our work, shape our positions, and tell us where we need to improve and what we need to do better.

Ultimately, we’re an organization that relies heavily on our supporters, the average citizens of rural America, to let us know where we can be most effective and where we can make the biggest difference. It’s this partnership that makes the Center for Rural Affairs the best organization it can be.

With this in mind, we asked each and every one of you to tell us how you feel about clean energy in rural America. We offered questions of varying length, covering a wide swath of issues important to those of us who reside in rural areas. While we focused primarily on climate change and clean energy transmission, each query gave responders ample latitude to touch on topics important to them.

The survey was open for one month, and results were submitted evenly over this period. Many of you responded with thoughtful, informed insight and provided better feedback than any of us could have expected. We were impressed with the results, and think you will be too.

Climate Change

Climate change is an important aspect of our energy work. Sometimes we address this indirectly, through work on renewable energy or opposition to the Keystone XL pipeline. Other times we take a more direct route, such as holding community workshops that explore the relationship between climate change and agriculture. As our energy focus expands, we wanted to know how you felt about this issue and how we can best engage in research and analysis most relevant to you.

The vast majority of responders, 76 percent, believe that climate change is occurring mostly because of human activity such as burning fossil fuels.

Fewer than 3 percent believe that climate change isn’t occurring at all. While 18 percent of respondents suggested that climate change can only be attributed to natural patterns, an overwhelming number of you left comments indicating that you would have chosen an answer that points to both human and natural causes, an option we did not offer.

Staying on that topic, we found out that 65 percent of you know “some” about climate change, and recognize that there is room to learn more. Over 30 percent of you consider yourselves as having advanced knowledge with respect to this topic.

Is climate change important to you personally? Just over 49 percent said it is “very important” to you. Over 39 percent say it’s “important” and 2.5 percent of responders say it’s “not at all” important. This tells us that climate change deserves more of our focus.

We then asked which factors are most important to you when considering climate change. We offered 11 options, but also provided space for each responder to add something that may not have been listed. Overwhelmingly, the impacts of climate change on agriculture were most important, with almost 73 percent of responders indicating that this is a significant consideration. Many of you also expressed concern with the impact of climate change on future generations.

What if nothing is done to combat climate change in the future? Almost 47 percent of responders feel this would be a serious problem for your community.

Clean Energy Transmission

We’ve spent a lot of time working on clean energy transmission during the past two years. Renewable energy development – and, consequently, opportunity for rural economic development – can’t go forward unless we find a way to move energy from where it can be cost effectively produced to where it’s needed most. As our advocacy moves forward, we wanted to make sure this issue is as important to you as it is to us.

We found responses to the first two questions reassuring. How much do you feel that you know about clean energy transmission? Almost 73 percent said that they know some, and there is room to learn. Exactly 19 percent of responders consider themselves advanced in this area.

When it comes to your attitude toward clean energy transmission, we didn’t know what to expect. We were pleased to find that over 54 percent of responders have a very favorable attitude, compared to only 1.8 percent of responders who aren’t supportive at all.

How important is clean energy transmission to the rural economy? Almost 47 percent of you recognize that it’s very important. This is something that we’ll try to focus on more.

Finally, what does clean energy transmission mean to you? Over 63 percent recognize that it opens up new areas to wind development. Almost 60 percent of you recognize that it provides jobs and economic activity.

As a staff, we appreciate your participation. Understanding your opinions and perspectives are important to us. Knowing where we can improve and what we’re doing right guides our approach as we work together for a better rural America. Read more about Your Opinion: Clean Energy and Rural America

  • Clean Energy

Study Finds Diversified Crop Rotations Profitable

Iowa State University research shows diversified crop rotations can be as profitable as corn-soybean rotations, while reducing the need for purchased farm inputs and addressing challenges presented to farmers by climate change.

Most climate researchers predict more extreme weather – droughts, downpours, and hot spells – presenting profound agronomic challenges. Farmers will need healthy soils that absorb heavy rain and hold it for dry periods, and cropping systems that reduce the risk of total crop failure.

Farmers will also be asked to reduce greenhouse gas levels by cutting fossil fuel and nitrogen use and capturing more carbon as soil organic matter.

The new research suggests diverse rotations could be helpful in meeting those challenges. It compared a two-year corn-soybean rotation; a three-year rotation of corn, soybean and small grain/red clover; and a four-year rotation of corn, soybean, small grain/alfalfa and alfalfa from 2003 to 2011.

