Friday, May 18, 2018

Anti-immigration Republicans beat GOP Farm Bill in House

Republicans who want action on immigration brought down their party's own Farm Bill on Friday.

"The House leadership put the bill on the floor gambling it would pass despite unanimous Democratic opposition," Erica Werner and Mike DeBonis report for The Washington Post. "They negotiated with members of the conservative House Freedom Caucus up to the last minutes. But their gamble failed. The vote was 213 to 198, with 30 Republicans joining 183 Democrats in defeating the bill."

The bill "included President Donald Trump's push to impose stricter work requirements on food stamp recipients," Politico notes. "It is a huge setback to the farm lobby and House Speaker Paul Ryan's welfare-reform agenda." The current Farm Bill expires Sept. 30, and "GOP farm-state lawmakers are hoping that the farm bill can provide some relief for agricultural producers dealing with a multiyear drop in crop prices and an uncertain trade environment."

The House Freedom Caucus, a bloc of ardent conservatives, had "held the bill hostage" for two days, Politico reports, "demanding that the House first vote on controversial immigration legislation in exchange for their support for the sweeping agriculture and nutrition legislation." The Post reports, "With moderate Republicans maneuvering to force a vote on legislation offering citizenship to some younger immigrants who arrived in the country as children, conservatives revolted."

Politico reports, "GOP leaders said they would delay a motion to reconsider the bill until a later date. It is unclear if they intend to try to pass the partisan bill again — or move to a bipartisan document that could easily clear the Senate."

The Post looks ahead: "The outcome exposed what is becoming an all-out war within the House GOP over immigration, a divisive fight the Republicans did not want to have heading into midterm elections in November that will decide control of Congress. . . . The House farm bill would have been a non-starter anyway in the Senate, which is writing its own farm bill. Any legislation that ultimately makes it to Trump’s desk will have to look more like the version in the Senate, where bipartisan support will be necessary for anything to pass and there is not sufficient support for the food-stamp changes."

And Politico looks back: "Rejection of the legislation is reminiscent of the last Farm Bill cycle in 2013, when the House also voted down a conservative version of the legislation, delaying the process for months. Ultimately, the sweeping bill was bailed out by Democrats the following year. . . . A partisan farm bill is a departure from past tradition, when a coalition of moderate lawmakers from rural and urban America came together to support the agricultural economy and some 40 million people who now get help buying groceries."

Farm states say they bear 'unfair' brunt of Chinese tariffs; Commerce secretary says administration will try to help

"Several senators whose states are already feeling the effects of escalating U.S. trade tensions with China pressed Wilbur Ross at Thursday’s Senate Appropriations [Committee] hearing on the Trump administration’s tariff strategy," Dave Nyczepir reports for Route Fifty.

Sen. Jerry Moran, the Kansas Republican who chairs the committee said the tariffs imposed by China have done "significant economic harm" to his state, which he noted is a leader in beef, pork, wheat, sorghum and soybean production--all of which have been slapped with heavy tariffs.

Ross, Trade Representative Robert Lighthizer, and Treasury Secretary Steven Mnuchin went to China last week in an attempt to halt the escalating trade war. Both sides delivered specific demands, Ross said at the hearing, but said the gap between what the two countries want remains "wide." 

Agriculture had figured heavily in the trade discussions with China, Ross said, and promised "we will do our level best to minimize the problem and to maximize the support we can provide in helping them."

EPA sued for not requiring mining companies to prove they have the money to clean hazardous waste spills

"Six environmental groups on Wednesday filed a lawsuit against U.S. Environmental Protection Agency chief Scott Pruitt for abandoning a rule that would have forced hard-rock mining companies to prove they have enough money up front to clean up hazardous substances released at mine sites," Reuters reports

The groups, including Earthjustice, Earthworks, and the Sierra Club, filed the lawsuit in the District of Columbia Circuit Court. Many abandoned former mines in the U.S. West are still polluted and harm public health, the groups argued. When mining companies go bankrupt, taxpayers have to pay millions or even billions in cleanup. The EPA estimates the current backlog of cleanup costs for hard-rock mines in the U.S. is anywhere from $20 billion to $54 billion. 

"In December, the EPA decided to abandon the rulemaking process after determining that modern industry practices already address risks from operating hard-rock mining facilities," Reuters reports. Pruitt said at the time that the rule would impose an "undue burden on this important sector of the American economy and rural America, where most of these mining jobs are based."

4-H project propels Penn. teen to successful hog business

Dakota Grumbine feeds his Berkshire hogs. (PBS NewsHour video footage capture)
4-H has been helping students gain confidence and learn about animal husbandry for more than 100 years, and a Pennsylvania teen has taken those lessons to heart with extraordinary results, Alexis Lesher reports for PBS NewsHour's Student Reporting Labs series, Making It Work.

When Dakota Grumbine was 8 years old, he raised some pigs for a 4-H project. But with hard work, the Lebanon teen has turned that project into a profitable business breeding pasture-raised Berkshire pigs and selling the meat to butchers and restaurants. Berkshires are a specialty breed that bring more than a dollar more per pound than regular pork. 

Grumbine's Berkshires now has 20 sows, four boars, and nearly 200 customers, but he had a lot to learn to get his business off the ground. "When I first started off, I didn’t really have any luck as far as the breeding standpoint goes," Dakota told Lesher. "I couldn’t get pigs settled. The litters were small. Not many of them had a second litter, or they just didn’t work out. So it took me a while to get a sow base built up."

Dakota said that even if he doesn't stick with raising hogs as a career, he's glad he's learning how to manage time and money, as well as other skills. His dad, Darren Grumbine, agreed: "The younger you are when you start something, the easier it is to pick it up. I see other kids don’t enjoy certain opportunities such as public speaking and talking to strangers. He did that stuff at such a young age, that now he doesn’t even really think about some of those things that hold a lot of kids back."

Kentucky lost half a million acres of farmland to homebuilding in the last 20 years, preservationists say

A new report from the American Farmland Trust, the nation's leading farmland-preservation group, says that America has been losing twice as much farmland as the group thought, and the leading cause of it is low-density residential development, especially in Kentucky, Al Cross reports for the Midway Messenger in Kentucky. Cross is the director of the Institute for Rural Journalism and Community Issues.

The president of AFT, John Piotti, announced the findings in a May 12 press conference on a farm in Scott County, Kentucky. "Piotti said a study that AFT will issue in May will show that Kentucky lost 791,000 acres of farmland from 1992 to 2012, and 499,000 acres of that, or 61 percent, was from building of single-family homes on lots of two to 10 acres. He said the national figure was 41 percent, so 'Kentucky stands out.'" Cross reports.

Counties can preserve farmland by purchasing development rights to farmland, or put farms under a conservation easement. Preserving farmland not only helps existing farmers and encourages tourism, Piotti said, but it helps keep land prices down so more young people can get into farming.

Thursday, May 17, 2018

MIT project helps self-driving cars navigate rural roads

How MIT's car sees the world with a LiDar sensor (MIT illustration)
Self-driving cars are already on the streets in a few urban areas, but they face a significant barrier to driving rural roads: there may not be detailed three-dimensional maps available (think Google Street View maps), and the roads can be twisty with few or no buildings nearby to help the car assess landmarks or road edges. But researchers at the Massachusetts Institute of Technology have come up with a way to help autonomous cars navigate rural roads, and "their strategy involves teaching cars to drive like humans," Rob Verger reports for Popular Science.

