By Tess Vrbin for The Arkansas Advocate.
Broadcast version by Freda Ross for Arkansas News Service reporting for The Arkansas Advocate-Winthrop Rockefeller Foundation-Public News Service Collaboration.

Brandy Sandersfeld had been putting off a minor surgery for her 4-year-old son, Cypress, for months.

Over three weeks this spring, the Sandersfelds made four trips to Arkansas Children’s Hospital in Little Rock from their home in Big Flat. Having enough gas money for multiple five-hour, 240-mile round trips was stressful, and it wouldn’t have been an issue if the family still had the financial support of the federal child tax credit, which ended in December 2022, Sandersfeld said.

What pushed her to go forward with Cypress’ surgery was the fact that the grant funding her job at the University of Arkansas System was about to expire, she said. She and her two sons have now been without health insurance since July 1.

In 2020, Sandersfeld and her husband moved “away from the hustle” of exurban life in Eureka Springs, and they value their rural community, but they’ve taken on the difficulties of being far away from the specific health care resources their children need, she said. Jasper, their 11-year-old son, needs both physical and behavioral therapies.

“To drive three hours three times a week for physical therapy [is] just not financially doable once I lose this job,” she said in May.

The family’s struggles obtaining health care for their children are among the tough realities Arkansans face if they’re asset limited, income constrained and employed (ALICE), especially in rural areas. ALICE signifies households earning enough money to be above the federal poverty line but struggling to afford the cost of living in their area.

“I make enough money to get by, but too much money to find any programs or resources [for low-income people] and not enough money to have any sort of stretch in my budget,” Sandersfeld said.

Data from United for ALICE, a research movement led by United Way of Northern New Jersey, shows North Central Arkansas, where the Sandersfelds live, and the Delta as regions with the state’s highest percentages of ALICE and poor households.

The annual “household survival budget” for ALICE families in Arkansas varies greatly depending on each county’s cost of living and the number and ages of the people in the household, according to United for ALICE. For a single ALICE adult, the necessary annual income to get by ranges from $22,488 ($11.24 per hour) in Monroe County to $31,152 ($15.58 per hour) in Pulaski County.

For a couple with two school-aged children, that threshold rises to $57,732 ($28.87 per hour) at the low end, again in Monroe County, and $72,120 ($36.06 per hour) at the high end in Benton County.

In the Sandersfelds’ home of Searcy County, the threshold is $30.75 per hour and $61,500 per year.

Affording health care can be a struggle even for well-off Arkansas families, according to United for ALICE.

“In November 2022, nearly one in four Arkansans — both above and below the ALICE Threshold — reported that they had an unexpected major medical expense that they had to pay out of pocket for because it was not completely paid for by insurance,” the group’s 2023 ALICE report states.

Unexpected medical expenses can lead to medical debt, which is “more concentrated in the South and among residents of low-income ZIP codes,” the Urban Institute reported in 2022.

Some states provide protections from medical debt for low-income people whose insurance plans require cost-sharing, but Arkansas is not one of those states.

ALICE households struggle to be prepared for both retirement and financial hardship, according to United for ALICE data. In 2022, only 32% of households below the ALICE threshold in Arkansas, Oklahoma, Texas and Louisiana had three months’ worth of savings that could cover a medical or economic emergency, an increase from 30% in 2019. 

Additionally, Arkansans in rural areas face challenges that might not be directly related to health care or insurance but might have an impact on their ability to access both, said Craig Wilson, director of health policy at the Arkansas Center for Health Improvement and a member of United for ALICE’s state research advisory committee.

“You don’t think that something’s going to happen to you in the immediate term,” Wilson said. “When you’re thinking about the hierarchy of needs, you’re thinking about food, transportation, housing and all those other things that are very much immediate needs and not so much [about] insurance.”

Scarcity of services

Sandersfeld has applied for her children to receive insurance from ARKids First, Arkansas’ Medicaid program for children, and she said she is waiting for the state Department of Human Services to process her application. Her husband, Kurtis, is a construction worker and does not have access to employer-provided coverage.

