HASTINGS, Neb. — Last year, Nebraska voters passed a measure to expand Medicaid, but state officials are stumbling out of the gate to implement the plan.

The move would bridge a health-coverage gap for 94,000 Nebraskans who don't earn enough to get subsidies for market-rate insurance, but earn too much to qualify for standard Medicaid. Valerie Bower is a registered nurse at Mary Lanning Healthcare in Hastings. She said expanding Medicaid also is critical for keeping hospital doors open.

"Rural hospitals especially benefit from Medicaid expansion,” Bower said. “A lot of rural hospitals have been closing in the last few years, and a lot of that has to do with uncompensated care."

Bower's hospital has carried more than $9 million in bad debt, on top of providing $5 million in financial assistance for patients who just can't pay. Medicaid expansion would help reimburse hospitals for skilled care provided by nurses, doctors and technicians, as well as supplies and medication.

Nebraska's Department of Health and Human Services has cited technology upgrades, staffing and reporting requirements as reasons for a possible delay in coverage.

Jordan Rasmussen, policy manager with the Center for Rural Affairs, said Medicaid expansion also would get Nebraska closer to a goal championed by many state lawmakers: strengthening the economy and bringing more economic opportunities into the state.

"There are strong economic benefits that will result because of our expanded coverage,” Rasmussen said. “A report that was shared last fall estimates that $1.3 billion in economic activity is going to occur in the state. That's a huge gain for the state."

Nebraska must submit its plan for Medicaid expansion to the Centers on Medicaid and Medicare by April 1 of this year. More than two-thirds of Nebraskans who fall into the Medicaid coverage gap are employed, and more than 1-in-3 live in rural counties.


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As the Atlantic coast braces for what could be an active hurricane season, environmental groups are warning about the dangers of agricultural pollution.

They say large amounts of animal waste, often stored in unsecured, outdoor lagoons, make already harrowing events such as flash floods an even greater health and safety risk.

Krissy Kasserman, factory farm organizing director for the group Food and Water Watch, said heavy downpours can spread toxins to local drinking water supplies and area farm fields.

"We see climate change making these storms bigger, they're more intense," Kasserman pointed out. "They flood these manure lagoons, which creates a really potentially deadly mess of pollution for people who live downstream to have to deal with."

Kasserman noted low-income communities are often closest to agricultural waste sites and are most at risk. She stressed the cost of cleanup for drinking water sources after storms often falls to ratepayers and well owners themselves.

Agricultural waste not only poses a risk during and after a storm but is a major source of greenhouse gas emissions, which scientists say are fueling more climate change-related weather events. It is estimated livestock production alone accounts for nearly 15% of worldwide emissions.

Kasserman argued federal legislation known as the "Farm System Reform Act" would impose a moratorium on construction of new and expanding factory farms to better protect nearby communities.

"The answer is to move toward a more sustainable form of agriculture that doesn't involve confining a large number of animals and their manure in one very small space," Kasserman contended.

Kasserman acknowledged it will take strong political will to stand up to "Big Ag" to get it done. Meanwhile, forecasters are warning residents along the Atlantic coast to prepare for an above normal number of hurricanes this season with up to 25 named storms along with four to seven major hurricanes by the end of November.

Like kids everywhere, New Mexico preschoolers balk at eating fresh vegetables. But an educational project has found that with a creative nudge, they'll try just about anything - even purple carrots.

Kids who start off eating processed foods are more likely to suffer health consequences, including obesity and juvenile diabetes. And often, low-income children of color don't have access to local fresh produce.

Sayrah Namaste, a program co-director with the American Friends Service Committee, leads an educational project that partners with the federal Head Start program, to provide young students with engaging nutrition activities.

"If we can intervene with children at a young age - before the age of 8 - to shape their palate, to shape their sense of what they want to eat," said Namaste, "we have greater success with their health outcomes."

The AFSC program helps small-scale, organic farmers supply fresh vegetables to preschoolers - especially low-income children - near Albuquerque, the Española Valley, the Taos Valley, and two nearby pueblos.

Until five years ago, most of the preschools were buying their vegetables from large grocers - but have since arrived at a price point with local farmers that benefits both groups.

To cajole them into trying more nutritious food, Namaste said they've introduced the kids to campaigns such as the "Great Carrot Crunch," "Cherry Tomato Chomp," and "Give Peas a Chance."

She said steamed broccoli and purple carrots have been recent favorites.

A recent activity included bringing a local organic farmer into the classroom, who along with drumming, showed them how to plant a garden.

"He taught them a song, a blessing before you plant your seeds," said Namaste. "And so, the kids got to do that and got to play on the drum - and then they planted the seeds together. So, he brought in the cultural pieces of farming, because farming is very cultural here."

Namaste added that structural racism has removed many New Mexico kids from their own cultures - and that led to a specific activity guide.

"We created a farm-to-preschool guide that's only for tribal preschools and tribal home visiting, and it's called Connecting with Corn" said Namaste. "It is restricted for use only with Indigenous folks, because it does talk about that, in the Southwest, corn is a really sacred crop."

Corn has been a diet staple of Indigenous communities for more than 3,000 years.



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New global guidelines for aquaculture aim to address growing concerns about the industry's impact on the oceans.

Scientists have suggested ways to protect aquatic ecosystems, reduce antibiotic use, and even prevent ocean litter from discarded aquaculture gear.

Danielle Blacklock, director of the Office of Aquaculture at the National Oceanic and Atmospheric Administration, calls the guidelines "a big deal," as consumer demand for seafood outpaces supply.

"We're developing a new food system for the first time in millenia," said Blacklock. "That means that things are changing quickly. We're learning fast. We're adapting."

Blacklock said the U.S. currently imports up to 85% of its seafood.

She said the new guidelines should help level the playing field for Massachusetts farmers to ensure they, too, can reap the financial benefits of aquaculture while using sustainable practices.

For the first time, the amount of seafood produced on farms has surpassed the amount harvested from the wild, according to the United Nations.

Critics of finned fish farms, in particular, say they're no different than land-based factory farms and are detrimental to ocean habitats.

But Blacklock said aquaculture, including New England's numerous shellfish and kelp farms, will play an important role in countering food insecurity.

"When we mix climate change with our growing population," said Blacklock, "it clearly starts to rise to the top as part of our solution set to fight hunger."

Blacklock said the new guidelines also suggest ways aquaculture itself can reduce its carbon footprint.

She said the new guidelines are voluntary - but if implemented, they could help lift local economies and coastal communities, while building climate change resilience.



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