Though self-driving cars rely on detailed maps to help them figure out where they are in a city, many have a LiDAR (Light Detection and Ranging) sensor that helps it see curbs and other obstacles. The MIT team juiced up their test vehicle's LiDar sensor to help it detect the difference between the asphalt and the grass. The LiDAR's 64 lasers each spun around 10 times per second, providing constant feedback on what the car's surroundings look like and where it was on the road.

That’s how the car perceived where the road was in front of it, but it still had to know how to drive to its destination without a great 3D map in its silicon brain (although it did have GPS)," Verger reports. "To do that, it picked a 'local goal'—a point in the road up ahead that the car could see, and drove towards it. But it didn’t just drive to that point and stop. The vehicle constantly refreshed that goal as it approached it, like paddling towards a point on the horizon on a big, flat lake."

Christoph Mertz, a scientist at Carnegie Mellon University's Robotics Institute, admires the project because he says rural areas are sometimes neglected by scientists, and this project could help rural residents: "If these autonomous vehicles don’t drive in rural areas, then the elderly there might be stuck in their houses because nobody can drive them."

North Carolina teacher protest exposes urban-rural divide

N.C. teachers march on Raleigh. (AP photo by Gerry Broome)
Thousands of North Carolina teachers marched on the state Capitol in Raleigh yesterday in support of increased school funding.

About two-thirds of the state's children were out of school yesterday because there weren't enough substitutes to cover for teachers who requested the day off. "But the districts that canceled class, affecting nearly 1 million students, are concentrated in the state’s urban and suburban counties. Most of the state’s 100 counties are rural, and their school districts stayed open," Valerie Bauerlein reports for The Wall Street Journal. "That divergence isn’t a coincidence, and reflects the growing divide in the state between the liberal cities that drive the state’s economy and the conservative small towns and rural areas that control state politics."

The protest differed from those in other states in that teachers only expected to march for one day, and many said they didn't expect lawmakers to raise teacher pay immediately, Bauerlein reports.

One protesting teacher, Jenna Moore, said she has to work a second job as a real-estate agent to make ends meet, and that schools are not given enough funding for classroom supplies. Moore is a fifth-grade teacher in the city of High Point, pop. 111,223.

The state Republican Party said the protest unnecessarily inconveniences parents and students, and noted that the legislature has increased teacher pay every year for the past four years, with another increase scheduled for next year. North Carolina ranks 37th in teacher pay, with an estimated annual average of $50,861, compared to the national average of $60,483, according to a report from the National Education Association. While North Carolina law bars public employees from joining unions, the organization that sponsored the march, the North Carolina Association of Educators, is an NEA affiliate.

Were chicken prices fixed? Are they still being fixed?

In February several grocery retailers and the country's two biggest food distributors filed suit against a slew of poultry companies like Tyson Foods and Perdue Farms, accusing them of colluding to fix the price of broiler chickens for 10 years. It's the third lawsuit in less than two years alleging poultry price fixing, and a fascinating new story from NPR explains how the story leaked in the first place.

In 2016, some Wall Street hedge fund investors had bet a lot of money that the stocks of chicken companies (along with the price of chicken) would fall, but the stock prices and chicken prices remained high, Dan Charles reports for NPR. The investors wondered if chicken companies were keeping prices artificially high, and hired a lawyer to investigate.

The lawyer found that many big chicken buyers, such as supermarkets and restaurant chains, were using the Georgia Department of Agriculture's chicken price index to set their prices, since Georgia is the nation's leading poultry producer. A department employee named Arty Schronce was in charge of compiling the index. He called big companies like Tyson weekly and asked how much they were selling chickens and chicken parts for, then sent out the index in a newsletter. But the hedge-fund lawyer noticed that Schronce's numbers were too high -- sometimes 30 percent to 50 percent higher than other indexes, Charles reports.

Then the lawyer found a memo Schronce had written to himself, saying he didn't believe his own index anymore. There was no protocol to make sure chicken was actually selling at the prices the producers quoted. "Within a day of the lawyer getting that memo, it's been passed on to The Washington Post," Charles reports. "When it's published, it destroys the reputation of that price index. Georgia stops publishing it. Which is what Artie Schronce had proposed in his memo; it just took some short-selling Wall Street guys to make it happen."

Chicken prices still didn't fall after chicken buyers stopped using the index, and that's part of the reason for the current lawsuit: chicken buyers say poultry producers had fixed the prices and somehow still are. Not only is this a study in poultry pricing, it may be a cautionary tale about data and their sources.

Senate votes to save net neutrality in mostly symbolic vote

The U.S. Senate voted 52-47 yesterday to preserve federal net neutrality rules, which had been repealed in December by the Federal Communications Commission. The resolution of disapproval was mostly symbolic, since the heavily Republican-controlled House is unlikely to pass it, and even if it did, President Trump would likely veto it. But because most Americans favor net neutrality, Senate Democrats are likely looking to use the vote as political fodder against Republicans in the upcoming midterm elections.

The Senate vote was mostly along party lines, with all Democrats and three Republicans voting for the resolution: Susan Collins of Maine, Lisa Murkowski of Alaska, and John Kennedy of Louisiana, Alyssa Newcomb reports for NBC News.

The major battleground for net neutrality rules is now at the state level. Several states have passed net neutrality protections by legislation or executive order, such as Montana, Oregon, and Washington.

Wednesday, May 16, 2018

Salt Lake Tribune lays off a third of newsroom employees; won't have separate section for Utah news on most days

A little over two years ago, Utah's two major newspapers cut back on their rural circulation. Such moves are often followed by a reduction in rural coverage, and that happened this week, as the Salt Lake Tribune announced that it would cut its newsroom by a third and "eliminate its high-profile Utah news section Tuesdays, Thursdays and Saturdays, having already gone dark with its Monday version of the local news page," Tony Semerad reports for the Tribune.

"Local coverage will still be available every day of the week, but on Mondays, Tuesdays, Thursdays and Saturdays, you’ll find it in the A section," Editor Jennifer Napier-Pearce wrote in an editor's note. "I thank our loyal readers and subscribers — both print and digital — for standing by us through these difficult times. We feel the love and hope you’ll continue to value our coverage. Send us news tips. Share our stories on social media. Sign up for our newsletters. Listen to our podcasts. Attend our live public events. Encourage local businesses to advertise in the paper and online. And, of course, subscribe."

Paul Huntsman, who bought the paper in 2016, warned of the cuts last week, saying they were "part of breakthroughs in talks with The Church of Jesus Christ of Latter-day Saints, owner of the Deseret News, The Tribune’s business partner on print, advertising and circulation, Semerad reports. "But for staff, going from the journalism high of winning a 2017 Pulitzer Prize and confidence in Huntsman’s philanthropic ownership to Monday’s hard and sobering shift felt like a blow to the Tribune’s identity — not least its ability to keep a watchdog role in Utah and build audiences."

U.S. Department of Education derails for-profit college investigation, hires people with for-profit college ties

"Members of a special team at the Education Department that had been investigating widespread abuses by for-profit colleges have been marginalized, reassigned or instructed to focus on other matters," Danielle Ivory, Erica Green and Steve Eder report for The New York Times. That's derailed probes of several large for-profit colleges where some of Education Secretary Betsy DeVos's top hires had worked, such as DeVry Education Group, now known as Adtalem Global Education. For-profit colleges are prevalent in rural areas or tend to attract a disproportionate number of students from young adults in rural areas.