“I’m a little excited about ARKids because my insurance right now doesn’t pay enough for [therapies] to make a difference, but now I have a new issue: I’m going to have availability for these services, but I have nobody to provide these services,” Sandersfeld said.

Searcy County is one of several Arkansas counties that do not have hospitals, according to the Arkansas Department of Health. Many counties also had very few full-time primary care physicians per 10,000 residents in 2020, according to ACHI data.

The cities closest to Big Flat with any health care providers at all are Marshall and Mountain View, each more than 20 miles away on roads that twist through the Ozark Mountains and require more time and gasoline than flatter terrain.

Long-distance travel for health care is not unique to North Arkansas. Many specialized medical services are only available to Arkansans if they travel out of state or to the Little Rock or Northwest Arkansas metropolitan areas.

The nonprofit Community Health Centers of Arkansas has about 50 sites statewide that provide primary care services with a sliding scale cost system, depending on the patient’s ability to pay. Dr. Lanita White, the nonprofit’s CEO and a University of Arkansas for Medical Sciences professor, said in February that not enough Arkansans are aware of this resource, calling it “a PR issue.”

Phillips County in the Delta has two community health centers, but the number of beds at the local hospital in Helena-West Helena has shrunk to 25 when at one point it was 120, said Donna Dunlap, who has been a nurse in the county for 33 years.

Physicians from more populous areas used to regularly visit Phillips County, but the decline in population in the county and the region has led to fewer available health services, Dunlap said.

“We had surgeons, we had an orthopedic doctor that came to the area, we had cardiologists,” she said. “They may have had to travel in from another town — a lot of times they would come from Little Rock — but at least we had those services available for our patients to go locally instead of having to travel two hours to see someone.”

Barriers to care

While state officials have increased Arkansas’ minimum wage over the past several years, Medicaid income limits have not been adjusted accordingly, which has created coverage gaps, Dunlap said.

“A lot of people [are] kind of falling through the cracks on the kind of health care they can receive,” she said. “Say they’re covered at work, but they can’t afford to cover their spouse or their family.”

Melissa Cleveland of Harrison is also a nurse and said she has had this experience: she is covered by her employer’s insurance, but covering her family would reduce her paycheck by an untenable amount. Her family is already “barely making it” since her husband cannot work due to disabilities, she said, and her three children were covered by ARKids before unexpectedly losing coverage earlier this year.

“You’re paying a high deductible for a cheaper plan, but you’re still losing money and you can’t ever climb out of that,” Cleveland said. “It’s just going to keep you under, and you get denied crucial benefits just because an insurance [company] looks at you on a piece of paper and says, ‘Nope, you don’t need that, we’re not going to pay.’”

Alison Guthrie of Little Rock said she had to turn down a job offer that pays more than her current employer because the medical expenses she would have incurred after losing Medicaid coverage would have led to an overall financial loss.

Guthrie needs a wide range of specialists and medications to treat her Ehlers-Danlos syndrome, which causes chronic pain, gastrointestinal issues and a host of other problems, she said. The job she turned down had a “generous” insurance policy but still would not have covered as many copayments as Medicaid does, she said.

“Being chronically ill is a full-time job,” Guthrie said. “There are times when you can’t function and you have no control over that, and if you’re not salaried and you’re paid by the hour, you’re screwed that way too.”

While Guthrie has the benefit of living in the vicinity of the specialized care she needs, low-income people in poorer, less resourced areas such as Southeast Arkansas might not even seek primary care, said Isierene Brown, who was the nurse at Reed Elementary School in Dumas until she lost her job in the school district’s recent layoffs.

Residents of Desha County often don’t have the means or the time to go to the doctor, so they “opt out not to do it, and they just hope for the best,” Brown said.

Potential remedies

In her 25 years as a school nurse, Brown saw students consistently develop respiratory illnesses such as the flu, strep throat and COVID-19 as a result of a lack of preventative health care, she said. She added that many children in the Dumas School District aren’t vaccinated against these illnesses because their parents are vaccine-resistant due to insufficient education.

“We definitely need more clinics and more doctors, but when you don’t have a lot to offer people — I mean, we don’t even have a Walmart — people don’t want to relocate to our area of the state,” Brown said.

