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By the time Sadie Kendall turned 18 and aged out of West Virginia’s foster care system, she had lived in more than two dozen places. There was her mother’s house in Mineral County, where she lived until the state took her away after discovering her mom’s substance abuse. There were foster homes, and a revolving door of parents who ultimately couldn’t or didn’t want to keep her. There was shelter after shelter, short-term spots where Sadie waited for something better. 

And there were the treatment centers, a series of in-patient hospitals the state started sending her to when she was only eight. The first one — Southwood in Pittsburgh — is fuzzy in her memory. She knows there were other kids, some of whom were scary to her. She remembers being restrained, and nurses giving her shots in the butt. And she can still taste the psychiatric medications. She was too young to swallow pills, so nurses fed them to her crushed up in peanut butter. They made her sleep all day. 

“I was sedated most of the time, pretty much,” Sadie, now 27, recalled.

It didn’t help. There were outbursts, tantrums and repeated attempts to run away. Sadie missed her mom and was confused about why they weren’t all together. Time and time again, West Virginia sent her to short-term homes where she struggled to get adequate mental health care and form permanent relationships. 

“I think I just had a lot of trauma in my life, and I just needed somebody to care for me how you’re supposed to care for a child,” she said. 

By the time Sadie turned 18 and left the state’s care in 2015, the U.S. Department of Justice had concluded West Virginia was over-relying on these types of group facilities and treatment centers. This “systemic failure,” officials wrote in their findings, violated kids’ rights under the Americans with Disabilities Act and “places children with mental health conditions who currently live in the community at risk of unnecessary institutionalization.” In 2019, West Virginia and the DOJ agreed to a plan to fix the issues. But several months later, there hadn’t been enough action for the state to avoid a lawsuit over the issue. 

And even now, more than five years later, West Virginia is still failing to meet the mental health needs of kids like Sadie, a Mountain State Spotlight investigation has found.

Undoubtedly, there are some foster kids who need in-patient mental health care and benefit from short-term intensive treatment. But in a system where by definition almost every child in it has either experienced trauma or neglect, West Virginia officials have fallen short of helping kids get access to therapy while they live with families in communities. 

Despite early gains reducing the overall number of kids in group homes and institutions, kids with any kind of physical or mental disability were still institutionalized at a rate more than three times the national average as recently as 2022, according to an analysis of the data West Virginia submits to the federal government. The state’s Department of Human Services still doesn’t have an adequate number of social workers to investigate child abuse cases and help find homes for foster kids; this in turn means untenable case loads that leave kids in care and foster families without adequate mental health care and necessary supports. 

And though the state has trumpeted increased enrollment in a new program to help kids access mental health care in their communities, in practice it has fallen short of giving biological, adoptive and foster parents and kids the support they need to keep kids safe and healthy at home.

Behind the data

Foster care has gotten a lot of attention, but we had more questions. Here’s how we got answers.

By mining the data West Virginia submits to the federal government, we were able to fill in some of the blanks about the state’s foster care system.

by Erica Peterson
January 28th, 2025January 27th, 2025

Over the last two months, Mountain State Spotlight has shared findings of our reporting with state human services officials. A spokesperson initially responded, referring us to previous agency press releases. We then sent the agency a long list of our questions, but received no response.

For kids like Sadie, hard to place because of behavioral issues, it may seem like there are few good options. But sending vulnerable children to residential facilities, including group homes, shelters and in-patient treatment centers, can end up doing more harm than good, according to warnings from years of research.

“Sending children to live together among other children who have behavior problems, we have good evidence, makes them worse,” said Mary Dozier, the Amy E. du Pont Chair in Child Development at the University of Delaware.

That’s what happened to Sadie, who spent her early adulthood struggling to piece together a life after her years in state custody. 

“It never got better,” Sadie said. “It was always just the same shit over and over again.” 

Kids still being institutionalized 

The system’s problems are deep, entrenched, and intertwined. But there are two points that can’t be ignored: mental health care is hard to access for many West Virginians, and there is a dire need for quality care among foster kids.

Most kids enter the foster care system because they are either abused or neglected, both of which can cause lasting mental health problems. Nearly half of the West Virginia kids who spent time in foster care from 2012-2022, were there at least in part because of a parent’s substance use. One-third of all foster kids were neglected, nearly one-fifth were exhibiting some sort of behavioral problem and one in six were physically or sexually abused.