The team was created in 2016, the last year of the Obama administration, after the collapse of California-based Corinthian Colleges. It began investigating advertising, recruitment practices and job-placement claims by several for-profit colleges, but the probe suddenly stopped early last year, and last summer DeVos named former DeVry dean and current Education Department employee Julian Schmoke as the investigative team's supervisor. Last summer the Trump administration also suspended rules aimed at protecting students from predatory for-profit colleges.

Other former for-profit college employees who now work for DeVos include "Robert S. Eitel, her senior counselor, and Diane Auer Jones, a senior adviser on postsecondary education. Last month, Congress confirmed the appointment of a lawyer who provided consulting services to Career Education, Carlos G. Muñiz, as the department’s general counsel," the Times reports.

The investigative team now only has three members, and its scope has been narrowed to focusing on processing student-loan forgiveness applications and lesser compliance cases, according to former members. Department spokesperson Elizabeth Hill said the team is smaller because of attrition, and investigations are only one way the department provides oversight. Hill said the refocus of the team's efforts isn't an indication that the department is curtailing its oversight, and said none of the new employees who had worked in the for-profit industry influenced the team's work.

"The former and current employees disputed Ms. Hill’s account, and said the group and its work had become an issue of contention during meetings with the Trump transition team," the Times reports. "Several of the employees said that there had been a staff push to continue the investigation as recently as this year, with no result."

Recreation is a key to rural population and economic growth

"The outdoor recreation industry is a critical engine for the national economy, larger in size than the agriculture and fossil-fuel mining and drilling sectors, according to a recent Department of Commerce report," Bryce Oates reports for The Daily Yonder. "The report also said that rural communities and small business owners are a key ingredient in the growing economic engine."

A Stateline analysis of census data found that outdoor recreation helped drive the slight growth in rural population from 2016 to 2017. While populations shrank in big mining and farming counties, those with large recreational industries grew, and grew the most. Independent research group Headwaters Economics found that population, employment and personal income grew an average of two times faster or more in Western rural counties with the most federal lands, Oates reports.

The Commerce Department's Bureau of Economic Analysis began compiling its report in 2016 after President Obama signed the Outdoor Recreation Jobs and Economic Impact Act, which directed the department to work with the Agriculture and Interior departments to assess and analyze the outdoor recreation economy. Commerce Secretary Wilbur Ross hailed the report as a good source of data that businesses can use to help them plan for the future, as it measures the economic impact of recreational activities such as boating, fishing, RVing, hunting, camping and hiking.

According to the BEA report, the largest industry in outdoor recreation is motorized vehicles (mostly RVs), which accounted for $59.5 billion of economic activity in 2016. Boating and fishing contributed $38.2 billion that year, and hunting/fishing/trapping brought $15.4 billion.

An industry trade group called the Outdoor Industry Association did a similar study that found $887 billion of economic activity generated by outdoor recreation, more than twice what BEA found. The difference lies in the methodology: "The BEA report did not account for the revenue produced from apparel and equipment manufactured overseas, which makes up a large portion of outdoor gear," Oates reports. "In addition, the BEA did not measure recreation spending on trips that happen less than 50 miles from home."

Massive billing schemes found at recently purchased rural hospitals, insurance companies allege

We asked in March, "Heard of a rural hospital in danger of closing being rescued by a buyer when no one else seemed willing to buy it?" and warned, "It may be a scam." Now insurance companies are trying to get back nearly half a billion dollars they paid rural hospitals in several states because of alleged fraud. "In March, Blue Cross Blue Shield filed a $60 million lawsuit against Hospital Partners, alleging their arrangement with labs was a 'fraudulent scheme'," Jim Axelrod reports for CBS News. Hospital Partners is in turn suing Missouri State Auditor Nicole Galloway, claiming she had no right to audit Hospital Partners property Putnam County Memorial Hospital in 2016.

The scheme works like this: a company that owns a laboratory service (such as Hospital Partners) buys a struggling rural hospital, then issues bills for laboratory work from all over the country through the rural hospital. This means more profit, because insurance companies reimburse rural hospitals at higher rates to help keep health care in those areas. The labs sometimes plump their bottom lines by paying kickbacks to health-care providers for specimens they could then bill at the higher rates, Axelrod reports. "Essentially the hospital appeared to act as a shell company for these questionable lab billings," Missouri Auditor Galloway said. "In a six-month period, [Putnam] funneled through about $92 million in revenues. To put that in perspective, the previous year their total revenues were $7.5 million."

Jason Mehta, a former federal prosecutor who specialized in health-care fraud cases, told Axelrod that defining the scheme as fraud requires specific parameters: "The question's gonna be, did the laboratories intend to cheat? Did they intend to trick? Did they mislead the insurance companies? Because simply making extra money isn't a crime in and of itself. It's the question of, was someone tricked? Was some deceived?" The situation also has implications for Medicare and Medicaid, which provide a larger share of revenue for rural hospitals than for others.

Tuesday, May 15, 2018

Fewer U.S. workers are using prescription opioids, but more are using cocaine, methamphetamine and marijuana

Fewer U.S. workers are using prescription opioids, but more are using methamphetamines, cocaine, and marijuana, according to data released by Quest Diagnostics, which conducts workplace drug testing, Katie Zezima reports for The Washington Post.

The overall percentage of workers who tested positive for drug use remains unchanged since 2016 at 4.2 percent, but it's higher than the 3.5 percent return in 2012. Positives for meth have increased 167 percent in the South and Midwest in the past five years, and cocaine positives have increased dramatically in some areas: there was a spike of 91 percent in Nebraska and 88 percent in Idaho from 2016 to 2017. Marijuana positives have increased in states where recreational use of the drug has been legalized, such as Nevada, Massachusetts, and California. Those states also saw a bump in positive marijuana tests among safety-sensitive workers such as pilots and truck drivers, Zezima reports.

"The increases come as the number of workers testing positive for prescription opioids and heroin have declined, even though the opioid crisis continues to ravage the United States," Zezima reports. "The rate of drug tests that were positive for a prescription painkiller declined by 17 percent from 2016 to 2017. Tests for a metabolite that is in heroin dropped by 11 percent from 2016 to 2017, a three-year low." Part of that may be because Quest doesn't test for synthetic opioids such as fentanyl, which is driving the increase in drug overdose deaths.

Barry Sample, senior director of science and technology at Quest, told Zezima: These changing patterns and geographical variations may challenge the ability of employers to anticipate the 'drug of choice' for their workforce or where to best focus their drug prevention efforts to ensure a safe and healthy work environment."

Click here for a handy guide for journalists on how to cover rising meth use, from Journalist's Resource at Harvard University.

$71-a-barrel crude gets more drilling rigs into the oil patch

Wall Street Journal graphic from Baker Hughes data (Click to enlarge )
Higher oil prices have triggered a rise in drilling into deep shale formations in the U.S, and though oil fields in the Permian Basin of West Texas and New Mexico are still the fastest-growing spot, shortages in labor and materials and congested pipelines there have prompted drillers to look further afield. "From Oklahoma to North Dakota, companies are increasing investment in oil fields that fell out of favor several years ago, as $70-a-barrel crude prices make fracking and horizontal drilling economical in more places again," Rebecca Elliott reports for The Wall Street Journal.

The oil-rig count in the Permian more than tripled over the past two years because its existing infrastructure and high-yielding shale made it the least expensive place in the U.S. to get oil from fracking, but the number of oil rigs in other basins more than doubled in the same period. That includes North Dakota's Bakken region, the Eagle Ford in South Texas, the Granite Wash in the Texas Panhandle and the Cana Woodford in Oklahoma.