Most physicians practice in the same state where they complete their residencies, and the University of Arkansas for Medical Sciences sponsors roughly 80% of residencies statewide. Medical school graduates have outpaced available residency slots throughout Arkansas the past few years, according to ACHI data.

Republican U.S. Sen. John Boozman, an optometrist from Rogers, has been sponsoring multiple bipartisan bills to create more residency slots nationwide and retain the doctors that train in those positions, particularly in rural areas. One proposal would allow medical and dental school graduates to pause student loan payments during their residencies, and another would give areas where a hospital has recently closed — often in rural communities — a greater chance of receiving new residents.

Meanwhile, President Joe Biden’s federal fiscal year 2025 budget proposal calls on Congress to revive the child tax credit and expand it “from $2,000 per child to $3,000 per child for children six years old and above, and to $3,600 per child for children under six.” The new federal fiscal year begins Oct. 1.

A $78 billion tax package moving through Congress would fulfill the request, but it stalled in the U.S. Senate in March after Republicans compared the child tax credit to welfare programs.

In May, Sanderfeld was one of five mothers from across the country invited to the White House to advocate for the return of federal aid for families with children.

Sandersfeld said she and her husband could afford preventative health care for their children, including the cost of travel, when the child tax credit gave them “a little bit of surplus” financially.

“We didn’t have to worry about unexpected health expenses or these copays at the children’s hospital,” she said. “…When you give people enough money to make good decisions for their family, they will.”


Tess Vrbin wrote this article for The Arkansas Advocate.


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Alabama has made some strides in its fight against poverty but substantial challenges remain, according to a new report from the group Alabama Possible.

The annual Barriers to Prosperity report, which examines poverty, food insecurity, educational attainment and health coverage across all 67 counties, revealed mixed progress.

Chandra Scott, executive director of Alabama Possible, said while there are signs of improvement, many issues demand urgent attention.

"We're no longer the sixth-poorest state in the nation. We're the seventh," Scott, pointed out. "We're seeing some positive uptick there, but that still accounts for over 798,000 of our neighbors that are in poverty. And unfortunately, the number of children that sits within that is 237,000."

The report highlighted increasing food disparities, with the percentage of food-insecure children rising from 18% last year to 23% this year.

The report showed slight gains in educational attainment among those in poverty, with an increase in individuals earning associate and bachelor's degrees. However, Scott argued more resources are crucial for those seeking higher education.

"Of course we have federal aid," Scott, acknowledged. "But we as a state, we have to figure out how do we close the gap for students to be able to have degree attainment without financial constraints."

Scott pointed to opportunities identified in the report, particularly the need to re-evaluate the federal poverty threshold for a family of four, currently set just below $30,000 annually. She asserted the figure may not accurately reflect the true cost of living and the essential needs of families.

By Wesley Brown for the Arkansas Delta Informer.
Broadcast version by Freda Ross for Arkansas News Service reporting for The Arkansas Delta Informer-Winthrop Rockefeller Foundation-Public News Service Collaboration.

For many working-class Arkansans, finding a reasonable place to live has become incredibly daunting amid skyrocketing rental prices, weak tenant protections, and inadequate housing stock.

For those who identify as an Asset Limited, Income Constrained, and Employed (ALICE) family or individual, the obstacles may seem insurmountable. Yet, despite these challenges, there is a resilience that shines through, as noted by Kendall Lewellen, Housing Subject Area Manager at the Center for Arkansas Legal Services (CALS). 

In her role, Lewellen offers pro bono legal advice to ALICE households on housing issues—from eviction notices, unlawful detainers, and lease-to-own fraud to foreclosure, heirs’ property, fair housing, and discrimination issues. Coming out of the pandemic, Lewellen sees an emerging long-term economic crisis as post-pandemic rent is pushing household budgets to the limit.

“There are a lot of people who are their rent burdened; they’re spending a very high portion of their household’s income on rent,” said the CALS housing expert. “And you know, Arkansas has fairly weak health and safety standards for rental housing. So, people may be spending a large portion of their income on unsafe or habitable housing.”