The diverse rotations received clover and alfalfa residues and composted cattle manure, so 80 to 86 percent less synthetic nitrogen was applied. The diverse rotations also limited herbicide use to 15-inch bands on corn and soybean rows, while cultivating between rows.

The corn-soybean rotation required more than twice the fossil energy inputs, primarily due to increased herbicide and fertilizer usage. The diverse rotations had higher yields and declining weed pressure.

The research did not report on soil organic matter levels in three cropping systems. However, deep-rooted forages build soil organic matter deep in the soil where it is most stable. This contributes to long-term improvements in soil quality and reduces atmospheric carbon dioxide. Between rows, cultivation would have to be managed to minimize the breakdown of crop residues.

The three systems were close in profitability. In the language of scientists, there was no statistically significant difference. Of course, profitability of different rotations varies with fluctuation in prices for corn, soybeans, hay, fertilizer, seed, and herbicides.

For the diverse systems to be widely used, forage use would need to increase in beef production. But forage-based livestock production systems have come a long way with advancing research. Many top-end restaurants now feature forage-fed beef. Read more about Study Finds Diversified Crop Rotations Profitable

  • Farm PolicyFarm and Food

Across the Nation: Post Offices-Veterinarians-Plant Zones

Missouri Prepares for Reduced Post Office Hours: In south central Missouri the post office and people of rural Pomona prepared for reduced hours.

KBIA, Mid-Missouri Public Radio reported that a similar story has played out all around America as cuts by the US Postal Service go into effect. About 4,000 offices nationwide will reduce hours. The Pomona postmaster relief, Anna Carnefix, says, “Nothing is changing as far as what they can expect out of the post office other than the hours.”

The USPS wanted to close many of its rural offices at first. However, an upheaval from rural America and its Congressional representatives prompted a rethinking of that plan. It now has sent out surveys and held town halls to solicit feedback.

Some find the reduced hours inconvenient, but preferable to closings. KBIA says, “The USPS is giving these low-traffic communities four options: to keep their offices open with reduced hours, to close the offices but keep mail routes, to close the offices but use an alternative retail spot – like a grocery store, or to just close it and use another post office.”

Number of Rural Veterinarians Shrinks in North Dakota: A serious threat to the nation’s food supply and its quality is the shortage of food animal veterinarians.

The Grand Forks Herald explains food animal vets do much more than simply treating sick animals. Vets are “on the front lines for catching disease and stopping it from spreading to other animals — and people — and are vital to food safety.”

The Herald goes on to explain that this function is also an economic one. They write, “Healthier livestock means more money for farmers.”

North Dakota is much like the rest of the nation coping with a shortage of vets. The problem is more pronounced in the central and western areas of North Dakota.

A number of reasons are cited for this shortage of food animal vets, including a general downturn in rural populations, the tough working conditions of vets, school loan debt. Though North Dakota does not offer a veterinary medicine program, The Herald reports, “North Dakota is better off than about a dozen years ago.”

They go on to cite Jesse Vollmer, assistant state veterinarian, that this is due in part to state programs that support students who are admitted to out-of-state veterinary schools. Vollmer explained, these programs help people by offering incentives like loan forgiveness to return to North Dakota.

Plant Hardiness Zones Revised: Warming winter temperatures have already made the US Department of Agriculture’s new cold-weather planting guidelines obsolete.

That’s the conclusion of research from Dr. Nir Krakauer at The City College of New York. Krakauer developed a new way to map cold-weather zones that takes rap¬idly rising temperatures into account. USDA’s 2012 Plant Hardiness Zone Map had shifted boundaries northward. Yet the true zones moved even further, according to the researcher.

“Over one-third of the country has already shifted half-zones,” Professor Krakauer wrote in this summer’s Advances in Meteorology Journal, “and over one-fifth has shifted full zones.” Find his hardiness zone warming calculator here.
  • Small Towns

Wyatt Fraas Celebrates 20 Years

Wyatt is that rare individual whose impact goes both deep and broad. Working one-on-one with a beginning farmer or tackling how agriculture can mitigate climate change, he’s left an indelible imprint on the land and the people who manage it. Here he takes a look back at his 20 years and some of the changes he’s witnessed in his career at the Center.

What kind of changes have you seen in the last 20 years working with beginning farmers?

One positive change is the public interest in food, particularly artisanal, locally-produced, high-quality food – things that take a lot of labor and management skill, rather than mass-produced in great quantity. Beginners can put the time and labor into it, because that’s what they have. The public interest in those kinds of food has helped beginners get started in many places around the country.