And of course, all of them had experienced the trauma of being taken away from their families. While the goal of the state’s foster care system is to reunify kids with their biological parents, that’s not always possible. In those cases, West Virginia is their guardian on paper, tasked with making sure their needs are met and that they’re able to eventually leave the system as productive adults.

But all this is happening in a state where access to mental health care is a struggle. Only six of West Virginia’s 55 counties exceed the very low target adopted by the World Health Organization of one psychiatrist per 10,000 people. Thirty-five counties have no psychiatrist or addiction medicine specialist. None of the state’s public school districts met the recommended ratio of one psychologist for every 500 kids during the 2023-24 school year.

The result has been the state sending many kids with mental health needs to in-patient hospitals and residential facilities. In 2014, the rate of kids living in these kinds of residential treatment facilities was so high, it kicked off the DOJ investigation that concluded West Virginia had built its entire child welfare mental health system around these segregated facilities. 

It’s a system that Orion Flynn knows well. He was only 10 when he spent his first long-term stint in a psychiatric hospital. At that point, he had been through a lot in his short life — taken away from his parents as his mother struggled with substance use and his father repeatedly robbed the bank down the street. 

This led to behavioral issues. Orion says he “was a child who didn’t know what was going on, throwing a tantrum, yelling, slamming a door, that sort of thing,” he recalled. “And it would sometimes get me sent to actual in-patient psychiatric hospitals.” 

That first hospitalization at Charleston’s Highland Hospital lasted a year. Orion is 19 now, and still remembers the types of restraints the hospital used on him. 

There was the four-point restraint, a system of wrist and ankle cuffs that held the ten-year-old child to the bed for up to four hours. Then, there was the papoose board, immobilizing Orion on the floor when he acted out.

A spokesperson for Highland Hospital noted that the facility has changed ownership since Orion was hospitalized there, but that it uses these kinds of interventions for patients’ safety and in accordance with “the latest least restrictive psychiatric intervention guidelines” and to “prioritize de-escalation.”

But for Orion, it was an experience that didn’t seem to help any of the mental health issues he was experiencing. “When I left, I think I was on 12, maybe 13 different medications, and I received mediocre therapy at best,” he said.

West Virginia officials have spent the last decade arguing that they’re making progress on fixing the issue. In 2015, in the wake of the DOJ investigation, then-Cabinet Secretary Karen Bowling wrote in a press release that she had already been working for two years to “turn these statistics around.”

But four years later, in 2019, disturbed by the ongoing high rates of kids in institutions, a group of foster kids sued the state, seeking more independent oversight of the system. 

“Basically what's happening is the system is killing a lot of children who remain alive but who have just been so devastated by the circumstances that they encounter that they’re effectively destroyed,” said Marcia Lowry. She is a lawyer and the executive director of A Better Childhood, a nonprofit advocacy group that is representing the foster children in the lawsuit against West Virginia. Her group has successfully sued other states over similar issues, forcing reforms to their foster care systems.

“They are just destroyed, and they continue to walk around, but when they get to be 18, there's no way that they can effectively contribute to society. Some of them survive, lots of them don't, but they're all damaged,” she said.

In response to the suit, agency officials once again argued they were in the process of making major improvements, and shrugged it off as the work of outside lawyers. 

“The issues they raise are generally those the Department has already publicly reported to the Legislature and is working to resolve with the input of the Department of Justice, our local stakeholders, the West Virginia Judicial Branch, and the West Virginia Legislature,” former Cabinet Secretary Bill Crouch said in a press release. “For an out-of-state group to sue the State of West Virginia to take over our child welfare system is offensive to the many federal, state, and community partners who have worked tirelessly to transform and improve our system.”

It’s true that since the DOJ first issued its findings, West Virginia has made some progress. 

In the years immediately following, West Virginia cut the overall percentage of kids going to group homes and institutions by half. There’s also been an effort to keep more kids closer to home, rather than sending them to out-of-state group homes and institutions, which a 2021 Mountain State Spotlight investigation found left some kids in unsafe situations. 

But while the state improved, the majority of those gains weren’t for the kids who needed it most.