Rising Inflation

Data compiled by the St. Louis Federal Reserve shows that the consumer price index (CPI) has exceeded the overall CPI for the past 20 years. Produced by the U.S. Bureau of Labor Statistics (BLS) each month, the CPI is the leading barometer for U.S. inflation, measuring the change in prices paid by consumers for goods and services, measuring the change in prices monthly paid by consumers for goods and services.

The CPI is not just a single number but a comprehensive tool that covers a wide range of goods and services. Key CPI indexes highlight pricing for food, shelter, motor vehicle insurance, household furnishings and operations, education, recreation, and personal care. It also includes indexes for big-ticket items such as used cars and trucks, medical care, airline fares, back-to-school clothing, and other apparel, providing a holistic view of the economy.

In July, the CPI for All Urban Consumers (CPI-U) increased by 0.2% after declining 0.1% in June. The shelter CPI for rent of primary residency fell from 0.1% to 5.1% in July. That is well above the “all items” index, which rose 2.9% for the 12 months ending July, the smallest 12-month increase since March 2021. The yearly CPI peaked in June 2022 at 9.1%, pushing inflation to a 40-year high led up by gasoline and other energy price spikes.

In Arkansas, the working-class ALICE population in the 75 counties across the state generally earns above the federal poverty level (FPL) but often cannot afford the basic cost of living. Despite struggling to make ends meet, these same households often do not qualify for public assistance.

According to the latest United ALICE data, the number of poverty-stricken Arkansas households increased by 6,141 between 2021 and 2022. During the same period, the number of ALICE households increased by 4,813, continuing a more than decade-long trend in the growth of this population. In 2022, of the 1,201,499 households in Arkansas, 562,879, or 47%, were below the ALICE threshold.

In Little Rock, Keri Whimper is one of those single-parent, diligent ALICE households who has faced significant post-pandemic challenges in balancing her monthly budget. Although most ALICE families and individuals in Arkansas saw some relief through the multi-billion-dollar COVID-19 rental assistance program and national bad on evictions, the mother of two teenage daughters said she went through the downturn without any state or federal aid, highlighting the crucial role of public assistance in these challenging times.

“I never received any rental assistance, (but) it’s still hard, and I have never been evicted,” said Whimper, who works in the healthcare field. “I am blessed to have the landlord that I have – she’s basically taken us in like family.”

Arkansas lawmakers reject federal rental assistance

Under two COVID-19 era bills passed by former President Trump and President Biden, Congress approved more than $46 billion for the Emergency Rental Assistance program. The first round of ERA funds was allocated $27 billion under the Consolidated Appropriations Act of 2021, signed into law by Trump in late December 2020. 

After Biden took office in early 2021, the American Rescue Plan added another $19 billion to extend the COVID-19 rental assistance program, ERA2. In 2022, however, former Arkansas Gov. and the Arkansas Legislature rejected more than $146 million from the Biden administration, saying the program had served its purpose. 

“Our economy has returned, there’s jobs aplenty out there and we have existing programs in place for rental assistance that were pre-pandemic,” Hutchinson said in late 2022.

Out of the millions of dollars allocated to Arkansas under the Biden-era assistance program, the state Department of Human Services only distributed $68 million in rental and utility assistance.

Despite her friendly landlord, Whimper notes that inflation has impacted other household expenses, such as utilities, transportation, groceries, health care, and school costs for her daughters.

For other families and individuals that meet the ALICE threshold, the number of renters with household “cost burdens” has hit an all-time high, according to the recently released State of the Nation’s Housing 2024 report by Harvard University’s Joint Center for Housing Studies. Although rent growth slowed to just 0.2% year over year in early 2024, rent prices remain up 26% nationwide since early 2020 and are still rising in three out of every five markets.

“Rents have been rising faster than incomes for decades,” said Alexander Hermann, a senior research associate at the Center. “However, the pandemic-era rent surge produced an unprecedented affordability crisis that continues.”

Rental prices outpacing Arkansas wages

According to a recent analysis by online real estate giant Zillow and StreetEasy and wage data from the Bureau of Labor Statistics, U.S. rent costs have grown 1.5 times faster than wages. Also, demand for rentals from the large millennial generation—many of whose members have remained renters longer than previous cohorts—and Gen Z adults has run headlong into the country’s housing shortage.