"Last year it was all about, 'How much can you put in the Permian?'" Daniel Romero, an analyst with the energy consulting firm Wood Mackenzie, told Elliott. "But now, a few months later, it’s what else are you doing outside of the Permian?"

Maine's senators introduce bill to suspend newsprint tariff

"Maine’s two U.S. senators have introduced a bill to delay final implementation of an import tax on Canadian newsprint," Dennis Hoey and Edward Murphy report for the Press Herald in Portland. "Federal agencies have begun imposing a tariff on imported newsprint of as much as 32 percent, and critics say it is already hurting U.S. newspapers and other print publications."

A newsprint mill in Washington state that was recently purchased by a hedge fund triggered the tariffs after it complained that Canada unfairly subsidized newsprint manufacturing. The Department of Commerce and the International Trade Commission announced the first round of countervailing duties on uncoated groundwood paper in January. Countervailing duties are a sort of tariff levied on imported goods to offset subsidies given to producers in the exporting country. In March, Commerce also announced preliminary "anti-dumping" duties as high as 22.16 percent on Canadian newsprint imports.

The proposed PRINT Act, sponsored by Republican Susan Collins and independent Angus King, who caucuses with the Democrats, "would require the Commerce Department to study the health of the domestic newsprint industry along with the newspaper industry, and issue a report to the president and Congress within 90 days . . . since Commerce and ITC typically don't typically study the impact of import taxes on secondary industries, only the industry that duties would help protect--in this case, newsprint makers," Hoey and Murphy report. The bill would also freeze the import tax until the president has received the report and agrees it's in the nation's economic interest.

Medicare boost payments to durable medical equipment suppliers in rural areas hurt by competitive bidding process

"Companies that supply medical equipment through Medicare say the program's plans to boost their payments isn't a giveaway, but rather a reflection of the reality that small companies serving remote areas have been crushed by Medicare's competitive bidding system," Bob Herman reports for Axios.

Medicare implemented a competitive bidding program several years ago to control costs. It mostly affected the durable medical equipment (DME) industry, which has a long history of Medicare fraud and questionable billing practices. Durable equipment includes walkers, wheelchairs, oxygen tanks and insulin pumps.

But the program hurt rural DME suppliers, so the Centers for Medicare and Medicaid Services raised payments for DME suppliers in early May to help mitigate those losses. Seniors and taxpayers will foot the bill for an estimated $70 million of the $360 million annual expenditure for the payment raise. "Medigap plans and Medicaid will cover part of those out-of-pocket costs, but "beneficiaries who do not have supplemental insurance or who are not dual eligible will have increased cost-sharing as a result," according to the regulation," Herman reported in an earlier piece.

Journalist-author, a rural native, says metro and national editors should commission stories from rural journalists

Editors of national and metropolitan publications should commission stories from rural journalists who have more knowledge of their communities than urban reporters who parachute in, journalist Sarah Smarsh told Journalist's Resource, a service of the Shorenstein Center on Media, Politics and Public Policy at Harvard University, where she was recently a Joan Shorenstein fellow, developing a podcast about the intersection of health and poverty.

Sarah Smarsh
“I’m most partial to the strategies that essentially harness the reporting power of people who are already there in those places who perhaps were laid off five years ago from their local newspaper,” Smarsh said. “I think we’ll find out the extent to which those strategies succeed over the next few years.”

Smarsh says too many urban reports on rural areas paid with a broad, white brush. Rural areas are much more racially diverse than one would think from reading national headlines, she told JRThose parts of the country have always been much more than white people, and as we speak they are diversifying, in some places quite rapidly, often due to an influx in immigrant populations taking jobs in industries like industrial agriculture and meatpacking plants. Barely a majority of the eligible voting population ends up at the polls, and then somewhere around under half of people vote for the candidate who wins that state, and then the whole square is colored red on a cable-news graphic.

"Smarsh reports on socioeconomic class, politics and more for national and international outlets, including The Guardian, The New Yorker and The Cut," JR reports. "Her forthcoming book, Heartland: A Daughter of the Working Class Reconciles an American Divide, delves into her experiences with class and place growing up on a working farm in Kansas."

Monday, May 14, 2018

Resentment of coastal elites, much of it rural, still motivates Trump voters, according to three new reports

By Al Cross
Director, Institute for Rural Journalism and Community Issues

A resentment of coastal elites is a key to the support that President Trump still enjoys in parts of the country that abandoned their usual Democratic allegiances for him in 2016. That's a thread that runs through three recent in-depth reports: one by a Democratic pollster, one by The Washington Post's chief political reporter, and the other by a conservative journalist who was one of the leaders in defining the who and why of Trump voters before the election.

Much of this resentment is in among Americans, as I outlined in a speech to a rural-education conference last week and in a chapter for a book, The Trump Presidency, Journalism and Democracy, published by Routledge in Februrary. The latest reports are by pollster Stan Greenberg, on voters in suburban Macomb County, Michigan; the Post's Dan Balz, who reported from rural counties along and near the upper Mississippi River; and Salena Zito, who with Republican operative Brad Todd wrote The Great Revolt, a new book based on "10 counties they studied across the five states that tipped the election to Trump, as the Post's James Hohman describes it in the paper's "Daily 202."

Here's what Michael Martin of Erie, Pa., told the authors: “Live in a small or medium-sized town, and you would think we were dragging the country down. We aren’t a country just made up of large metropolitan areas. Our politics and our culture up until now has dictated that we are less than in the scale of importance and value.” That is reflected in much of the national news media, based mainly on the East Coast, and resentment of media portrayals is a big part of the attitudes of rural voters, who gave at least 62 percent of their votes to Trump, a record.

Zito and Todd note "a polarization between those who live in dense cosmopolitan communities with higher-than-average education levels and those who live in rural, exurban and industrial locales that, as a rule, have . . . lower-than-average education levels and less transience." Four of the 10 counties where they did interviews are rural; evangelical voters are represented largely by rural Howard County, Iowa, where Obama got 62 and 59 percent of the vote and Trump got 58.

Greenberg has long studied “Reagan Democrats” in Macomb County, "which Trump won by 12 points after Barack Obama carried it twice, including by 16 points in 2008," Hohmann notes. “Trump voters complain that there is no respect for President Trump or for people like them who voted for him,” Greenberg writes in a new memo summarizing his latest findings, with Nancy Zdunkewicz of Democracy Corps. “A healthy diet of Fox News is feeding the white working-class men fending off the challenges of Trump’s opponents, including those within their own families. They … feel vindicated that a businessman like Trump has produced a strong macro-economy and kept his promises on immigration. They continue to appreciate how he speaks his mind, unlike a typical politician.”
Balz's report was illustrated by the map above, which also shows how reliably Republican the overall rural vote has become. "One reason Balz’s piece is great is that it’s longitudinal: It tracks in a nuanced way how specific people’s attitudes about Trump have shifted gradually since he took office," Hohmann reports. "The best illustration is Kurt Glazier, 50, from Sterling, Ill.," population 15,000. Balz visited him four times. "He’s a state worker, a union member and chairman of the Republican Party in Whiteside County. . . . By midsummer of 2017, Glazier had growing concerns about Trump. . . .Near the first anniversary of the president taking office, Glazier worried especially that those who voted for Trump are now viewed by others as therefore being like Trump. . . . Glazier drew a distinction between the staunchest Trump supporters and other Republicans – like him."