Progress getting kids with disabilities out of group homes and institutions was much, much slower, according to a first-of-its-kind Mountain State Spotlight analysis of the data states submit to the federal government. In September 2022, West Virginia was still putting half of the kids with any sort of disability — physical or mental — in these types of places. That was three times the national average for similar kids with disabilities for that year.

The West Virginia Department of Human Services wouldn’t provide any more recent data about whether that has changed. But it does post monthly reports about where foster kids are living on a dedicated website. That separate state data doesn’t indicate disability status, but it does show that since the time period when the federal data ended, the state has sent even more foster kids — and a larger percentage of kids in care — to residential treatment facilities. 

Quality mental health treatment for a short period of time can help kids with some conditions. But the class action lawsuit alleges kids are being left to “languish” in these kinds of settings, where they experience additional trauma. And even in the best case scenarios, workers in these group centers, no matter how caring, are still coming and going. These situations rob kids of the key ability to form attachments, which can have life-long implications.

“If there's no primary persons who are pretty much reliably there, they're not able to form that kind of attachment, which will impact them throughout their lives,” said Carole Shauffer, the senior director of strategic initiatives at the Youth Law Center.

State’s solutions to these problems are falling short

As West Virginia grapples with trying to find appropriate homes for the increasing number of foster kids in its care, it’s under a mandate from an agreement with the federal government to offer more alternatives to in-patient psychiatric care. 

The goal is to give kids more options for mental health care in their communities, whether that’s living with their biological parents, with adoptive parents or in a foster family. 

It’s hard to say how many foster kids could benefit, because the data shows West Virginia hasn’t determined whether a large percentage of foster kids have a disability or not. 

Starting in 2016, there was a sharp jump among West Virginia foster kids who “had not yet” been diagnosed with any kind of mental or physical disability. In 2015, only 6% of kids had this undiagnosed status. The next year, as the DOJ continued to closely examine how West Virginia treated kids with diagnosed disabilities, 26% of kids were undiagnosed. Some remained that way for years, and West Virginia’s foster care agency didn’t respond to questions about why that might be.

But people familiar with the system weren’t surprised. 

“There’s a lot of things they’re supposed to do that don’t get done,” said Layne Diehl, a Martinsburg attorney who is frequently appointed to represent foster kids’ interests in court. She said often she’s had issues even tracking down kids’ basic medical records for their foster parents. 

“The way that that abuse and neglect system works, a lot of times I feel like the focus gets placed on putting resources around the parents and the kids oftentimes get left out,” she said. “You have parents who have to complete an improvement period and so they need to get a psychological evaluation, but the child’s not necessarily getting the services they need.”

And while kids entering foster care are required to be scheduled for an initial medical exam within the first several days, there’s no similar requirement for a mental health screening.

“There were times they needed a psychological that they didn't get it until they were court-ordered,” said former Child Protective Service worker Kathie Giboney, who worked for four years in the district that covers Pleasants, Doddridge and Ritchie counties.

Over the past 12 years, the state has rolled out program after program designed to help kids access mental health care in their communities. The list of programs has been a moving target as they change names and services over time; Safe at Home morphed into West Virginia Wraparound, for instance, and the state’s services now include a veritable alphabet soup of acronymic programs: ACT, CCBHCs, FSCs, CSED. 

The idea is simple: if you provide whatever mental health services a West Virginian might need in their own community, you may be able to avoid having to send them somewhere else for residential psychiatric treatment.  

For the last several years, the state has offered a special program for kids on Medicaid with serious mental health needs. It’s not just for foster kids or adoptive kids, but there is a large overlap between the two groups. 

Stacy Jacques’ son was one of the first kids to get into this program, back in 2020. Jacques adopted him from the foster care system and he had been struggling with significant mental health issues — so significant that they had posed a safety threat to Jacques and her other children and necessitated him living with another family for a while.

Jacques said this Medicaid program is the only solution the state has offered her son. “And it’s just not enough,” she said. 

West Virginia has touted the program’s increased enrollment as a sign of its success. In a December press release, the Department of Human Services reported that nearly 4,000 children have enrolled in the program, and provider numbers have doubled since 2020 to meet the growing demand. 

But while the program has grown exponentially — between 2020 and 2023, the number of kids approved on the first try grew six-fold — the providers haven’t kept up. There are just 26 providers now, up from 22 in 2021.

The state’s own reports have highlighted the program’s shortcomings.

