MEMPHIS, Tenn. – While the U.S. Senate battles over its version of a bill that would repeal and replace the Affordable Care Act - uncertainty about the future of health care is impacting local leaders.

The topic is among those being discussed this week at the National Association of Counties' annual conference in Columbus, Ohio. Shelby County Mayor Mark Luttrell says with the nation's counties investing $80 billion annually in community health - concern about what happens in Washington transcends party lines.

"We certainly have different political representations in our group, but yet we all face the same issue of how are we going to address health care going forward," he says.

Approximately two-thirds of the nation's 2,800 local public-health departments are county-based. Medicaid also is key to counties in Tennessee because of the state's growing opioid epidemic since it's the largest single funder for mental-health services and substance-abuse treatment.

Luttrell adds that with so many unknowns about the Trump administration's policies, it makes it a challenge for local leaders to know how to proceed.

"There's a tremendous amount of uncertainty about what support and what priorities will be coming out of Washington," he notes. "The Trump administration is still getting its feet under the table, so to speak. We're still looking for the guidance that you expect to see from Washington."

TennCare is the state of Tennessee's Medicaid program and is funded by both the state and federal governments. The program is administered by the state with federal oversight.


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Kentuckians have less than a week to register to vote in next month's primary election.

If folks miss the April 22 deadline, residents can still register to vote in the presidential election this fall.

Laura Weinstein, chair of the League of Women Voters of Kentucky, is encouraging people to take action now. Voters will need to bring photo identification to the polls. A list of acceptable forms of identification is on the Secretary of State's website.

Weinstein added the website vote411.org includes personalized information about registration and what's on the ballot.

"We'll be posting what are called voter guides," Weinstein explained. "The candidates will be filling out questionnaires so voters can have a better sense of the candidates' positions before going to the polls."

Polls will be open from 6 a.m. to 6 p.m. on Election Day, May 21 and early voting runs from May 16-18. This year, Kentuckians will vote for state legislative and local offices, nominate candidates for Congress, and nominate their pick for the next U.S. president.

Weinstein noted there is still time to sign up to be a poll worker, through the website powerthepolls.org.

"And you can get compensated," Weinstein pointed out. "You get $260 for Election Day and it's a great way to learn, again, more about the process. So, that's another excellent way to participate in a primary election as a voter this year."

Research shows primaries typically have lower voter turnout than general elections. Weinstein stressed in a climate of widespread polarization and mistrust in elections, it is more important than ever people participate in the electoral process.

"We also know that voting is habit-forming," Weinstein observed. "Even though there may not be a competitive race in your district, the more you go vote, the more likely it is you'll vote in the future."

More than more than two million Kentuckians showed up at the polls in the last presidential election in 2020, according to the Kentucky State Board of Elections.

Support for this reporting was provided by The Carnegie Corporation of New York.


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Alabama civic-engagement groups are searching for strategies to maintain voter engagement outside of major election years.

As candidates gear up for the runoff election in Alabama's 2nd Congressional District, grassroots organizations such as Faith in Action Alabama are finding ways to amplify residents' voices and address critical issues.

Muaath Al-Khattab, community organizer at the Montgomery hub for Faith in Action Alabama, said they are shifting efforts to fostering civic participation beyond election cycles.

"We wanted to transition from a strictly election-based type of phone banking to a year-round phone banking," Al-Khattab explained. "Where we have voter engagement and voter education throughout the year as opposed to right before elections."

He pointed out the goal is to target diverse demographics including youths, middle-aged adults and seniors. Through targeted outreach and education initiatives, Faith in Action Alabama seeks to bridge gaps in voter knowledge and foster civic participation across the state, especially for local races.

Beyond the ballot box, Al-Khattab noted advocacy is extending to pressing issues such as community safety. He highlighted their push for voting restoration and gun-violence reduction programs.

"We try to educate people on this community involvement," Al-Khattab emphasized. "Whether it be what we call the night walks, which is going through at-risk or high-risk areas of gun violence, and just kind of strengthen the bonds with the communities, and then also pushing for publicly funded community violence intervention programs."

The group is also lobbying for bills to help reduce barriers to voting for people previously incarcerated. Al-Khattab added he sees their initiatives as vital steps toward fostering a fairer and more inclusive electorate. He stressed their work extends across their offices in Birmingham, Huntsville, Mobile and Montgomery, with established hubs in areas such as Tuskegee, Phenix City, Greenville and Selma.

A new report examines election official turnover since 2000 and found it's something that has been increasing steadily and might continue to rise.

Rachel Orey, senior associate director of the Elections Project with the Bipartisan Policy Center, is among several researchers who dove into the issue. She said their analysis draws on an original dataset of more than 18,000 local chief election officials across more than 6,000 jurisdictions in all 50 states.

Orey said local election officials around the nation have experienced intense levels of scrutiny and hostility, especially prevalent in certain states such as Arizona.

"We know that counties like Maricopa have been in the limelight, and it makes it challenging when these election officials are receiving a lot of public scrutiny. We had an official in Maricopa County last year come out publicly and say that he was experiencing PTSD," she explained.

According to the report, the Federal Bureau of Investigation received more than 1,000 tips about threats to election workers since June of 2021, 11% of which warranted the FBI opening an investigation. The agency deemed Arizona as one of the states with "an unusual level of threats to election workers."

But Orey said turnover is being seen nationwide. While the report states it "discourages" legislators from making statutory changes in an election year, they can still help ensure officials have adequate resources and funding to do their jobs.

Despite the high turnover rates, Orey said there is no cause for concern when it comes to the integrity of elections, including the likely high-stakes rematch between President Joe Biden and former President Donald Trump. Orey said their research shows 65% of local election officials have experience administering a presidential election.

"Where there are new officials, we find that they have an average of eight years of experience in an election office. Typically that looks something like a deputy clerk position where they're supporting that chief election official. "

The report recommends investing in training and mentorship, evaluating training programs as well as calls for developing comprehensive systems for capturing institutional knowledge to not only mitigate the immediate impacts of turnover, but promote a more resilient election official workforce over time.


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