Glazier told Balz, “I think the real party faithful, the educated voters, might be beginning to distance themselves from him, and I wouldn’t be too surprised to see a Republican challenger or challengers against Trump. They wanted so much of a change. But he has some changing to do himself before I would be supportive of him again. … A 71-year-old man like he is, I don’t foresee him changing a whole lot.”

Visa review puts rural America at risk of losing more doctors

Physician Bhupinder and his wife Jasmine, a medical student,
with their daughter. (Post-Dispatch photo by Sharon Mai)
Changes to the guest-worker visa program are doing more than hurting small businesses and farms: they could also take doctors away from rural areas that already face a doctor shortage. President Trump signed an executive order last April aimed at preventing fraud and abuse of work visas that allow foreigners to replace American workers. "This April, the Trump administration announced that the spousal visa of H-1B visa holders will be eradicated, effectively making the H-4 dependent spouses not able to seek employment or run businesses," Sharon Mai, Sudipto Maity, and Ranojoy Saha report for the St. Louis Post-Dispatch.

H-1B visas allow highly skilled foreigners, about 70 percent of them Indians, to work in hard-to-fill fields such as rural medicine for up to three years. Physicians were once barred from obtaining temporary work visas, but Congress allowed the practice in 1991. The number of American physicians hasn't kept up with demand; a recent study by the Association of American Medical Colleges predicted the U.S. will face a shortage of between 40,800 and 104,900 physicians by 2030, the Post-Dispatch reports.

But the H1-B program may become far less desirable if foreign physicians' spouses can't also work. Khorzad Mehta, a Maryland attorney who works with immigrant physicians, advised that the U.S. must make green cards more readily available to foreign physicians to keep them in medically under-served areas of the U.S. Because Indian physicians are in the same category as information-technology and finance professionals, it can take up to 15 years to get a green card.

A Missouri immigrant physician named Bhupinder, who asked that his last name not be used, said "You're not taking away somebody's job by coming on H-1B as a physician . . . You're not hurting the country, you're taking care of people." His wife Jasmine, a medical student, could lose her visa under the new rule.

Farm Bill on House floor this week; Republican leaders scramble to find the votes to pass it

The U.S. House of Representatives is scheduled vote this week on a Republican-created Farm Bill that includes several controversial amendments, such as deep cuts to the Supplemental Nutrition Assistance Program, once known as food stamps. Agriculture Committee Chair Mike Conaway told Melanie Zanona ofThe Hill that the bill is still short of the 218 votes it needs but "He expressed confidence that he can flip enough members by working the phones over the weekend, clearing up any questions and concerns and pointing out that some amendments will get a floor vote."

"Democrats walked away from the normally bipartisan Farm Bill process when Republicans decided to include the SNAP revamp, which they say is unnecessarily cruel and would prevent 1 million people from receiving food stamps," Zanona reports. "Even the GOP conference is divided over the changes, with some moderate Republicans worried the requirements are too tough and others worried the changes don’t go far enough."

Changes to sugar subsidies are also a divisive issue, and one that regularly cuts across party lines. Rep. Virginia Foxx, R-N.C., has proposed an amendment to ensure taxpayers don't have to pay for federal bailouts of the sugar industry. But far-right Rep. Ted Yoho, R-Fla., says the amendment would be a "poison pill" that would put the farm bill in jeopardy if it gets to a vote, Zanona reports.

Another controversial provision: stricter work requirements on some food stamp recipients. "All able-bodied adults between the ages of 18 and 59 have to be working or enrolled in a training program for at least 20 hours per week in order to qualify for food stamps," Zanona reports. "People who are elderly, disabled or pregnant would be exempt from the requirements."

Dairy farmers, who have been facing hard times lately, will get some attention in the farm bill too with changes to the Dairy Margin Protection Program. The program has been criticized for not adequately reimbursing farmers hurt by falling milk prices. The farm bill proposal "the amount of milk that can qualify for coverage from four to six million pounds and made the payout monthly," Whitney Bashaw reports for The Daily Star in Oneonta, New York. It will also "strike 'margin protection' to replace it with 'dairy risk management.' The Dairy Margin Protection Program will be renamed Dairy Risk Management. Additionally, dairy producers will now be eligible to participate in the Livestock Gross Margin Insurance Plan for Dairy Cattle, which legislators said can provide flexibility for farmers."

Some ag groups say trade more urgent than new Farm Bill

"While debate continues on the 2018 Farm Bill in Washington, a majority of farm groups say trade is a bigger issue for them than passage of the new farm legislation," Michelle Rook reports for AgWeek.

Specifically, farmers are concerned about the fallout of the increasing trade war with China as well as ongoing negotiations on the North American Free Trade Agreement. Top U.S. officials, including Treasury Secretary Steven Mnuchin and U.S. Trade Representative Robert Lighthizer went to China last week to negotiate a deal to delay threatened tariffs and prevent more in the future, but little progress was made.

Gregg Doud, chief agricultural negotiator with the U.S. trade representative's office, said that though 82 percent of U.S. ag exports to China have been hit with tariffs, he believes the U.S. will come out on top in negotiations, Rook reports.

Jon Doggett, executive vice president of the National Corn Growers Association, said the uncertainty of the market is causing customers to question whether the U.S. is a reliable supplier. And though Agriculture Secretary Sonny Perdue has promised a trade compensation program, Zack Clark, director of government relations for the National Farmers Union, told Rook that "It certainly will not replace getting a good price from the marketplace, which is ultimately what we want to see.

Sunday, May 13, 2018

Ala. editor who dealt with owner's long-ago misconduct leaves the paper and the South for High Plains Radio

Bob Davis (Anniston Star photo by Trent Penny)
The Alabama editor-publisher who had to deal with reports of sexual misconduct by the newspaper's owner has quit to become executive director of High Plains Public Radio, comprising stations in Colorado, Nebraska, Kansas, Oklahoma and Texas.

Bob Davis announced his resignation as editor and publisher of The Anniston Star, long considered one of the nation's best small dailies, in Saturday's edition. The paper reported that the new publisher will be Josephine "Josie" Ayers, who became chairman of the family-owned Consolidated Publishing Co. after her husband, H. Brandt "Brandy" Ayers, resigned following reports of him spanking female employees in the 1970s. His name did not appear in Saturday's story.

Davis had been at the paper for 15 years; the last was surely his most difficult. When a former Star reporter Joey Kennedy of Alabama Political Reporter wrote in a November column that his wife had been spanked by her employer at her first newspaper job, a Star reporter recognized that was Ayers, and chased the story. Editors told him to wait until they could discuss how to treat "sources who wished to remain anonymous and inquiring into events alleged to have happened more than 40 years ago," Davis wrote in a January column, in which he said he had never heard such allegations in his 14 years at the paper.

Reporter Eddie Burkhalter, who said such talk was "common knowledge" in the newsroom, resigned after admitting that he had continued to pursue the story, and told Kennedy that he thought it was being dropped. Davis wrote that no decision had been made. When APR broke the story with a Dec. 28 column and a Jan. 1 story by Burkhalter, the Star quickly published its own story about Kennedy's wife and mentioned other victims but said it lacked permission to use their names. Ayers said he didn't recall such incidents, but in a later Star story he said that had spanked a female reporter on doctor's orders, claiming that she had been out of work because of a psychological problem.