Since 2022, the expert hired by West Virginia to assess whether it’s complying with the state’s agreement with the DOJ has warned that the number of hours of therapy each kid is getting through the program is too low. Even when there were fewer kids enrolled in the program, the report found they were getting less than nine hours a month of services. In a recent report — from March 2024, which analyzed 2023 data — kids were only getting 10 hours a month, and half of that was staff time for administrative tasks. 

When Jacques signed her son up, she says the program promised 2-4 hours of in-home services a day. But that didn’t last for long.

“Now we’re lucky to get half an hour every week.”

She said they’ve had some amazing providers through the program, but there have been major gaps and inconsistencies. She’s been waiting four years to get access to family therapy through the program, but has been told there are no therapists available in Cabell, Kanawha or Putnam counties. Once, her son didn’t have a therapist for a year because of a lack of providers. Once, during a crisis on a Friday night, she tried to access the emergency support that’s supposed to be part of the program. The coordinator who answered the phone said she was at a party and would call back on Monday.  

“With other families that I’ve known, most have given up,” Jacques said of the program. 

Now, after five years enrolled, she said assessments of her son still indicate he has severe needs, despite all that she’s done to keep him at home and improve his life.

“But the hand he was dealt before he even came to me has made it impossible to achieve those goals,” she said. “At some point it breaks your heart when the system screws a child so badly you know they’re never going to be fixed.”

Around the state, others have reported problems too. Giboney said while she saw kids get into the programs, they ended up being plagued by the same staffing shortages that are an issue among state CPS workers. “They had a worker that would come once in a while but then the worker had to either drop them, or they just didn’t have a worker because the worker quit,” she said. 

And in Martinsburg, Diehl said though the concepts behind many of the state’s programs are excellent, “the bureaucracy around it is absolutely maddening.”

She’s worked to get kids approved for the Medicaid program, but then their caseworker left the agency. Then, she has encountered the same sort of turnover among the mental health providers and the facilities. After months of calls trying to find someone else with a record of the approval, she’d reach someone only to learn the services were withdrawn because they weren’t used. 

“Right about the time you feel like you’ve got everybody on the same page, there’s a ball that’s dropped over in the corner somewhere. And everybody’s scrambling trying to find that,” she said. “It can be very, very frustrating.”

The cycle

As West Virginia enters its second decade of trying to fix the problems in its foster care system, thousands of children have entered adulthood having spent time in group homes and institutions. In the cases of both Orion Flynn and Sadie Kendall, they were released from the state’s custody with lasting trauma, ill-prepared to thrive on their own. 

Carole Shauffer of the Youth Law Center says that moving kids from one abusive or neglectful home to another goes against the goals of the system. “I think once the state intervenes, it has an obligation to intervene in such a way as to provide you with high quality care that will enable you to thrive and become a healthy adult,” she said.

It can be a vicious cycle, where it’s easy for former foster kids to see their own children taken away and put into the same system that defined their childhoods.

That’s what happened to Sadie. After she aged out of the system, she struggled to get back on track. She was sometimes homeless and worked low-wage jobs at Walmart and a local hotel. She moved in with her boyfriend to a house that she said was so bad, it should have been condemned. And she had two children.

“I didn’t have anything. I took care of my kids, I took care of them very well. But it wasn’t enough for the state,” she said.

After Sadie was arrested on a series of misdemeanor charges including disorderly conduct, obstructing, public intoxication, refusal to fingerprint and battery on an officer, the state intervened.

“They took them and that was it. That was it.”

To regain custody of her children, Sadie was told she could enroll in a series of parenting classes and report for regular drug tests. But she didn’t have reliable transportation to get there, and was trying to keep a job. The state had created a set of hurdles she just couldn’t clear.

“I kind of gave up,” she said sadly. 

At that point, it’s easy to see how for Sadie, the cycle might have continued. She signed away her parental rights, and her children were eventually adopted by a foster family. For many, that would be the end of the story. It wasn’t for Sadie.

She made more mistakes, trusting the wrong people and struggling with drug addiction. 

“At this point, what do I have left to lose?” she said.  

Then, she had another child. And she was determined not to repeat the mistakes she made with her older children.

Today, her daughter Zariyah is four years old. And despite Sadie’s best intentions, she’s continued to struggle to retain custody. Last year, she made a huge error in judgment when she gave an acquaintance a ride home. She got pulled over, and he had drugs on him. The state took Zariyah away. For a minute, it seemed the cycle would repeat itself again. 

