BELLINGHAM, Wash. - As debate in the nation's capital continues over repealing the Affordable Care Act and ending Medicaid expansion, rural Washington is bracing for the effects of repeal.

Rural counties face a different set of health-care challenges than do urban areas, and could be disproportionately hurt by repeal. There are fewer facilities for rural residents who need care, and operational budgets for hospitals often are lower.

If the ACA is repealed, said Sherilyn Hughes, who works at a nursing home in Bellingham, her patients will feel the cutback.

"I definitely worry about our residents," she said. "If they lose their insurance or they have less access to care, what would happen to them? If they would be in facilities that are poorer staffed with less-trained people, if they would end up in assisted-living facilities, or places where they're by themselves."

According to a report by the Center on Budget and Policy Priorities, if the ACA is repealed, 775,000 fewer people in Washington state would have health insurance in 2019. President-elect Donald Trump has said a repeal would come with a "simultaneous replacement" plan, but no details have been released.

Repeal also would affect states' budgets. The same report estimated that Washington state would lose slightly more than $3 billion in 2019, which is likely to fall heavily on rural hospitals. Another study, published in Health Affairs, said rural hospitals have seen greater increases in Medicaid revenue than have urban hospitals under the ACA.

Belinda Hewett, a home nursing aide in Richland, said she worries that, if fewer patients are able to afford care, it means job cutbacks for nurses, as well.

"It'd cut our hours back for me and my co-workers," she said, "and then we'd have to go look for a second job to just make our income to pay our rent and the bills, and the stuff that we have."

Repeal could affect Hughes in another way. She has asthma and uses an inhaled steroid twice a day. Hughes said the medication is expensive and wonders how she would pay if she were dropped from her insurance.

"Through the Medicaid expansion, I get those paid for, so I'm able to continue to go to work. I'm able to pay to go college," she said. "I would not know what I would do if I lost my insurance. There's no way that I could afford to pay for the insurance plan that my employer offers."

The CBPP report is online at cbpp.org, and the study in Health Affairs is at content.healthaffairs.org.


get more stories like this via email

Washington joins a handful of states to do away with mandatory meetings for employees on political or religious matters.

Sometimes known as captive audience meetings, the gatherings were seen as a way for employers to give their opinions on subjects like unionization, and held potential consequences for employees who didn't attend. Lawmakers passed a bill this session allowing workers to skip the meetings without repercussions.

Sen. Karen Keiser, D-Des Moines, a sponsor of the bill, said we live in a divided society where emotions run high on political topics.

"This bill simply protects employees to have a real choice on whether or not to attend a meeting called by their boss to be told about some political or religious issue," Keiser explained.

Keiser pointed out the legislation is nonpartisan. For instance, employers could not force employees to attend anti-union meetings, but also could not force them to attend a meeting about the importance of reproductive rights. The bill takes effect June 6.

Keiser noted the bill likely got across the finish line this session because of the uptick in union organizing and support for labor. She added there are widely known stories of Starbucks managers, for example, requiring employees to attend anti-union meetings while the employees organized the workplace.

"Employees have been forced to attend meetings to listen to the boss or the employer basically tell them why they shouldn't join a union," Keiser observed.

Washington is the sixth state to pass a law prohibiting attendance at captive audience meetings. Connecticut, Maine, Minnesota and New York have passed similar laws in recent years. Oregon passed a law allowing workers to skip such meetings without repercussions in 2010.


get more stories like this via email

A bill vetoed by Virginia Gov. Glenn Youngkin would have raised the state's minimum wage to $15 an hour starting in 2026.

While the bill moved out of committee and the General Assembly, it did so on party-line votes. Youngkin opposed the bill, saying it could hurt small businesses and some restaurants.

Jay Speer, executive director of the Virginia Poverty Law Center, said it was disappointing to see the measure vetoed.

"Wages are way too low. People cannot afford housing and food and everything else," Speer pointed out. "It's a disappointment that they can't raise the minimum wage so people can survive. I mean, it's long overdue."

Passing the bill was part of a 2020 minimum-wage increase requiring a reauthorization to bring it up to $15. A state study found a person has to make at least $14.55 an hour to afford the cheapest place to live while only spending one-third of his or her income on housing. The current minimum wage in Virginia is $12 an hour, but around 500,000 Virginians make $12 or less.

Youngkin also vetoed a bill ending exemptions from Virginia's minimum-wage requirements for farmworkers or temporary foreign workers.

Kim Bobo, executive director of the Virginia Interfaith Center on Public Policy, said it was not as impactful since most farmworkers make more than the minimum wage. But she said the exemption remains for another reason.

"The only reason farmworkers continue to be exempted in Virginia is racism," Bobo contended. "That's why they're exempted. And, we should just change that, like there's no reason not to. It really does not affect that many workers in Virginia."

Youngkin and other legislators with a farming background said the bill would hinder farmers' ability to turn a profit.

New York restaurant workers need to know their rights to better navigate their workplaces. A new report finds high rates of what it calls "occupational segregation" in the restaurant industry, which can relegate some people to lower-paying jobs.

Workers' rights organizations are counteracting this with training programs. Alima Iskakova, a server for Exquisite Staffing, a catering company, said the CHOW training from Restaurant Opportunities Centers United is helping her.

"Since I completed this training course, I am more confident when it comes to job interviews," she said. "I am more confident - like, when it comes to these types of interviews, plus with all my experience and the knowledge that I got from ROC United, I have a higher income."

She was also trained in safe food handling, OSHA certification and other need-to-know information about the restaurant industry. These courses are available in several cities beyond New York.

The report also notes that, unlike training offered by organizations such as the National Restaurant Association, these courses prioritize developing restaurant workers' power to support individual career development.

The report says racism and sexism abound in the restaurant industry. White men make up a majority of higher-earning positions, such as bartenders.

Although these training courses are helpful, Iskakova noteed that not knowing English can be a disadvantage. She said other cultural differences can make this work challenging.

"In the hospitality industry, even like when people come here as an immigrant, they don't know the rules, they don't know the laws," she said. "And ROC United, they help us to do the cover letter, resume. There are certain things - like, there is a difference."

Another challenge she encountered was the difference between Celsius and Fahrenheit.

Iskakova said her work has been interesting, but she's got ambitions outside of food service. Along with photography, she's a communications major at CUNY.


get more stories like this via email