The Star's new editor will be Anthony Cook, who was a reporter and editor at the paper before moving to The Birmingham News and The Huntsville Times, sister papers in the Newhouse family's Advance Publications. "He returned to Consolidated in 2015 as editor of The Daily Home" in nearby Talladega, the Star reports, and will be executive editor of the two dailies and its weeklies, The Cleburne News, The Jacksonville News, The Piedmont Journal and The St. Clair Times.

Friday, May 11, 2018

Small-business owners worry about guest worker cutbacks, reflect similar gripes among farmers; regrets about Trump

Some small business owners who voted for President Trump say his immigration policies may put them out of business. Cuts in the Labor Department's H2-B "guest worker" program "are hurting small businesses across the country that can’t find Americans willing to do hard, manual labor: Maryland crab processors, Texas shrimp fishermen, and Kentucky landscapers and construction companies," Tom Eblen writes for the Lexington Herald-Leader. Not to mention workers needed to harvest agricultural crops, a major concern for fruit and vegetable growers.

Eddie Devine, who owns a landscaping company in Harrodsburg, Ky., population 8,500, has hired 20 seasonal workers for years, mostly from Guatemala. He'd like to hire Americans, he told Eblen, but he can't find enough dependable, drug-free citizens to take his $12-an-hour jobs. Devine lost a big client last year because of the lack of manpower, and worries he'll go out of business this year if he can't find workers. "I feel like I've been tricked by the devil," Devine said. "I feel so stupid."

Central Kentucky construction company owner Ken Monin, also a Trump voter, told Eblen his company almost went bankrupt last year because immigrant workers' visas were delayed for months, but is more charitable toward the president than Devine; he said Trump understands the need for immigrant workers but is "politically trapped by the far right," Eblen writes. Still, Monin worries he will go out of business this summer if he can't find workers. He's tried to hire locally, but said Americans don't want to do the grueling work required, even at $17 an hour.

Trump said at an April rally in Michigan that the U.S. would bring guest workers in because small business owners need them, but didn't get much of a response from the crowd. Devine wondered if cutting back on the guest-worker programs is about racism and not economics, and is angry that Trump's properties in New York and Florida use H-2B workers. "I want to know why it's OK for him to get his workers, but supporters like me don't get theirs," he told Eblen.

Coal predictions get more dire; renewables and gas benefit

"More coal plants are now projected to retire more quickly than experts thought a year ago, according to energy-industry analysts who gathered in Chicago Tuesday," Jeff McMahon reports for Forbes. "Three alternative energy sources—wind, solar and natural gas—are expected to divide up the spoils, they said at the American Wind Energy Association's Windpower 2018 conference."

Max Cohen, an IHS Markit analyst, said his company predict about 100 gigawatts of coal retirements in the next decade, about a third of the available coal energy. 

Bruce Hamilton of Navigant has projected 73 gigawatts will retire in the next 10 years. "That's more than twice what we projected last year at this time. It's more than we had two years ago when the Clean Power Plan was in the assumptions," Hamilton told McMahon. The predictions changed partly because of announced retirements of coal-fired power plants, but also because the costs of coal have gone up while its competitors have all gotten cheaper. 

Free Rural Health Journalism Workshop in North Carolina June 8; deadline to apply for travel stipend is May 23

The Association of Health Care Journalists is hosting a free one-day workshop on covering health on June 8 in Research Triangle, North Carolina.

The conference is free for AHCJ members, but registration is required by May 25. Members who need financial assistance should apply for one of the limited travel stipends by the May 23 deadline.

The keynote speaker will be Hannah Koch, a research and technical assistance associate at the Mental Health Program, Western Interstate Commission for Higher Education. Koch will tentatively discuss key behavioral health issues in rural communities.

Five workshops will cover a variety of topics, including "What reporters should know about rural residents and rural health," featuring Alan Morgan, chief executive officer of the National Rural Health Association and Dr. Jeffrey Heck, president and chief executive officer of the Mountain Area Health Education Center.

Another workshop, "Will your local hospital survive?" includes George Pink, deputy director of the North Carolina Rural Health Research Program and Dana Weston, president of the University of North Carolina Rockingham Health Center.

The "Addressing rural health workforce hurdles" workshop includes Mark Holmes, director of the North Carolina Rural Health Research and Policy Analysis Center and the director of the Cecil G. Sheps Center for Health Services Research and Dr. Robert Bashford, associate dean for the Office of Rural Initiatives at the University of North Carolina School of Medicine.

The "Rural opioid crisis: Access to treatment and harm reduction" workshop includes Regina LaBelle, visiting fellow, Duke-Margolis Center for Health Policy and a former chief of staff in the White House Office of National Drug Control Policy and Donald McDonald, executive director, Addiction Professionals of North Carolina.

And wrapping up the day is a workshop titled, "Can telemedicine transform health care in rural communities?" featuring Latoya Thomas, policy director for the American Telemedicine Association.

To register for the event click here. To request a travel stipend click here or send an e-mail to the membership coordinator Tina England at

On GateHouse and Gannett building 'stronger communities'

After GateHouse Media bought the Pueblo Chieftain in Colorado, it said  it would leverage its national resources "to support the community that will enhance quality of life and help create a stronger community." Kevin Slimp, founder of the news industry site State of Newspapers, was skeptical of the claim by the company that owns more U.S. newspapers than any other.

"Please, someone … anyone … who has been in a community where GateHouse has purchased the local paper and helped create a stronger community, please let me know. I just haven’t seen it," Slimp writes.

Same goes for Gannett Co., which posted a sign outside the Sioux Falls Argus Leader in South Dakota that said something about building a stronger community. "I couldn't help but chuckle, thinking, 'They just didn't mention the community is someplace besides Sioux Falls!'" Slimp writes.

Slimp concedes he may be missing something. It's possible GateHouse and Gannett really are building strong communities, but smaller newspaper publishers keep thanking him for sticking up for them, implying that Gannett and GateHouse don't. Slimp recalls a quote from Upton Sinclair's The Jungle: "It is difficult to get a man to understand something when his salary depends upon his not understanding it."

Some rural areas hit by opioid epidemic don't get priority for federal response grants; CDC cites lack of county drug data

"A federal agency recommended steering the $100 million Congress appropriated for rural counties to battle the opioid epidemic to those dealing with high rates of hepatitis C infection and HIV/AIDS instead," leaving out many rural counties hit by the epidemic, Susannah Luthi reports for Modern Healthcare.

In April, the Health Resources and Services Administration said it would award 75 grants to counties to develop plans for opioid-abuse treatment and recovery, selecting counties considered "at risk" by the Centers for Disease Control and Prevention. But the CDC prioritized counties based on confirmed cases of hepatitis C instead of opioid-overdose rates, according to emails obtained by Modern Healthcare. A CDC official wrote in one that the agency's selected counties are not those "most at risk for overdose or with the highest rate of opioid overdose." The emails said the agency chose hepatitis C infection rates as the key indicator because there is no county-level measure of injection drug use.

While there is a great deal of overlap between the counties facing hepatitis C and those with many  overdoses, some counties with high overdose rates and low hepatitis C rates were left out of the CDC's recommendations. "The CDC's metrics excluded some states battling the highest rates of opioid deaths, including New Mexico, New Hampshire and Florida. Other states with equally high rates, such as Nevada and Pennsylvania, have only a few counties flagged even though they are heavily rural," Luthi reports. "Kentucky, Tennessee, West Virginia and Missouri hold the most counties recommended for funding. These states face the same high opioid overdose death rates as excluded states like New Mexico and New Hampshire. But counties in other states with significantly lower death rates, such as Kansas and Georgia, also made CDC's priority list."