But this time, Sadie knew what to do. She fought.

“They think it’s how it used to be and it’s not. I’m going to show them that I’m not just a statistic,’” she said. She hired a lawyer, she drove herself to the drug tests, she attended the classes. And several months later, she got Zariyah back. 

Now Sadie is trying again to be the mother she always wanted to be. She works part-time as a bartender; when she’s not at work, she describes her life as “Mommy mode 24/7.” She loves to cook and started culinary school this month in hopes of eventually doing it professionally. 

Though Sadie’s life has stabilized, she continues to bear the scars of her time in foster care. She struggles with deciding who to trust. She won’t touch prescription medication, even if she needs it. And she feels like West Virginia’s system repeatedly set her up for failure. 

“They were convinced I wasn’t going to make it,” she said. “I’m going to prove them wrong.”

Mountain State Spotlight is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on the collaborative include The Carter Center and newsrooms in select states across the country.

The data used in these stories, [Dataset 176, 187, 192, 200, 215, 225, 235, 239, 255 and 274, Adoption and Foster Care Analysis and Reporting System (AFCARS), Foster Care File 2012-2021], were obtained from the National Data Archive on Child Abuse and Neglect and have been used in accordance with its Terms of Use Agreement license. The Administration on Children, Youth and Families, the Children’s Bureau, the original dataset collection personnel or funding source, NDACAN, Duke University, Cornell University, and their agents or employees bear no responsibility for the analyses or interpretations presented here.

‘They’re all damaged.’ Despite progress, West Virginia is still failing to get foster kids the mental health help they need  appeared first on Mountain State Spotlight, West Virginia's civic newsroom.

President Donald Trump signed a slew of executive orders on the evening of January 20, his first day in office, focused on offshore wind, fossil fuel development, and Arctic drilling.

Included in this windfall is a declaration of a National Energy Emergency, showing just how serious the incoming administration is about establishing its own energy policy.

The emergency declaration gives Trump the power to suspend some requirements under the Clean Air Act. It also aligns with the Trump administration’s priority to expand fossil fuel production in the U.S. to meet growing power demand.

At least 47% of all emissions from carbon-intensive energy production in the U.S. come from rural America, according to a 2024 report from the Rural Climate Partnership. Currently, about 60% of coal-fired power plants reside in rural America.

With the majority of the country’s coal plants and over 80% of clean energy plants like wind, solar, and geothermal based in rural areas, what happens to climate and environmental policy under the next administration has a bearing on rural Americans.

And the majority of American energy currently being built is renewable, according to the U.S. Energy Information Administration, which is under the Department of Energy. The passage of the Inflation Reduction Act (IRA) in 2022 made clean energy incentives widely available for communities and businesses across the country.

The U.S. Department of Agriculture (USDA) received more than $13 billion from the legislation to carry out three programs, including rural electrification efforts, under their Rural Development umbrella.

Trump has ordered federal agencies to “immediately pause” the dispersement of IRA funds. Additionally, the new administration has given agency leaders 90 days to review all “processes, policies, and programs for issuing grants, loans, contracts, or any other financial disbursements” of IRA funds to align them with Trump’s energy policy.

Notably, the new administration’s definition of “energy” and “energy resources” excludes renewables like wind and solar.

To date, the vast majority of U.S. solar and wind plants have been built in rural areas, per the Rural Climate Partnership’s report.

“Clean energy is rural energy,” said Josh Ewing, founding director of the Rural Climate Partnership. “Almost all of the clean energy that needs to be built to power the United States is going to be built in rural places.”

Funding from the IRA will accelerate the clean energy boom in rural places once it lands in communities. While it is difficult to get a complete picture of the IRA funding that has been allocated or spent by the USDA, nearly $9 billion in rural clean energy grants have been announced as of December 2024. Much of that funding is still on its way out the door.

According to Ewing, IRA funding that has been announced — like some of the grants from the USDA — may not yet have legally binding contracts in place. Without a contract, it could now be susceptible to Trump’s dispersement freeze.

“Highest Environmental Standards” and Deregulation

Trump has promised that his administration will maintain the “highest environmental standards,” including the “cleanest air and water on the planet.” The Environmental Protection Agency (EPA) is the nation’s top environmental regulatory office, charged with enforcing pollution and wastewater standards under the Clean Air and Clean Water Acts, which have been around since the 1970s.

