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 South Dakota and elsewhere.

The incoming Trump administration promises major cuts, and a House GOP proposal floats a nearly $2.5 trillion Medicaid reduction.

Findings from Georgetown University's Center for Children and Families show 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 reimbursements keep rural providers operating, limiting a key patient burden.

"In most parts of the Dakotas, we have vast, vast areas where people have to travel great distances to access basic care," Kozhimannil pointed out.

The report also found Medicaid is a significant health coverage source for Native Americans. Two-thirds of Indigenous elders in South Dakota's Oglala Lakota County are covered by the program. 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.

Joan Alker, executive director of the Georgetown University Center for Children and Families, said 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.

By keeping healthy enough for work and creating better health outcomes for kids, Alker argued policymakers need to realize programs such as Medicaid are not government waste.

"In the long term, it's a much better investment of taxpayer dollars," Alker contended. "Because it'll pay dividends to make sure that these families are getting the care they need."

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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A new report showed New York State loses nearly $3 billion a year due to tax exemptions.

The state Senate report found most exempted items cost the state millions, which could be spent elsewhere. The list of exempted items includes sales tax on private jet service, which would net around $6 million, and the sale of precious metals like gold, which could mean another $601 million in tax revenue.

Sen. Andrew Gounardes, D-Sunset Park, said such exemptions were not made for everyday New Yorkers.

"All of these exemptions don't serve the 99.9% of New Yorkers who are just trying to live ordinary lives," Gounardes asserted. "These are things that, I don't know about you, but I'm not buying gold bars in thousand-dollar increments, and I don't have a private jet to finance or maintain. Who's really benefiting from these carveouts and why can't we do better?"

Revising the state's tax code is what it would take to end the exemptions. Gounardes wants to see any additional revenue to be spent on programs to help families in poverty. A 2024 New York State Comptroller report found the state's child poverty rate is among the worst in the nation.

One option for cutting the child poverty rate is working its way through the Legislature. The Working Families Tax Credit bill would streamline existing tax credits into a single credit, raising the maximum tax credit to $1,600, with a $100 minimum credit per child regardless of income. Gounardes argued it could ensure more families can afford life in New York State.

"It would help us reduce deep child poverty by nearly 25%," Gounardes pointed out. "It would help us reduce child poverty overall by approximately 17%. That's significant. The total cost of that is approximately $3 billion. I think there's a great place to start. Let's actually help families afford living here."

He added the bill would also help the state achieve its goal of cutting child poverty in half by 2031. The state's Child Poverty Reduction Advisory Council has recommended public benefits reform and major investments in child care and housing to complete the goal.


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