Worker's rights advocates and nursing home providers say Washington has a long-term care workforce crisis, and that inadequate benefits in the nursing home industry are part of the problem.

Legislation moving through Olympia - known as the Essential Worker Healthcare Program - would provide affordable health insurance to nursing home workers.

Alicia Harris is a certified nursing assistant, or CNA, at a skilled nursing facility. She said a family of four has to pay $1,200 a month for insurance, with a high deductible and a 30% co-pay.

"It's money that we could be putting towards, you know, groceries," said Harris. "We could be putting towards rent, savings. It's tough."

Nursing home employers who join the new program would receive a payment from the state to provide at least platinum level health plans, which would be matched by Medicaid.

Employees could participate for about $50 a month.

Supporters of the legislation say poor nursing home benefits fuel an extremely high CNA turnover rate. Harris said when there isn't enough staff, the residents don't get the care they deserve.

"I love my residents," said Harris. "I love doing what I do, and I would hate to leave them just because of health insurance. But at the same time, it is a financial burden on me and my family."

Over the next ten years, the number of people who need long-term care in Washington, especially nursing home care, is expected to grow rapidly.

At the current rate, there won't be enough skilled care-givers to meet the need. Two Essential Workers Healthcare Program bills are currently in committee in Olympia.





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Federal data show roughly 75,000 South Dakota households rely on SNAP benefits to put food on the table and hunger-fighting groups paint a troubling picture if Congress goes through with big program cuts.

The Supplemental Nutrition Assistance Program, once known as food stamps, faces a possible downsizing in the budget reconciliation bill now in the Senate. It has already cleared the House. Relief organizations say cuts proposed along the way could take away enough food for more than 9 billion meals on average every year.

Lori Dykstra, CEO of Feeding South Dakota, said it would be harder for her network to pick up the slack with donations on the decline.

"At a time when resources are the lowest, need is the highest," Dykstra pointed out. "We're in this challenging space to be able to fill that gap as a food bank."

Because of economic uncertainty, she noted businesses that normally donate excess food are being careful not to overstock. Dykstra emphasized SNAP benefits give struggling households more healthy food choices during times like these. A key GOP Senator said even though legislative rules have cast doubt over some provisions, they will still seek reforms to preserve SNAP for those who need it, while saving taxpayer dollars.

The Senate version still has nearly $100 billion in proposed cuts as Republicans look to offset proposed tax cut extensions. Poverty researchers said misinformation continues to spread about the integrity of SNAP, noting payment errors are often unintentional and fraud is only a small portion of program activity.

Vince Hall, chief government relations officer for Feeding America, a nonprofit network of 200 food banks, said the current approach targets the wrong people.

"Instead of addressing fraud in a thoughtful and effective way, it's using fraud as an excuse to hurt people who are honest, hardworking; seniors, who are in their golden years; people with disabilities; active-duty military," Hall outlined. "It is harming all of those families."

Feeding America added losing access to SNAP benefits would hurt recipients in other ways, too. For example, adults who get SNAP benefits spend about $1,400 less on average per year for medical care than adults who do not. The organization worries people would have to make tougher choices, like whether to pay for health care needs or food.

The budget reconciliation bill being considered by the U.S. Senate proposes $863 billion in Medicaid reductions over a decade, with 10.9 million Americans projected to lose coverage by 2034, according to a June 4 Congressional Budget Office report.

In Florida, where 760,000 Medicaid enrollees rely on community health centers, advocates say the cuts would destabilize preventive care and overwhelm hospitals.

Austin Helton, CEO of Brevard Health Alliance, said the cuts would dismantle primary-care access, rupturing what he called Florida's "health-care ecosystem."

"If you cut spending on Medicaid and ACA, which primarily pays for access to primary-care health services at community health centers, that access is gone," he said. "The patients are still going to need that care. They're just going to end up sicker and they're going to end up going to more costly and more complex environments like the emergency room at the hospital."

Helton said the cuts would hit hardest at health-care facilities such as those under Brevard, where 60% to 70% of patients use Medicaid or ACA plans.

While the Florida Policy Institute warns of clinic closures and reduced hours, supporters say the changes target inefficiencies, with House leaders claiming they'll reduce wasteful spending while protecting vulnerable patients.

Florida's community health centers, which serve one in eight Medicaid patients statewide, face what advocates call an impossible math problem: more patients but fewer resources.

"As the population in Florida increases, the number of our patients increase, the number of Medicaid enrollees decreases," said Jonathan Chapman, CEO of the Florida Association of Community Health Centers. "Therefore, by process of elimination, you're going to see more uninsured people on our doorstep."

The Congressional Budget Office projects Florida would lose $7.3 billion in federal Medicaid funds by 2030 under the House plan, with rural counties such as Gadsden and DeSoto facing severe strain. The bill remains stalled in the Senate, where Republicans are divided over many issues, including rural hospital protections.

After the Department of Government Efficiency cut AmeriCorps funding earlier this year, a federal judge last week granted a temporary halt to the cuts on behalf of a group of states that filed a lawsuit against the move. Montana is not on the list.

AmeriCorps is a national service program which has been running for three decades. In the year before the cuts, about 2,800 members, called VISTAs, served at 300 Montana host sites including food banks, schools, youth centers and more.

Rochelle Hesford, executive director of Southwest Montana Youth Partners, relied on AmeriCorps service in the group's five-year plan. But its VISTA member was on board for less than four months before funding was cut.

"We're in kind of that early critical stage where we really need to get that public support and get our name out there and build capacity for the organization," Hesford observed. "We're losing, like, a year's worth of work, I would say."

Two dozen states plus Washington, D.C., filed a lawsuit against the Trump administration arguing it did not provide sufficient notice or comment period according to law but because Montana was not a plaintiff, its AmeriCorps funding remains cut.

Groups hosting VISTA members pay about one-third of their income and AmeriCorps funding covers the rest.

Erin Switalski, senior program director for the Headwaters Foundation, which provides grants for groups across the state, said it is a big leg up for many Montana groups.

"We're a resource-scarce state in many ways, and AmeriCorps VISTAs can really come in and help organizations build new systems and find efficiencies," Switalski explained. "Losing that support is really critical."

Montana's population is one of the least dense in the country but it has the most nonprofits per capita, nearly 10 per every 1,000 residents, according to the Tax Foundation.

Switalski noted she worries cuts to AmeriCorps signal something bigger.

"It's tied to this broader trend that we're seeing in really just a gutting of civic infrastructure that helps hold our communities together in Montana," Switalski added.