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.


get more stories like this via email

From North Dakota to Texas, the beef raised on farms goes through a production process controlled by four major companies and independent ranchers hope a proposed federal rule gives them more power to act if they feel they have been ripped off.

The U.S. Department of Agriculture said the plan it unveiled last week would provide clarity regarding unfair market practices under the Packers and Stockyards Act.

Aaron Shier, government relations director for the National Farmers Union, said in the past, some courts have said there needs to be proof the broader market is harmed. He noted the update addresses the problem within the long-standing law.

"It has many producer protection elements," Shier explained. "Over the long history of this law, that has gotten confused and muddled. And so, this proposed rule is meant to set the record straight on that issue."

Supporters said not only does it help prevent smaller farmers from going out of business but potentially gives consumers a fair shake on the prices they pay for meat and poultry. Industry groups like the Meat Institute are criticizing the move, saying it would set meat production back decades by encouraging litigation while actually hurting consumers.

The Institute also questioned such efforts when cattle prices are at record levels. Shier suggested there are specific examples of questionable tactics beyond current market dynamics.

"Failure to pay," Shier emphasized. "If a meatpacker, someone in the market fails to pay a producer, that is something USDA has consistently taken action on."

With more clarity under the law, policy analysts said there might be more consistency regarding court decisions when individual farmers push back against an industry giant. Shier pointed out the ultimate goal is to avoid lawsuits with this action and similar steps recently taken by the USDA setting a tone to foster market competition. A public comment period is the next step ahead of the rule becoming final.


get more stories like this via email

Family farm advocates are calling for cuts in federal subsidies to large animal feeding operations - technically known as Concentrated Animal Feeding Operations - in the Farm Bill being debated in Congress.

Iowa family farmers want more support for conservation programs that benefit smaller agriculture operations.

Right now, CAFOs can qualify for as much as $100 million every year to reduce some of the environmental damage they can cause.

That's taxpayer money that Barb Kalbach - a fourth-generation family farmer in Adair County, Iowa - said could be put to much better use by small family farmers on their land.

"Things like filter strips along streams and rivers," said Kalbach, "which helps with erosion, and it also helps with nitrates and other pollutants entering the water."

CAFO operators contend they use the federal money to defend against environmental damage and that they're always looking for cleaner, safer ways to raise high-quality meats while responding to increased consumer demand.

As a board member for the Campaign for Family Farms and the Environment, Kalbach said she is calling for more support of conservation programs that would help family farmers. But she said she is just as adamant that the long-standing rules governing CAFOs are changed.

"Industrial-scale factory farms, even though they are industrial scale, they do not have to go by industrial standards," said Kalbach. "They go by ag standards. And that's why we have the problem with pollution that we have. That should be addressed in the Farm Bill."

The Farm Bill saw its first action in the House Agriculture Committee May 23.

The House version of the measure also proposes $30 billion in cuts to SNAP benefits over the next decade, including $170 million in Iowa.

For 15 years, U.S. restaurant chains have pledged to stop using gestation crates for pregnant pigs but a new report from an animal welfare group showed many are still dragging their feet.

Devon Dear, institutional outreach manager for the group Animal Equality, said too many restaurants still source their pork from suppliers who lock pregnant pigs in cages so small they cannot turn around. Eleven states, not including New Mexico, have already made the practice illegal, for good reason, Dear emphasized.

"Pigs are under lots of stress in crates," Dear explained. "More stress means more antibiotics; more and more antibiotics means higher chances of antibiotic resistance, and stressed animals are less healthy."

Hog production is not a major contributor to New Mexico's ag statistics, but the state does have its fair share of fast food restaurants. Dear pointed out some big chains have moved away from crates including McDonald's, Wendy's and Chipotle. The report lists Denny's, Chick-fil-A, Dunkin and KFC among 13 companies it contends have not been aggressive enough in reducing their use of crates.

The report comes as Congress is debating an update to the Farm Bill. As proposed, Animal Equality's analysis shows it would have negative effects for animals across the board. She hopes the report will put the inhumane treatment of pregnant pigs in the spotlight.

"One thing we do want to emphasize is that these corporate commitments predate any version of this Farm Bill," Dear noted. "Many are back from 2009, 2012, so irrespective of what happens with the Farm Bill, consumers expect companies to do better for animals."

U.S. pork production is highest in Iowa, while New Mexico is better known for crops such as chili peppers, corn, pecans and onions.