Thursday, May 10, 2018

Report: industry insiders influence EPA more than ever

The Environmental Protection Agency is on the verge of "regulatory capture," a form of government failure in which an agency advances the interests of the industries it's meant to regulate instead of public interest and impartial research, according to a new study in the American Journal of Public Health, Neela Banerjee reports for Inside Climate News.

The study, based on interviews with current and former EPA staff and reviews of White House and EPA initiatives, found that the agency is closer to regulatory capture than it has ever been in its 47-year history. "New EPA leadership has thus far aimed at deconstructing, rather than reconstructing, the agency by comprehensively undermining many of the agency's rules, programs, and policies while also severely undercutting its budget, work capacity, internal operations and morale," said the study.

The report suggests that EPA Administrator Scott Pruitt has enabled this shift toward industry interests by making policy decisions with little input from scientists or longtime staff, and also notes "the extraordinary lengths that Pruitt has [gone to] to preserve secrecy and autonomy from the EPA career staff, such as cordoning his office wing off from career employees, reportedly forbidding note taking at some meetings and employing 24-hour armed guards," Banerjee reports.

The report also chronicled Pruitt's efforts to trash longstanding scientific practices in the agency by dismissing scientific advisory boards and hiring industry insiders. It also noted that the EPA issued 60 percent fewer civil penalties in the first six months of Pruitt's term and an overall decline in enforcement.

Searching public notices nets this reporter big stories

Jim Lockwood
Public notices may seem dry, but they can provide leads to good stories. Jim Lockwood, a reporter at the Scranton Times-Tribune, has won numerous awards for stories he wrote after discovering their genesis in public notices, from estate sales, meeting notices and sheriff's sales of property confiscated in drug seizures. He began searching public notices and clipping out interesting ones as a young reporter in New Jersey, a practice he continues today.

"Reading public notices for story ideas is a skill Lockwood has acquired through years of practice. He can look at most notices and tell, at a glance, if they hold a key to unlocking a good story," Teri Saylor writes for the Public Notice Resource Center. "Lockwood’s sharp eyes and skilled follow-up have earned him several prestigious awards over the years, including PNRC’s Public Notice Journalism Award in 2015, and every public notice award in the Pennsylvania NewsMedia Association’s annual journalism contest since that category was opened in 2014."

And this year he won first place in PNA's contest, and honorable mention in the PNRC competition, for his coverage of municipal issues discovered in the Times-Tribune's public notices. "The notices inspired extensive reporting on a variety of topics including the municipal budget, a delinquent-tax sale affecting 1,900 properties, local government plans to divert federal money allocated for a bridge repair to a variety of street paving projects, and one of his favorites — the sale of the local sewer authority to a water company," Saylor reports.

Some officials complain that public notices are too expensive, and are trying to get state legislatures to cut back on them. Lockwood notes that Scranton taxpayers benefited when the city was forced to publish a list of delinquent tax bills. The city had failed to published them for years, so the notice took up 10 pages. Because people don't like seeing their names in print for delinquent taxes, they're more likely to pay up, Lockwood said. That means fewer people owe delinquent taxes, the city has to spend less on publishing notices, and gets more revenue from back taxes. "It's a great return on their investment," Lockwood told Saylor.

Five myths about U.S.-Mexico border

A group of Central American asylum-seekers who arrived at the U.S.-Mexico border last week has prompted a new round of debate on border management and security. But some of the rhetoric isn't based in fact. So Christopher Wilson, the deputy director of the Wilson Center's Mexico Institute and a knowledgeable source on border affairs, has debunked five popular myths about crossings at the  U.S.-Mexico border.

The first myth is that the border is out of control. Though retired Gen. Barry McCaffrey's 2011 strategic military assessment described conditions along the border as tantamount to living in a war zone," the Mexico Institute's data analysis shows that all but one of the 23 U.S. counties along the border had violent crime rates lower than the national average for similar counties from 2011 to 2015, Wilson reports for The Washington Post.

The second myth is that a border wall would help the opioid epidemic. President Trump said in March that 90 percent of the heroin in America comes through the U.S.-Mexico border, Wilson reports. But heroin was only the third most frequent cause of opioid-related deaths in 2016. The top two were fentanyl and prescription opioids, respectively. Prescription opioids are produced and shipped within the U.S. Some fentanyl is trafficked through Mexico, but usually in vehicles at official crossings where a border wall wouldn't help, and the lion's share of fentanyl is shipped by mail from China. And though most heroin is trafficked from Mexico, like fentanyl, smugglers mostly bring it in vehicles through legal border crossings.

The third myth is that border enforcement doesn't reduce illegal crossings. For decades, increased border security spending failed to reduce illegal immigration, instead causing immigrants to simply try crossing in more remote, dangerous areas. But border officials have gotten better at catching undocumented immigrants. "And surveys show that Mexican migrants apprehended and returned to Mexico have become much less likely to attempt to reenter the United States, with the share saying they’d try again falling from 95 percent in 2005 to 49 percent in 2015, according to a Migration Policy Institute report," Wilson reports.

The fourth myth is that terrorist groups are exploiting a porous border. In 2014, Rep. Duncan Hunter (R-Calif.) said least 10 ISIS fighters were caught crossing the border into the U.S. in Texas. In 2015, some reported the Islamic State had a camp outside of Ciudad Juarez, Mexico. Both claims were quickly proven false. "As the State Department has reported, Mexico has cooperated closely with the United States on counterterrorism issues, and there is 'no credible information that any member of a terrorist group has traveled through Mexico to gain access to the United States,'" Wilson reports.

The fifth myth is that Mexico has strong border laws and the U.S. has weak border laws. President Trump has bolstered that claim recently, tweeting that the caravan of Central American asylum-seekers was "largely broken up thanks to the strong immigration laws of Mexico," Wilson reports. It's true that Mexico plays an important role in either absorbing Central American migrants by giving them refugee visas or deporting them before they reach the U.S. border, but Mexico also reformed its immigration policy in 2011 to decrease corruption and strengthen protection of migrants' human rights. "As for U.S. immigration laws being weak, that is hard to square with an immigration and border security system that detains and removes hundreds of thousands of people from the country each year," Wilson writes."Rather than a weak legal framework, the United States has an under-resourced asylum and immigration court system. Asylum applications have more than quadrupled over the past decade, causing a backlog of more than 300,000 cases."

'Blue wave' Democrats hope for in fall elections isn't likely unless they do better with voters outside the largest cities

With the midterm elections approaching, pundits and news stories keep talking about a possible "blue wave," a surge in votes for Democrats as a response to President Trump and Republican policies. In this narrative, rural residents triggered Republican control of Congress in 2010 and the White House in 2016, "at best a misleading and incomplete account," Bill Bishop and Tim Marema write for The Daily Yonder. "And it also misses a more important trend in the nation’s politics since Barack Obama won the presidency in 2008: the increasing concentration of Democratic voters into the largest metropolitan areas."

