Nebraska saw nine long-term care facility closures in 2022, second only to 13 in Texas.

In the past three years, Nebraska has lost a combined 29 assisted living facilities and nursing homes. Inadequate funding for Medicaid patients, workforce issues and the rising costs of goods and services have all contributed to these closures.

Two bills to be heard in the Unicameral's Appropriations Committee today would mean substantial increases in state and federal funding for both types of facilities.

Jalene Carpenter, Nebraska Health Care Association CEO, says additional funding is crucial to stem the state's long-term care crisis.

"In Nebraska, 15 counties do not have a nursing home or an assisted-living [facility], and we are really starting to see a 'care desert' be created. And that causes significant issues for Nebraska seniors, " Carpenter expressed.

LB-941 would increase the daily reimbursement rate for assisted living residents on the Medicaid Waiver program. The new daily rate of just under $79 is based on a Nebraska Department of Health and Human Services study. LB-942 would increase the nursing home Medicaid reimbursement rate by about 5% over the next year. Both bills were introduced by state Sen. Myron Dorn, R-Adams.

Carpenter says the COVID-impacted long-term care workforce is improving in the state, but she stresses Medicaid reimbursement rates play a large part.

"A large portion of the Medicaid rate -- when you look at what it covers -- it's primarily going towards labor and benefits. Nursing-facility and assisted-living care is very hands-on, and we need adequate rates to be able to attract and retain team members," she added.

Carpenter said the state, educational institutions and organizations, including the Nebraska Health Care Association, are also focused on building the long-term care workforce -- including introducing young people to careers in health care and strengthening Certified Nursing Assistant programs.

"We're trying not only to increase the rates so that our facilities can attract and retain (employees), but then also, as an association, to look at other ways to drive people into the workforce for this profession, " she said.

In 2023, Gov. Jim Pillen approved a one-year, 3% increase in the Medicaid reimbursement rate, but vetoed the Legislature's 2% increase for the second year.

The election is less than six weeks away and Washingtonians will be deciding on a slate of initiatives, including one measure affecting funding in support of children.

If passed, Initiative 2109 would repeal a 7% tax on capital gains for assets worth more than $262,000. The repeal has support from hedge fund manager Brian Heywood, who said it is a slippery slope toward a state income tax, which the state does not have.

Gabriela Quintana, senior policy associate for the Economic Opportunity Institute, said fewer than 4,000 people in the state pay the tax.

"It's a very privileged move to be able to fund these initiatives for your own needs and to not think about the impact this will have on a huge majority in Washington state," Quintana contended.

Last year, the tax pulled in about $786 million. The first $500 million collected from it goes toward schools, early learning and child care. Any additional money collected goes toward school construction.

Justin Fox-Bailey, president of the Snohomish Education Association, said the vast majority of Washingtonians who do not pay the capital gains tax will be affected if Initiative 2109 passes, especially kids.

"They're going to feel it in their communities when we give a tax cut to these millionaires and billionaires and you don't have the same access to child care, your kid's school isn't getting updated, public services are being cut or reduced," Fox-Bailey pointed out.

Washington has historically had one of the most regressive tax systems in the country and a recent report found the lowest-income 20% pay more than three times as much of their income as the top 1%.

Quintana argued the capital gains tax is vital for the state.

"We all need to play a role, including the wealthy individuals," Quintana asserted. "Repealing it will only really hurt families and children."

Ballots start going out on Oct. 18.

Congress has one week from today to reauthorize a sweeping policy playing a big role in shaping the nation's food production system, and Wisconsin agricultural voices are paying close attention.

The Farm Bill is supposed to be renegotiated every five years. A temporary extension was approved one year ago, amid big differences about where to prioritize aid, including subsidies typically helping industrial-level farms.

Chuck Anderas, associate policy director at the Wisconsin-based Michael Fields Agricultural Institute, said as the issues get sorted out, organizations like his hope lawmakers do not lose sight of the need to adequately fund conservation programs to benefit small farms.

"To neglect that is basically just picking winners and losers within the agricultural economy," Anderas contended.

Advocates are concerned about proposed language which would essentially spread conservation funding to "climate-smart" practices skeptics say only benefit big farms. The Farm Bill also covers the Supplemental Nutrition Assistance Program. House Republicans have proposed formula changes hunger-relief advocates say would amount to a $30 billion cut. GOP leaders dispute the claim, saying they would lower costs without cutting anyone's benefits.

According to the National Centers for Environmental Information, Wisconsin has seen more than 20 weather-related disasters -- each resulting in at least one-billion dollars in damage -- in the past five years, four times the totals from the 1980s and 90s.

Anderas argued stronger and effective climate resiliency aid in the Farm Bill means participating producers can mitigate some of the damage.

"Even if you are skeptical about climate change, these practices infiltrate more water and hold more water in the soil and make a huge difference on the amount of water coming off of farm fields," Anderas outlined.

He added it protects natural resources, as well as infrastructure in farming communities, with local governments not having to spend as much on fixing washed-out roads and bridges.

With the current focus on the November election, analysts said it is likely Congress will approve another temporary extension of the current Farm Bill, rather than agree on a new one.

Even in a stable economy, consumers in Wisconsin and elsewhere still express pessimism and advocates said a key federal agency working on issues like unfair business practices cannot risk losing resources needed to help consumers.

To avoid a government shutdown, Congress has to approve a new federal budget by month's end. Over the summer, House Republicans floated cuts in certain areas, including a 27% funding cut for the Federal Trade Commission.

Erin Witte, director of consumer protection for the Consumer Federation of America, said the timing could not be worse for such a move.

"We've seen people talk a lot about feeling like their costs are increased in lots of ways," Witte pointed out. "The FTC's work is really aimed at trying to lower a lot of those costs, to bring some fairness back to the process."

Last month, the agency co-hosted the first meeting of a task force about whether companies are price-gouging and the effect on consumers. GOP leaders on the Appropriations Committee said they want a financial services bill prioritizing combating terrorism-money activity, maintaining the integrity of financial markets and spurring small business growth.

Witte contends the FTC has made progress in standing up for consumers with great efficiency. She pointed to the proposed "click to cancel" rule, which would remove barriers for people worried about recurring charges for an unwanted subscription for a service or product.

"That would make it as easy for someone to cancel a subscription as it is to sign up for it," Witte explained. "That proposal has gotten thousands of comments from consumers about how much time they are wasting on things like unnecessary subscriptions."

The state-level organization Opportunity Wisconsin has also cited concerns about consumer protections being gutted. It called on Congress to pass clean funding bills without extreme provisions it said would "hurt Wisconsin families." It is unclear if any of the budget ideas floated over the past several months will find their way into a final spending plan.