But the President has plans to deregulate the EPA as a means to spur American businesses. Rollbacks of rules governing chemical standards and the disposal of toxic coal waste that occurred during Trump’s first term provide some insight as to how the new administration plans to deregulate the EPA.

In the time since Trump’s first term, the U.S. Supreme Court overturned the long-held “Chevron deference” precedent, giving courts the power to overrule how federal agencies interpret laws that pertain to their areas of expertise. This new standard gives Trump more latitude to make changes at the EPA following his political priorities.

Trump also plans to revamp his efforts to cut down on government regulations, notably through his new Department of Government Efficiency, to be led in part by Elon Musk. Those efforts could look like this executive order from his first term, directing federal agencies to eliminate two regulations for each new one passed and weakening environmental regulations.

Trump issued an executive order on January 20 freezing all rules not yet published in the Federal Register and subjecting them to a review, a move which is typical for new administrations to take upon assuming office.

The new administration also rescinded 78 executive orders issued by former President Joe Biden, including a number that made explicit reference to climate change.

“Climate extremism has exploded inflation and overburdened businesses with regulation,” the White House wrote in the day one executive order.

Some Optimism Remains

Ewing told the Daily Yonder he is optimistic that the grants that have been announced will still reach rural communities.

“I have a hard time seeing any lawmaker want to take money away from rural electric cooperatives that they are going to use to reduce energy costs for their consumers,” Ewing said.

“You start cutting support for clean energy, you’re going to hurt rural people more than you hurt anybody else.”

This article first appeared on The Daily Yonder and is republished here under a Creative Commons license.

Majority-Black, rural school districts in Mississippi like the one where Jacqueline Brown has taught for 17 years cannot afford budget cuts. 

It’s already difficult to recruit a certified math teacher or offer additional incentives to retain experienced educators who are nearing retirement in a rural area, she said.

One federal program that helps rural counties navigate such challenges is the Secure Rural Schools (SRS) program. Brown’s state received $2.2 million from the program, which supports schools, roads, emergency services and other municipal services. These funds have kept rural counties afloat, especially facing declining populations, sinking tax bases and limited state funding. 

But, last month, as Congress scrambled to prevent a government shutdown, lawmakers failed to renew funding for the program. 

As a result, rural communities in over 700 counties will lose millions of dollars, forcing counties to delay road improvements and school districts to consider staff layoffs and cuts to extracurricular activities or after-school programs. Education advocates worry the lack of resources could further deepen existing disparities, especially for Black rural communities that often are invisible to policymakers. 

“Every student should have access and opportunities and resources, and it shouldn’t be determined by the ZIP code,” said Becky Pringle, president of the National Education Association. “Kids need access to a science lab, but they also need access to arts and music. They also need access to after-school programs and sports. They also need a rich, diverse, inclusive curriculum. … They can’t have it all because they don’t have the resources.”

In 2016, the only other year the program’s funding expired, one school district in California couldn’t afford to make repairs to school buildings, which caused toxic mold outbreaks at several campuses. If Congress does not address the funding shortfall, the superintendent fears the district will have to downsize, which will lead to bigger class sizes and fewer enrichment programs. In southeast Alaska, school leaders say the funding loss will be “dramatic” as school districts there are already facing budget deficits. 

Less than a week after the Senate passed its bill to renew funding, a bipartisan coalition of 22 members in the House — including Democratic U.S. Reps. Joe Neguse, Bennie Thompson, Nikema Williams, Don Davis, and Sheila Cherfilus-McCormick — urged Republican House Speaker Mike Johnson to bring the legislation before Congress before the end of the year. 

Despite the plea, Johnson did not bring the bill to a vote on the House floor before the end of the congressional session, leading to its failure. It wasn’t due to opposition or lack of support that it didn’t get passed; it was a matter of timing, Thompson told Capital B.

“I just think we just didn’t have enough time to get it across the finish line. I would say that we had a little small thing — like a presidential election — that took a lot of time away from it,” he said. “A lot of us are still here, and we see the benefit of that program. Don’t be disheartened. I’m convinced that before the funding runs out, we’ll have to reauthorize it.”

