Congressional Republicans are taking a hard look at Medicaid as they pursue spending cuts and a new report shows how the public health program is preventing care access from further eroding in rural North Dakota and elsewhere.

A House GOP proposal floats a nearly $2.5 trillion Medicaid reduction. Findings from Georgetown University's Center for Children and Families showed people in rural areas are more likely than metro populations to receive health coverage through Medicaid.

Katy Kozhimannil, professor of health and policy management at the University of Minnesota School of Public Health, said the program is a key contributor to pregnancy care in these settings.

"Offering obstetric care is a financial challenge for hospitals as revenues may not cover the costs of providing that care," Kozhimannil pointed out. "Medicaid covers nearly half of all births nationally and plays a substantially larger role in paying for births in rural areas."

The report said in 2022, 52% of rural hospitals no longer had maternity wards, compared with 36% of urban hospitals. There is concern the gap would widen with Medicaid cuts and North Dakota almost leads the nation for lack of rural OB/GYN services. Some House Republicans insist the programs need reform to avoid a fiscal collapse. But skeptics said drastic changes are a way to offset a planned extension of federal tax cuts.

The report also pointed out residents in rural areas have worse health outcomes.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said it demonstrates why Medicaid is so important, adding it serves as a lifeline to a range of populations living in these communities.

"It is serving children. It is serving seniors in nursing homes, people with disabilities," Alker outlined.

Alker noted Medicaid helps recipients get ahead of health challenges through preventive care, as
opposed to letting conditions worsen.

"People wind up sicker and then they're in the emergency room and children can't get their asthma inhalers and they miss school," Alker explained.

A lawsuit has been filed against the Trump administration over its budget-cutting plans targeting medical research led by colleges and universities.

Their allies warn of negative consequences for curing diseases, as well as local economies. The suit was brought by Minnesota and 21 other states after the National Institutes of Health said it would follow through on orders to cut $4 billion through a grant funding formula for indirect expenses.

North Dakota is not part of the legal case, but an analysis said the state could lose more than $3 million in research funds.

Ellie Dehoney, senior vice president of policy and advocacy for the group Research!America, said no matter the state, the pain will be quickly felt.

"The suddenness of it is one of the ways that you degrade your research capacity," Dehoney pointed out.

Beyond the effects on finding cures for diseases such as Alzheimer's, Dehoney warned of job losses at lab equipment makers and other supporting businesses. Trump advisers suggest too much grant money goes to overhead costs but advocates countered the argument misrepresents the facts. They said even indirect funds keep the lights on at university labs and support other key infrastructure such as data storage. A federal judge on Monday temporarily halted the cuts as the case proceeds.

Dehoney said medical research at the academic level needs to play out first because the private sector does not have the resources or patience to play the long game in advancing treatments. She also warned slowing scientific progress could keep more people dealing with chronic health issues from improving their quality of life and participating in the workforce.

"I know a person who is on Social Security disability," Dehoney observed. "She went on a biologic (drug), she has rheumatoid arthritis, and now she's working full-time."

Dehoney argued abruptly stalling important research work also benefits global competitors such as China. She feels there is room for groups like hers to work with the Trump administration on finding efficiencies but only if they actually boost research capacity, not reduce it.


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Gov. Josh Shapiro's proposed state budget includes a significant increase for public education to address Pennsylvania's school funding issues and educator shortage.

The proposed budget would boost funding for basic and special education and the state's student-teacher stipend program.

Aaron Chapin, president of the Pennsylvania State Education Association, is praising the commitment to education, and sees the $1 billion proposal as a vital investment in public schools.

"More than $600 million of that is going right to our public schools when it comes to providing adequacy, as well as tax equity payments to qualifying school districts for the Ready to Learn Grant," Chapin outlined.

Chapin noted an additional $75 million will be distributed to all school districts through the basic education funding formula, which he called "a big step forward." The state House and Senate will need to vote on the budget by June.

The proposed budget includes a $20 million boost for the Student Teacher Support Program, which provides a $10,000 stipend to eligible aspiring educators.

Kaylin Shewmake, a senior at Penn State University, second grade student teacher and Central Region president of Student Pennsylvania State Education Association, said the stipend has helped with her tuition, rent, groceries and other living expenses.

"It honestly was a huge relief when I saw I'd gotten the stipend," Shewmake recounted. "Because if not, I would have had to work a part-time job on top of student teaching, which would have been really difficult for me, because I am really involved outside of student teaching with my extracurriculars. With this extra money, I didn't have to take out any loans."

Chapin noted it is the first year the stipend is available and with the governor recommending doubling the funding, $40 million would support student teachers with these stipends.

"Gov. Shapiro, with legislators, designated $20 million this year -- didn't pay for everybody, it only paid for just over 2,000," Chapin pointed out. "Another $20 million is going to cover another 2,000. We're getting very close to making sure that every Pennsylvania college student that is student teaching will receive a stipend."

The proposed budget would also deliver $111 million for student mental health and school safety grants.

Gov. Kay Ivey delivered her 2025 State of the State address this week, focusing on education, public safety, and economic growth in Alabama. She pointed to improvements in math and reading scores and expanded school choice options. But beyond academics, she also called for tighter regulations on cell phone and social media use in classrooms, saying it's time to tackle this issue nationwide.

"Sen. Donnie Chesteen, R-Geneva, and Rep. Leigh Hulsey, R-Helena, will carry a bill to put a ban on cell phones in schools, she said. "This legislation will also require local boards to adopt internet safety policies and provide students with social media training."

Ivey also wants to strengthen support for teachers, particularly those looking to start families. One way, she says, is by improving maternity-leave policies. On the economy, Ivey outlined plans to turn the Department of Labor into the Department of Workforce, aiming to create more job opportunities across the state. She also emphasized supporting veterans by making their department part of her Cabinet.

Public safety was another priority in her address, particularly gun violence. Ivey pushed for a ban on Glock switches and stricter monitoring of high-risk youths, and called for expanding legal protections for police officers while backing second-chance legislation aimed at criminal justice reform.

"While we are moving forward in building two new men's prisons and graduating a number of corrections officers, we must also see that the DOC resources are reserved for the worst of the worst offenders," she continued. "That's why I'm supporting the Second Chance Act."

Ivey did not shy away from national issues either, reaffirming Alabama's commitment to border security and offering state resources - including the Alabama National Guard and ALEA - to assist where needed. Other topics on her agenda included water and sewer infrastructure, broadband expansion and policies related to gender and religion in classrooms.


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