Compared to the national trend, rents have grown 1.8 times faster than wages in the Little Rock metro area since early 2019. At the end of 2023, the median rent price for central Arkansas was $1220.47, 34.5% from 907.23 at the beginning of the COVID-19 pandemic in early 2019. During that same period, average hourly earnings for local workers have only increased by 21.97% from $24.44 to $29.81 per hour.

Average rental prices in central Arkansas officially breached the $1,000 mark in 2021, rising 10.8% from $992.84 to $1,101.62. The biggest gain in hourly earnings occurred between 2022 and 2023, when wages grew 12.8% from $26.42 to $29.81 per hour.

Although rental prices have cooled across the U.S., the market is still teetering on the edge of what is considered affordable. The typical U.S. rent rose 0.4% in July to $2,070, down from 0.5% growth in June and 0.6% growth in April and May. Annual rent growth also slowed, with rents up 3.4% yearly, compared to 3.5% year-over-year growth in June. 

Zillow officials said that this slowdown in rent growth is helping the typical renter stay just on the right side of affordability. A household earning the median renter’s income would spend 30% of that income on rent. That is an improvement from 2022 but right on the edge of what is considered affordable. 

“Builders have stepped up and built an incredible number of homes in response to soaring rents during the pandemic, and renters are now seeing the benefits,” said Zillow Chief Economist Skylar Olsen. “Now is a great time for renters to find a deal, with more new apartments hitting the market than at any time in the past several decades. Rents are still growing, but it’s a far cry from the steep rent hikes of two or three years ago, and renters will find sweeteners being offered by more than half of rentals in some places.”

One reason for the rental market cooldown is a multifamily construction frenzy that is opening new options for renters and rebalancing the supply-and-demand seesaw. According to the latest data, almost 60,000 multifamily units were completed nationwide in June, more than in any month in half a century.

The rental vacancy rate, another measure of market tightness, held steady at 6.6% in the second quarter of this year, where it has sat for the past four quarterly readings. That’s the highest since winter 2021.

National and state renters’ rights legislation faces strong opposition

For the future, the Biden-Harris administration in July announced a proposal to temporarily cap rent increases by large landlords at 5% for two years, a policy that would affect half of all rental properties in the U.S. The proposal is part of a more extensive set of comprehensive policies to address the housing crisis through increased supply and other means. 

A month before the president’s announcement, the National Low Income Housing Coalition also released the National Tenants Bill of Rights, which would establish national tenant protections for renters.

“It is our hope that there is a bipartisan effort to really understand and recognize the breadth of tenant rights that are needed across the continuum of the leasing and rental process,” said Sarah Gallaher, NLIHC’s vice president of state and local innovation. “We are only working with the (Biden-Harris) administration, but also with members of Congress to hopefully educate them and have them understand why these renters’ rights are so important, and the impact that will have on renters’ long term.”

Gallaher said NLIHC is working with national, state, and local house partners to bring the new policy proposal before Congress next year. 

“There are now no consistent renters’ rights (nationally). Some states, like Arkansas, have very few tenants’ rights, and some states have more robust laws,” she said. “So having a federal platform helps level the playing fields, and it helps renters understand, no matter where they live or what jurisdiction, there are these fundamental rights that are available.”

Among key proposals, the legislation would provide universal protections for renters from the application, screening, and credit check process throughout the lease period. It also would strengthen fair housing protections and enforcement, enforce the right to a habitable and safe home, and regulate rent increases and associated fees and expenses.

The proposed legislation would also shift the current imbalance between renters and landlords by giving tenants the right to organize without fear of retaliation or eviction. It would also create a federal “just cause” provision against evictions, require landlords to give all tenants a 30-day notice before removing tenants, and strengthen due process protections in court.

In the past three legislative sessions, however, the Arkansas Legislature has rejected all attempts to revamp the Arkansas Residential Landlord and Tenant Act of 2007, which holds landlords mostly immune from tort liability. Backed by the Arkansas Realtors Association, the state arm of the powerful National Association of Realtors, the Arkansas law is also notable for the lack of an implied warranty of habitability for residential leased premises.

