AUGUSTA, Maine – A new report shows Medicaid is vital to ensure that rural Mainers and families across the nation have access to the care they need to stay healthy.

The Georgetown University Center for Children and Families finds 38 percent of children in rural Maine are on Medicaid for their health care coverage, compared with 30 percent in metro areas.

Vanessa Santarelli, CEO of the Maine Primary Care Association, says if Congress goes forward with proposed Medicaid cuts, the result could be the loss of a bundle of services health centers are currently able to provide for children.

"You know, if we didn't receive these adequate reimbursements through programs like Medicaid and Medicare, our health centers would find it very challenging to be able to keep their doors open for all of the rural communities and residents that we serve," she stresses.

Santarelli notes that Maine was not among the states that opted to expand Medicaid coverage under the Affordable Care Act. She says that is likely a major factor in why the state saw the number of uninsured children in the report rise from 6 percent in 2009 to 7 percent uninsured in 2015.

Joan Alker, executive director of the Georgetown University Center for Children and Families, says this means more than a trillion dollars in proposed cuts to Medicaid would have an outsized impact on people who live in rural communities.

"Children and families living in small towns and rural areas risk losing access to health care and their protection from rising health care costs as Medicaid funding is cut, as congressional leaders are currently thinking about," she states.

One bright spot in the report is that 19 percent of adults in Maine have Medicaid coverage compared with 13 percent in metro counties. Santarelli says that should pay off for rural children down the road.

"When parents have coverage, and when they are able to see a primary care provider, there's a stronger likelihood that their children will also have regular visits, and well checkups, and that sort of thing," she explains.

Interactive maps with county level information can be found on the Georgetown Center's website.







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The long-delayed Farm Bill could benefit Virginia farmers by renewing funding for climate-smart investments, but it's been held up for months in Congress.

Some lawmakers want this bill to expand funding for such programs as the Environmental Quality Incentives Program, or EQIP, which gives financial and technical help to farmers and ranchers to make conservation a priority. About $250 million was allocated for the program, but more than 9,000 applications were submitted, bringing it to $475 million.

Gabrielle Walton, federal campaign associate with the Chesapeake Climate Action Network, said these programs' popularity proves their necessity.

"This money allows them not only to practice more efficiently - and to preserve the environment that they love so much and they're so attached to - but it also saves them money that they can devote to other concerns," she said, "and provides them stability for their pocketbooks going forward."

One issue with the new Farm Bill is a proposed increase in so-called "reference pricing," which critics have said only benefits large farming operations and would come at the expense of more widely used social and climate-smart programs.

Walton said she thinks political divisiveness and competing priorities have held up the new Farm Bill.

The previous Farm Bill was extended to this September, but lawmakers have said they aim to have a bill ready by Memorial Day. Along with climate-smart investments, the Farm Bill also funds social safety-net programs.

Geoff Horsfield, a policy director at the Environmental Working Group, said people don't always know how helpful nutrition programs are to families.

"There's a misconception that things like SNAP only benefit urban communities," he said, "and we just know that that's not true - that folks in all counties rely on nutrition assistance programs, some of these social programs, to be able to make ends meet."

SNAP and other nutrition programs received 75% of funding in the 2018 Farm Bill. More than 876,000 Virginians use SNAP and EBT benefits, since food insecurity has been a longstanding issue in the state.

Today, groups working with lower-income families in Connecticut are raising awareness about the state's "benefits cliff" with a day of action.

The benefits cliff is when a person might get a raise, have a kid with a part-time job, or some other income increase which then makes them ineligible for certain benefits. The changes can have severe impacts on communities and disproportionately affect families with children.

Stephen Monroe Tomczak, professor of social work at Southern Connecticut State University, said it is part of a larger workforce problem.

"People, particularly people of low income, are in a sense disincentivized to participate in the labor force and denied adequate jobs and income when they try to do that," Tomczak explained.

Several General Assembly budget bills could have dealt with the issue but most failed, which inspired today's action, a mock funeral procession to the governor's office to eulogize the bills, including the refundable Child Tax Credit, a housing voucher funding boost bill, and a bill eliminating the asset limit on the HUSKY C medical insurance program.

Social service advocates know the bills will resurface in next year's budget process.

Rose Ferraro, program lead of health justice policy advocacy for the Universal Health Care Foundation of Connecticut, said people are taking alternate steps like going to food banks or avoiding medical care to cover lost benefits.

"Folks will lose their rental assistance and then, they will sort of have to make some tough decisions," Ferraro noted. "'Do I put food on my table or do I make sure to pay rent?' And, so it becomes a sort of untenable position."

Ferraro added interwoven state and federal funding makes it hard to reach the core of the issues leading to benefits cliffs. One eulogized bill would have established a benefits cliff pilot program. For two years, it would have provided subsistence for people who've reached the benefits cliff.

New York towns are reaping many benefits since the Inflation Reduction Act was passed.

Along with funds for larger clean energy projects, the state was awarded $158 million for the IRA's Home Energy Rebates program.

Smaller towns and villages use these grants to implement their climate action plans.

Brighton Town Councilmember Robin Wilt said an IRA grant they applied for will help upgrade the town's HVAC system.

"We will be implementing geothermal and then use a solar array to make the system close to net zero, not quite," said Wilt. "I think we'll get 55% of our energy back with the solar panels."

The bureaucratic process to access the funding was challenging, but some groups are working with the Department of Energy to improve it.

Wilt said feedback on the clean energy projects has been positive. Future projects using IRA funding include increasing walkability and sustainable redevelopment.

Critics have said the IRA includes multiple provisions to increase fossil fuel production.

Towns nationwide are using IRA grants to bolster clean energy projects.

Joel Hicks is a council member for the Borough of Carlisle, Pennsylvania.

They've just applied for a grant to work on energy efficiency and solar projects with Harrisburg. He said this will have positive impacts beyond establishing clean energy.

"We were really excited at this potential," said Hicks, "because we saw that the cost savings we would have for putting in substantial solar projects on our public property would actually fund many of our other public municipal goals."

These include purchasing an electric vehicle fleet and having more efficient solid waste programs.

One thing Hicks said he wants to see in future is state and local governments helping small towns and municipalities with putting together their IRA grant proposals.