On the other hand, it’s gotten harder for people to get into operations that focus on commodities. Prices for everything have gone up up up. Land prices have gone up so much that the risk of failure has increased tremendously. If someone is putting lots of money into seed and machinery and chemicals and land, the risk of a crop failure can throw them out of the business in just one season and keep them out for a long time.

How has your job changed in the last 20 years?

One thing that has developed is my understanding that there are people who’ve had ideas and experiences I need to learn from. There have been some periods when farmers have struck me with being extremely innovative. Part of my job became identifying those folks and bringing their message to other people. It amazed me what people were thinking of.

The same sort of thing applies with community development or food system work. Innovators out there have great lessons. So, my role has changed from me identifying what needs to be done to identifying who’ve got the great ideas and helping those ideas get spread around.

At what point did you know this was a career, rather than just a job?

Probably three years into my job at the Center, my major professor contacted me with what would’ve been a dream job, managing and advising on a ranch in Montana. I said, ‘That sounds interesting, but I’m not done here.’ I haven’t been able to say I’m done ever since. The challenges keep showing up and some of them keep growing.

When will you know when your work is done?

On the beginning farmer front, I think the ideal situation would be that communities recognize the value of young people running businesses and the farms and ranches – and established folks take pride in mentoring young folks and helping them get started.

When people are in the coffee shop now they complain about the state of the world, the state of young people, and they brag about fairly inconsequential things: calving rates, bushels per acre, or the market price they got. It would be an ideal situation when they brag about the young farmer they got started.

See the full interview with Wyatt here. Read more about Wyatt Fraas Celebrates 20 Years


Should Old Acquaintance Be Forgot

This month, we’re saying goodbye to one intern and hello to three new staff!

We’d first like to thank Matt Gunther, who has been working on health care in our Montana office. Matt will be moving back to Nebraska and pursuing graduate studies in sociology next fall.

Also, welcome to Ed Toribio, Erin Frank, and Bailey Mahlberg! Ed is a former board member, and will be working with Latino beginning farmers and also on energy issues. Erin will be working with Ed on the Latino beginning farmer project. Bailey will be working with our Farm to School program to connect farmers with school cafeterias.

Thank you Matt! Welcome Ed, Erin, and Bailey! Read more about Should Old Acquaintance Be Forgot


You Speak! “There Is Hope!”

Jim Spence of Crawfordsville, Indiana, wrote to say that the Internet, Facebook, Twitter, and cell phones will shrink the world by connecting folks of similar interests from the ends of the earth as neighbors. He wrote, “This technology is going to put together would-be farmers with landowners, financiers, markets, agronomists, etc.”

“I think we will see a growth in the number of small farms not only from this technology but from the desire for fresh food, and food from healthy animals. … There is hope!” he concluded. “Keep up the good work at the Center for Rural Affairs.” Read more about You Speak! “There Is Hope!”


REAP Newsletter Fall-Winter 2012

Spotlight on Business: How Can You Tell a Happy Pet? The Tail Waggin Knows
Alison Martin owns The Tail Waggin, a mobile store operated from a decked-out and gaily painted SUV that takes toys, healthy treats, collars, leashes, beds, holistic food and wellness products to personal shopping appointments for pets. The small business offers customers a chance to shop at home and fills a void of quality pet products in the area. Read more about REAP Newsletter Fall-Winter 2012

Rural Enterprise Reporter 2012: REAP's Annual Report

REAP Continues to Produce, Innovate, and Evolve
Fiscal Year 2012 was a massive, record-breaking year for the REAP program. Staff served more Nebraska startup and existing entrepreneurs than ever before. We placed the most loans in program history. Demand for our services is at an all-time high, showing the huge need in Nebraska and our ability to deliver results. Read more about Rural Enterprise Reporter 2012: REAP's Annual Report

REAP Newsletter Summer 2012

Gobs and Gobbs of Fun
Two women dreamed of a place where kids could get together and have fun. In December 2011, their dream became a reality. Tara Jordan and Tracy Anderson opened Gobs and Gobbs of Fun in Norfolk, Nebraska.

Time Management Tip: Learn to Delegate
Think Boldly about Nebraska’s Rural Future
Out & About for Micro Entrepreneurs
REAP Staff Receive Major Awards
REAP among Best Microlenders in America
Let the Data Tell the Story for Your Business Read more about REAP Newsletter Summer 2012


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