HASTINGS, Neb. — Last year, Nebraska voters passed a measure to expand Medicaid, but state officials are stumbling out of the gate to implement the plan.

The move would bridge a health-coverage gap for 94,000 Nebraskans who don't earn enough to get subsidies for market-rate insurance, but earn too much to qualify for standard Medicaid. Valerie Bower is a registered nurse at Mary Lanning Healthcare in Hastings. She said expanding Medicaid also is critical for keeping hospital doors open.

"Rural hospitals especially benefit from Medicaid expansion,” Bower said. “A lot of rural hospitals have been closing in the last few years, and a lot of that has to do with uncompensated care."

Bower's hospital has carried more than $9 million in bad debt, on top of providing $5 million in financial assistance for patients who just can't pay. Medicaid expansion would help reimburse hospitals for skilled care provided by nurses, doctors and technicians, as well as supplies and medication.

Nebraska's Department of Health and Human Services has cited technology upgrades, staffing and reporting requirements as reasons for a possible delay in coverage.

Jordan Rasmussen, policy manager with the Center for Rural Affairs, said Medicaid expansion also would get Nebraska closer to a goal championed by many state lawmakers: strengthening the economy and bringing more economic opportunities into the state.

"There are strong economic benefits that will result because of our expanded coverage,” Rasmussen said. “A report that was shared last fall estimates that $1.3 billion in economic activity is going to occur in the state. That's a huge gain for the state."

Nebraska must submit its plan for Medicaid expansion to the Centers on Medicaid and Medicare by April 1 of this year. More than two-thirds of Nebraskans who fall into the Medicaid coverage gap are employed, and more than 1-in-3 live in rural counties.


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Some Iowa farmers are putting a new spin on an age-old animal behavior.

They're using goats to remove weeds, overgrown brush, and non-native grasses - while helping some landowners restore native habitat to their acres at the same time.

Goats are pretty well known for producing milk and cheese. They're even used to help practice yoga these days.

Matt Vermeersch is a member of Practical Farmers of Iowa who farms about 170 acres near Red Oak - near the Nebraska state line - and operates Goats-On-The-Go, a side business stocked with herds of goats hungry for woody vegetation.

"A lot of really what we refer to as weeds, or pain-in-the-butt plants," said Vermeersch. "Things that they love are things like poison ivy, nettles, wild berry species with their thorns - then more woody species like Honeysuckle or buckthorn."

Vermeersch estimated his three Goats-On-The-Go herds cleared about 120 acres of various vegetation this year, and could have done more had it not been for Iowa's severe spring and summer weather.

There are ecological benefits to the practice, too. People hire Vermeersch's goats to clear land where native species once grew, and where farmers want it to return.

Vermeersch said while Iowa landowners are often trying to clear overgrown brush and reintroduce native species, sometimes they just need stands of troublesome weeds and brambles removed.

At which, Vermeersch said, the goats have no equal.

"It almost looks like a wildfire went through there the day after you take the goats off," said Vermeersch. "We refer to it as a grazing line - and pretty much anything under 6 feet tall all that will be left are sticks and stems. All of the leafy material underneath that is usually consumed."

Vermeersch said the goats are used for different reasons across the country.

In western states, for example, they are dispatched to clear brush that can serve as wildfire fuel, reducing the chances that a fire can become catastrophic by keeping the underbrush down.

Advocates for a fair, sustainable and healthy food system have released a report showing increasing consolidation in Montana's agriculture sector.

Economists said such conditions can lead to market manipulation. The report from the advocacy group Farm Action showed 85% of the beef raised on U.S. farms, including in Montana, is produced by four companies: Cargill, JBS USA, National Beef and Tyson Foods.

Angela Huffman, president of Farm Action, said the concentration in the ag industry is happening all the way from farm fields to the consumer's plate, and she warned it creates the potential for artificial price controls.

"This is the scenario in almost every sector of the food supply chain," Huffman pointed out. "Seeds, fertilizer, farm equipment, beef, pork and poultry processing, and retail groceries; every one of those sectors I just named has upwards of 60% to even 85% of those markets are controlled by four corporations."

Consolidation in the livestock industry means more animals are raised in large confinement operations, where manure runoff can affect air quality, ground and surface water in rural Montana. Operators have said they are researching more efficient and environmentally friendly ways to raise livestock while trying to keep up with growing consumer demand.

Huffman argued monopolies can lead to collusion, price fixing and other types of market manipulation. Her group and others are urging lawmakers in Congress to address the issue in the pending Farm Bill.

"We're calling on the government to reclaim its role as an enforcer of our antitrust laws and break up these dominant corporations," Huffman explained. "In order to free our economy to start working for the people who are producing, processing and distributing our food."

The current Farm Bill, which officially expired last September, has been temporarily extended, although lawmakers have yet to agree on a new version of the major legislation.


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Some northeast Wisconsin residents are challenging a wastewater permit issued by the state to a large dairy operation.

The Wisconsin Department of Natural Resources reissued the wastewater permit to Pagel's Ponderosa Dairy in August. Petitioners are now requesting the State Division of Hearings and Appeals to review the terms for water monitoring and limits on the number of animals.

Adam Voskquil, attorney for Midwest Environmental Advocates, said the DNR has the authority to protect communities.

"We've been pushing for a few years now to see them use that more often, and this is one of those instances where they didn't do enough," Voskquil contended.

A 2021 Supreme Court ruling allowed the DNR to include terms on groundwater monitoring and setting size limits on concentrated animal feeding operations. But with more than 330 of them across the state, Voskquil said the DNR has included the terms in only a handful of permits. A spokesperson for the agency said they cannot comment on ongoing litigation.

Pagel's Ponderosa Dairy owns about 20,000 animals between its two locations in Kewaunee County, and produces more than 100 million gallons of liquid manure it spreads across 10,000 acres of land. Voskquil argued the land is susceptible to contamination.

"Pagel's is kind of playing a shell game with transferring manure between their operations," Voskquil asserted. "There just needs to be some threshold, some limit, to the growth of this operation."

The DNR states concentrated animal feeding operations are required to spread manure on land set back from drinking water wells, sinkholes and fractured bedrock and cannot have any runoff to rivers and lakes, among other requirements.


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