Democrats have been losing voters outside large metros since 1980, but the trend is accelerating. "Democrats don’t have a rural problem. They’ve got an everywhere-but-the-nation’s-largest-cities problem," Bishop and Marema report. They broke down communities into six categories: Major Metro Core (pop. 1 million or more), Major Metro Suburbs (the suburban counties of major metropolitan areas), Medium Metro Core (pop. 250,000 to 999,999), Medium Metro Suburbs (the suburban counties of medium-sized metropolitan areas), Small Metro (pop. 50,000 to 249,999), and Nonmetro/Rural (all counties not located in a metropolitan statistical area). On the charts below, the red and blue lines denote congressional races, while the columns denote presidential races:
Daily Yonder map; click on the image to enlarge it.
Bishop and Marema note that rural voters didn't heavily swing Republican until 2010, two years after Democrats won the White House and took control of Congress. They have since turned more Republican, but so have smaller metros, to a lesser extent.

"For a 'blue wave' to crash into Washington this election season, Democrats will have to do more than activate the major metropolitan base," Bishop and Marema write. "That tactic was enough to get Obama re-elected in 2012 but not enough to fend off Donald Trump in 2016. And for congressional races, it hasn’t been enough to win a House majority since 2008."

Ohio voters pass limited reform of redistricting

Ohio's current congressional districts (Vox map)
Ohio voters reformed their redistricting system in a referendum Tuesday, with about 75 percent of voters favoring the proposal aimed at limiting partisan gerrymandering. "The new redistricting process, which affects how Ohio draws its congressional district lines, will be used when those lines are next redrawn, after the 2020 census," Andrew Prokop reports for Vox.

The ballot initiative received strong bipartisan support, and passed both the state House and Senate unanimously three months ago. That's notable in a state with some of the most pro-Republican gerrymandered districts: In 2012, though President Obama won the popular vote in Ohio, Republicans won 12 of the state's 16 congressional districts under the map Republicans created in 2010.

The plan could limit Ohio Republicans' power in the future, but groups like the League of Women Voters and Common Cause gathered public support for reform, and the GOP feared that failing to cut a deal would result in more radical measures later. With this plan, "the legislature would have to try to come up with a new map supported by a big bipartisan majority," Prokop reports. "If they fail, however, a one-party map could still pass — but it would now expire after four years, rather than the current 10." The plan also restricts how often counties can be split up, and mandates that maps can't "unduly" favor a political party or its incumbents. That will be open to interpretation by the courts.

Wednesday, May 09, 2018

Medicare-Medicaid agency says it will lower barriers to telehealth, improve outreach to rural health-care providers

This week the Centers for Medicare and Medicaid Services released a rural health strategy as a sign that it won't forget rural communities when creating regulations. More than 60 million people live in rural America.

The eight-page plan outlines "reduce regulatory barriers to telehealth, improve outreach to providers in these communities to make sure they understand CMS programs, and identify practical solutions that will help better care in these areas," Virgil Dickson reports for Modern Healthcare. "The document did not outline policy announcements."

The plan aims to formally analyze what, if any, impact proposed CMS rules will have on rural health providers and communities, which it has not consistently done until now. 

National Rural Health Association CEO Alan Morgan told Dickson, "We are optimistic that this effort at 'rural proofing' will provide a better regulatory environment for rural providers."

During grilling by House panel, some opioid distributors express regret for feeding West Virginia's drug habit

Past and present executives for five top pharmaceutical distributors testified before the House Energy and Commerce Committee's oversight subcommittee yesterday in a probe of their role in providing pills to West Virginia, the state with the highest rate of opioid-overdose deaths. "Lawmakers drilled the executives on key questions, such as whether they fell short of complying with federal regulations to report suspicious orders, whether their products have contributed to the opioid abuse crisis and how they’re ensuring pill dumping doesn’t happen again," Paige Cunningham reports for The Washington Post.

Some executives expressed regret: Miami-Luken Chairman Joseph Mastandrea said he thinks his company contributed to the opioid crisis. And Cardinal Health executive chairman George Barrett said he wished the company had moved more quickly to stop sending millions of opioid pills to West Virginia, and believes that Cardinal would "reach different conclusions" about the unusually large orders of opioids ordered for a handful of pharmacies. "But Barrett, along with executives from AmerisourceBergen, McKesson and H.D. Smith said they don’t think their companies contributed to the opioid crisis," Cunngingham reports.

Those executives who denied culpability argued that their companies only fulfill orders from pharmacies, but do not make or prescribe the drugs. Several said they've made changes in their distribution systems to stop suspicious orders from being fulfilled. Several companues face lawsuits from states blaming them for the epidemic.

Controversial coal man places poor third in W. Va. primary

Don Blankenship
Convicted coal operator Don Blankenship came in third yesterday in the Republican primary for a U.S. Senate seat in West Virginia. Blankenship got about 20 percent of the vote, compared to nearly 35 percent for the winner, state Attorney General Patrick Morrisey. U.S. Rep. Evan Jenkins got about 29 percent. "Blankenship, who has poured millions of dollars into state elections, vowed he would not support Morrisey in the general election," reports  Jessica Farrish of The Register-Herald in Beckley.

The former Massey Energy CEO's campaign grabbed national headlines as the public wondered how a candidate who called himself "Trumpier than Trump" would do in a region where the president enjoys some of the highest approval ratings in the country. Then Trump said in a Monday tweet that Blankenship couldn't win in the general election against Democratic Sen. Joe Manchin. "Blankenship said Tuesday night that he thought the tweet cost him 10 percentage points or more," Trip Gabriel reports for The New York Times.

Blankenship had pulled even with Morrisey and Jenkins in one recent poll after pouring $2 million of his personal fortune into ads. He painted himself as a victim of government insiders, referring to his prison sentence for his role in the Upper Big Branch mine explosion that killed 29 miners in 2010. He also decried national Republican leaders' efforts to derail his campaign, calling Senate Majority Leader Mitch McConnell "Cocaine Mitch," a reference to the drug being found on one of the ships owned by McConnell's Chinese-American in-laws (whom Blankenship described as "China persons"). Which explains the post-race tweet from McConnell's 2020 re-election campaign:

Telemedicine brings transgender care to rural areas

Much has been made about the value of telemedicine in rural areas, but there's another, not often discussed, benefit to it: its ability to help transgender people access discreet, experienced medical care. Ten percent of transgender people said they'd faced discrimination while seeking care, and 22 percent said they've avoided seeking care because they worried about discrimination, a 2017 poll found. "Many fear discrimination will increase with strengthened protections for doctors and nurses refusing to provide certain care on religious grounds," Keren Landman reports for NPR. "The more care refusals transgender people experience, the less care they seek, and the higher their rates of preventable and treatable conditions, including cancers, mental health problems, and substance-use disorders."

Beyond the fear of discrimination, it's hard for transgender people to find medical care in rural areas because there are far fewer doctors and nurses competent in transgender care. And that's on top of the challenges cisgender people face in finding rural medical care: long drives and long waits to receive care.

That's why Izzy Lowell, an Atlanta family practitioner who specializes in transgender care, created QMed in 2017. Transgender or gender non-conforming patients in the Southeast  can set up telemedicine appointments with Lowell in which she addresses sensitive topics like body changes or sexual function. To ensure privacy, Lowell uses headphones during webcam visits and uses white noise machines in her waiting room for in-person visits.

As with other telemedicine services, lack of reliable, affordable broadband may be a barrier for potential patients. And though 32 states have laws mandating that private insurance companies compensate doctors as much for telemedicine appointments as they do for in-person appointments, telemedicine providers in other states may struggle to get reimbursed and turn a profit, Landman reports.

Lowell reports that, less than a year after starting QMed, she's almost covered her startup costs and will soon turn a profit. But she says the administrative headaches are worth it. "The current system is not at all fair to transgender people," she told Landman. "And I don't like unfairness."