COLUMBUS, Ohio – As the Medicaid program faces possible changes at both the state and federal level, a new report finds the changes would be especially difficult for Ohio's rural counties.

This week, Republicans in Congress are expected to vote on a repeal of the Affordable Care Act that includes cuts of $800 million to Medicaid.

And Ohio's proposed budget makes it harder for those who are unemployed to maintain their Medicaid coverage.

John Corlett, president and executive director of the Center for Community Solutions, says his group's research shows this combination would have a disproportionate impact on rural Ohioans.

"Policymakers have this sense that Medicaid is an urban program, and that's really not true,” he points out. “Rural communities in Ohio have much less infrastructure to help them and so, Medicaid plays a much more important part in providing health care, to supporting employment, and making people healthier."

The report says rural counties have a higher percentage of their population enrolled in Medicaid than the state average, and many high enrollment areas also have higher unemployment rates.

And Corlett notes these areas also have higher per-capita spending on Medicaid, so cuts to the program would have an even greater impact on their local economies.

Ohio expanded Medicaid in 2014, but a proposal at the Statehouse would freeze new enrollment and prohibit anyone who falls off the rolls due to income changes from reapplying for coverage.

Corlett sees that measure as counterproductive.

"For example, if a plant or a large employer in a community closes, we want to make sure that people are able to access the Medicaid program so they can maintain their health care coverage,” he states. “This proposal in the state budget would make that much more difficult for many people."

Some lawmakers say the freeze is needed because current Medicaid expansion enrollment is nearly two-and-a-half times larger than the initial estimate from 2013.






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Gov. Janet Mills has signed legislation to increase temporary assistance payments to families experiencing deep poverty.

Payments will increase by 20%, meaning a single-parent family of three will now receive nearly $870 per month.

Ann Danforth, policy advocate with Maine Equal Justice, said the aid will help families get beyond just surviving.

"It enables parents to be able to have child care, to go to work," said Danforth, "and enables kids to grow up in strong families, where they are then able to participate in the workforce, too."

Nearly one in eight Maine children live in poverty. The bill passed both chambers with unanimous support, signaling what Danforth said is a greater understanding that poverty impacts us all.

Childhood poverty in the United States was cut nearly in half during the COVID-19 pandemic, as expanded federal and state tax credits put cash in parents' pockets to help cover their basic needs.

Danforth said Maine lawmakers heard testimony from families utilizing these rebates and temporary aid, providing them with direction on what policies work best.

"All of the research and data from these policies reinforce what people with low income tell us," said Danforth, "which is that when we give people the resources and supports they need and trust them to do what's best for themselves and their families, we all win."

Danforth said she'd like to see a renewed expansion of the federal Child Tax Credit and further consideration of direct cash payments in Maine.

She said these policies not only help families pay for rent and food but help lift the constant stress that comes with poverty, giving parents time to plan for the future.




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Arkansas is taking critical steps to address its high maternal mortality rate, especially among women of color.

In the Natural State, Black women are three times as likely to die from pregnancy-related causes than are white women.

Angela Duran, executive director with Excel by Eight, partners with families and communities to improve health and education outcomes for children up to age eight.

She said that as a result of focus groups and surveys, her organization has developed a new policy agenda that prioritizes maternal health.

"We are looking at is making sure that women have the right health insurance to cover them from prenatal to birth to postpartum," said Duran. "We have met some amazing doulas in the state of Arkansas, who have been very supportive to women, particularly some African American doulas, and been working with Black women around the state."

Duran said Arkansas now offers insurance to women up to 138% of the federal poverty level as a result of the Medicaid expansion.

She added that women at higher incomes can also access health insurance with low or no premiums, co-pays and deductibles.

Duran commended Gov. Sarah Huckabee Sanders' signing the executive order to address maternal mortality and increase access to doulas and various forms of health insurance.

Arkansas has a maternal mortality rate of approximately 44 deaths per 100-thousand live births.

Duran said her group's policy objective centers on examining populations that face disenfranchisement from systems for various reasons, hindering their ability to navigate existing structures effectively.

"In addition to maternal health, knowing that it has a stronger impact on Black women, we look at ALICE families - which stands for Asset-Limited Income Constrained and Employed," said Duran. "So, it's people that are working, doing the right thing, and still don't have enough income to meet their basic expenses."

Duran added that a prenatal care model called Centering Pregnancy helps to improves outcomes for Black and white women.

The University of Arkansas for Medical Sciences is launching a mobile version to reach underserved communities. It creates support groups for expectant mothers at similar stages.




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Supporters of a federal pilot program to distribute diapers to low-income families in Massachusetts hope to build upon its success.

More than 1 million diapers, along with wipes and other needed supplies have helped some 1,600 families over the past several months.

Adriana Leo, director of planning and grants management for Community Action Inc. in Haverhill, said the program gives parents with limited budgets a chance to get ahead.

"If a family knows that they have the diaper supply to send their child to care, they also know that they can then go to work, to their school programs," Leo explained. "They're going to be covered and their child's going to be comfortable."

Leo noted enrolled families have received 100 diapers each month, giving them the financial flexibility to cover other basic needs. More than one-third of Massachusetts families said they cannot afford enough diapers for their children.

The Massachusetts Association for Community Action, a coalition of more than 20 community action agencies in the state, was awarded more than 1 million dollars in federal aid to distribute diapers via four hubs across the state and Western Connecticut.

Rep. Mindy Domb, D-Amherst, is sponsoring legislation to create a state fund to keep up the effort, and has held diaper drives at the statehouse to build support.

"The biggest awareness building activity you can do is to hold a diaper drive and have people who haven't experienced the high cost of diapers recently go to the store and see how much they are," Domb asserted.

Domb pointed out diaper distribution is just one strategy to help families make ends meet, in addition to direct cash payments. She noted WIC and SNAP funds cannot be used for diaper purchases. The bill has already advanced to the House Ways and Means Committee.

Mary Marte, housing program director for North Shore Community Action Programs, said it is encouraging news, as parents have reported the challenge of paying rent and going without diapers at the end of the month.

"The clients and the families that we work with, they cannot afford to pay $3,000 rent in the north shore," Marte emphasized. "I think that people really appreciate the help."

Marte added she thinks of a young mother and her one-year-old daughter who have benefited from the diaper distribution program, who told Marte the diapers have brought her a sense of security as she attends college and the confidence to keep going.


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