CHAPEL HILL, N.C. – North Carolina's rural communities are paying the price for the state's decision not to expand Medicaid, according to a new report by the North Carolina Rural Health Research Program and the Georgetown University Center for Children and Families.

The report says states that expanded Medicaid saw more than three times the rate of decline in the uninsured adult population in rural areas.

Beyond that, John Coggin, director of advocacy for the NC Rural Center, says the economies in those communities are also impacted.

"One of the foundations of a healthy rural economy is a healthy rural health sector,” he points out. “It's important to make sure we have a healthy workforce, but the jobs the health sector provides are also good paying jobs. "

Prior to the Affordable Care Act, rural parts of North Carolina had a 35 percent rate of uninsured people, and that currently sits at 29 percent.

Comparatively, Arkansas, which did expand Medicaid, saw its uninsured rate drop from 45 percent to 22 percent.

Some states haven't expanded Medicaid because they fear being stuck with the costs if the federal government pulls out.

But study co-author Joan executive director of the Georgetown University Center for Children and Families, maintains states like North Carolina should expand, nonetheless.

"And this is sort of the fundamental issue with keeping folks uninsured when there's a real option here on the table to take these Medicaid dollars,” she states. “Really, it's a wiser use of taxpayer dollars to provide them with the primary preventive care that comes with having health insurance up front, so they don't get sicker and wind up in the emergency room."

So far, at least five rural hospitals have closed in the state since 2010, which Coggins says affects the quality and availability of care for everyone.

"That is money that not only would help hospitals pay for their current costs, but help them be in a stronger position to recruit more doctors and physicians, expand their services and create a better health sector for all people," he states.

According to the report, one-fourth of the people without coverage are also parents. Other studies indicate that when parents lack coverage, it also impacts their children's health and well-being.


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Everybody loves to get something free and right now, kids aged 12-17 can get a fishing and hunting license at no cost from the Nevada Department of Wildlife.

The license is good for one year and normally sells for $15.

Bobby Jones, outdoor connection coordinator for the Nevada Department of Wildlife, said the free licenses are funded by donations to the Nevada Youth License Fund.

"This is actually the third year that the program's been active," Jones explained. "We keep it open as much as possible. We're just limited by the amount of donations that we have. Right now, we have almost 2,000 available and they go fast."

Youth can get a free license on the Nevada Department of Wildlife website or wherever the licenses are sold. Children under age 12 do not need a fishing license. The state said almost two-thirds of the kids who have taken advantage of the program in the past have never had a hunting or fishing license before.

Jones emphasized the program is designed to tempt kids to leave the digital world behind for a short time and enjoy some time outdoors. It could lead them to even consider a nature-based career like wildlife biology, forest management or outdoor education.

"Essentially what we're up against is a lot of kids are engaged in their phones and social media, TV," Jones pointed out. "They're constantly bombarded with things. We're trying to make it a little bit easier for them to enjoy the outdoors."

Some of the most popular fishing spots include Lahontan in the Fallon area, Wild Horse and South Fork in Eastern Nevada, and Lake Mead down south.


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The University of Nebraska is addressing a shortage of lawyers who represent the state's most vulnerable children, especially in rural areas.

The attorneys are being equipped to work with kids who have suffered through physical, emotional, or financial trauma - and are often living in poverty.

Of Nebraska's 5,500 licensed attorneys, only 7% of them practice in rural areas.

Michelle Paxton, director of the Nebraska Children's Justice and Legal Advocacy Center, said two thirds of child neglect and abuse cases originate outside the Lincoln and Omaha metro areas, in what she calls "rural legal deserts."

"We have twelve counties in Nebraska with zero attorneys living in those counties," said Paxton. "We have 22 with less than three."

Paxton said that there are too few qualified rural child justice attorneys, which means lawyers may drive hundreds of miles for juvenile cases, creating delays and court backlogs.

The University of Nebraska program will add lawyers trained to handle issues unique to children in low-income families.

Attorneys who work on juvenile court cases are getting the tailored knowledge they need, but Paxton added that the program is also creating an opportunity for those attorneys to network and get support from other lawyers in the field - who are often isolated.

"And so they don't often have another attorney doing this type of work that they can rely on for support and mentorship," said Paxton, "and our program provides that support and mentorship so that they are not only willing to continue working in juvenile court, increase their hours in juvenile court and increase their commitment. "

The advocacy center will also develop a case-tracking tool, enabling people to find an attorney online.

Support for this reporting was provided by Lumina Foundation.



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Statistics show one in five children in Texas struggles with hunger.

Approximately 10,000 students a day are getting a nutritious meal through the Summer Food Service Program offered by the Houston Food Bank. The meals are distributed across the food bank's 18-county region.

Jourdan Stansberry, senior manager of education programs for Houston Food Bank, said they partner with summer camps, churches and other nonprofit organizations to serve the students. She added anyone who is not near a meal site can take advantage of their non-congregate option.

"Sites that are considered rural by the Texas Department of Agriculture," Stansberry explained. "It's a grab-and-go model where families can pick up the meals, It's like a five-day bundle of frozen meals, breakfast and snacks, so 10 meals all together. They're able to pick it up and take it home."

Locations of the meal sites in the Houston area and across Texas are available at the Department of Agriculture's Summer Meal Site Map. The meals are available to anyone 18 years old or younger or students with a disability, up to 21 years old.

The meals are distributed at more than 250 sites around the Houston area. Students do not have to register to take advantage of the meals. Stansbury emphasized it is a great way to ensure kids have access to fresh fruits and vegetables during the summer. She added the menus consist of more than just a sandwich and chips.

"One thing that I know has been pretty popular is our orange chicken with rice, and we also have broccoli, vegetable-medley side that goes along with that. We saw also chicken tikka masala," Stansbury outlined. "We try to expose them to different meals, not only healthwise but also culturally."

The Houston Food Bank expects to distribute around 800,000 meals this summer. The meal program runs through Aug. 8.


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