In 2011, Act 1198 created the non-legislative Commission on the Study of Landlord-Tenant Laws to study, revise, and report one landlord-tenant law in Arkansas and other states. Two years later, the Commission issued a report to the legislature recommending reforming state law. 

During the pandemic, Arkansas Legal Aid, the ACLU of Arkansas, and the Bowen Legal Clinic filed suit in federal court, challenging the constitutionality of the state’s criminal eviction statute. The legal coalition represented a local renter facing eviction and potential criminal penalties after losing their job due to COVID-19.

The lawsuit, filed before President Trump’s moratorium took effect, asserted that Arkansas’ criminal eviction law denies people their right to due process and violates the state and federal constitutions. 

“Arkansas is the only state where being late on the rent can result in a criminal prosecution – purely on the basis of a landlord’s say-so,” said Holly Dickson, ACLU of Arkansas interim executive director and legal director. “This law allows landlords to use the criminal process to get the upper hand in a matter for civil court, and it disproportionately impacts Black and brown communities who already suffer from over-policing and systemic discrimination in housing, health care, and employment. Poverty is not a crime, and it is long past time for this cruel and unconstitutional law to be struck down.”

However, U.S. District Judge Brian Miller eventually refused to block enforcement of the Arkansas criminal eviction law, ruling that the plaintiff was unable to prove that the statute—the only one of its kind in the nation—was unconstitutional.

The law, passed in 1901, makes it a misdemeanor for tenants who owe rent to stay on leased property after a written notice to vacate is given. A tenant one day late on rent can also be ordered to vacate the property within ten days. Each day the renter remains on the property after that deadline is a separate criminal offense under the law.

Although lawmakers amended the century-old law in 2001, a Pulaski County Circuit Court ruled it unconstitutional in 2015, ending enforcement in Little Rock. The General Assembly, however, removed the parts of the law found unconstitutional by the circuit judge in 2017, returning the law to the version found to be constitutional by the state Supreme Court, Miller ruled.

Less than six months before the 2025 Arkansas General Assembly convenes in January, Lewellen said Arkansas Legal Services hopes a new proposal to rewrite current state law will emerge, calling the 2007 policy the “weakest tenant rights” legislation in the nation.

“I can’t speak to any specific bills that I expect to be introduced, but I anticipate that issue will be coming up again,” she said.


Wesley Brown wrote this article for the Arkansas Delta Informer.


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The most recent census figures show a significant drop in poverty in the Richmond metro area - and are being met with skepticism.

The American Community Survey reports the poverty rate in the metro area fell to 9.9% last year, down from 10.7% the previous year. Richmond City's rate is still higher, at more than 17%, although that's a notable drop from 21.7% in 2022.

Jay Speer, executive director of the Virginia Poverty Law Center, is unconvinced that these figures reflect real progress.

"First of all, I think the way we measure poverty is way, way, way too low," he said. "There's so many people struggling economically, trying to make enough money to pay the rent and utilities and all those sorts of things, that to say only 9% of people are in poverty just seems crazy to me."

In 2023, poverty-level income was about $31,000 for a family of four, and less than $16,000 for an individual. While conservative think tanks advocate for boosting businesses in the Commonwealth as a solution, others propose income support programs and universal health care as more equitable approaches.

Statewide, Virginia's poverty rate stands at 10.2%. The state's minimum wage has increased to $12 an hour, but Speer said he believes this is still insufficient to lift many families out of poverty. He contended that the federal poverty line also doesn't reflect real living costs, especially in high-rent areas such as Richmond.

"Basically, what I'm telling you is what I see, and I think a lot of this is sort of common sense," he said. "What does $12 get you for an hour's work? Or even $15, which a lot of people say is a living wage."

Speer shared his skepticism about poverty measurements with labor leader The Rev. William Barber, suggesting the census figures may mislead people into thinking the situation is improving. And stark disparities persist between urban and rural areas. Northern Virginia's poverty rate is lower than Richmond's, while regions such as Southside and Southwest Virginia still face higher poverty levels.