There will be one opportunity to pass a bill before the final budget deadline on March 14. 

How does the Secure Rural Schools program work? 

For decades, the bipartisan Secure Rural Schools and Community Self-Determination Act has compensated county governments surrounded by a large share of non-taxable national forest land. The system was originally designed so that certain communities received a share of timber sales generated from national forest lands managed by the U.S. Forest Service. However, in the 1990s, timber sales significantly declined, and these communities, which had relied heavily on this revenue, began to face financial strain. 

In response, Congress created the Secure Rural Schools program in 2000. This initiative replaced the previous revenue-sharing model, ensuring these communities and school districts continued to receive a stable funding source, even though they could no longer generate revenue from the timber sales on nearby federal lands. 

Over the past 10 years, the Forest Service has distributed $2.4 billion through the program. The funding continues to plateau and fluctuate by county. In fiscal year 2010, lawmakers allocated more than $415 million, whereas the most recent amount is $232 million.

Advocates are calling for a more permanent funding solution for these rural areas, rather than relying on a two-year authorization, said Tara Thomas, government affairs manager of the American Association of School Administrators.

“It is unfair to put superintendents and schools and communities in this position of where they’re constantly fighting for what, frankly, they deserve,” Thomas said. “This isn’t a handout. This isn’t someone … being reliant on the federal government. This is something that they are owed because they are unable to generate revenue any other way because of the federal government.”

Ann Levett, assistant executive director of the Leadership Network for the American Association of School Administrators, expressed that the funding mechanisms are antique and inadequate. 

“Even though people think we have too much, we simply do not collect enough tax money to meet all of the needs that are laid at the foot of the schoolhouse door,” she said. “If we say that we value schools, which play a critical role in caretaking and in educating, then we ought to find ways to finance them at suitable and appropriate levels, and I have not — in my long career as an educator — seen any successful effort to do that.”

Will Congress reauthorize the program under this administration?

It’s likely the program could be reauthorized this year.

Looking back to 2016, funding for the program lapsed before resuming in 2017. Oregon Public Broadcasting reported that GOP opposition in the House — similar to this past session — stalled progress on the bill. County payments returned to a revenue-based system, meaning they received payments based on revenue generated from fluctuating timber sales. In turn, they received significantly lower payments, according to a report by the Congressional Research Service. 

Some lawmakers are making plans to get a bill passed.

Last week, U.S. Rep. Marie Gluesenkamp Perez of Washington state wrote House leadership to prioritize extending the SRS program. Congressional leaders such as Thompson of Mississippi and U.S. Sen. Ron Wyden of Oregon, a sponsor of the bill, told Capital B they are committed to getting funds to rural counties. 

“This sad state of affairs due to congressional Republican failings is pointless and regrettable. But I am committed to working with anybody, anywhere, at the start of the new year who’s serious about reauthorizing these vital investments ASAP for rural communities in Oregon and nationwide,” Wyden wrote in a statement. 

Despite this push, Brown, the educator in Mississippi, urged legislators to “look at funding through the eyes of what type of society am I trying to build” when making crucial decisions that impact students and their communities.

“If you’re in the rural area and you’re just trying to have broadband so that the kids can have access to the internet, you need as many funds as you can get to give the students the type of society that you want to create, or the type of legacy that you want to leave,” Brown said.

The post Congress Failed to Renew Critical Funding Program for Rural Schools appeared first on Capital B News.

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A bill that would empower Wisconsin municipalities to block the construction of solar and wind farms in their backyards has been introduced a second time.

Currently, local governments possess limited authority to regulate the siting and operations of solar and wind farms, but as the number and size of projects grow — solar panel fields spanning thousands of acres and wind turbines as tall as the Statue of Liberty — some residents from the Driftless Area and central Wisconsin say the state’s system for approving energy projects unfairly stacks the scales of power against communities that live alongside the facilities.

Meanwhile, a clean energy advocacy group and former Wisconsin utility regulator said the bill would enable a discontented minority to dictate energy policy for the entire state, effectively kill renewable energy development and generate uncertainty for businesses.

The Republican-backed proposal comes amid a wave of construction after federal lawmakers invested billions of dollars during the Biden administration to slow the pace of climate change. The ensuing backlash and enactment of local restrictions are playing out across the country.

Here’s what you need to know:

Some context: Investment in renewable energy has been a state priority for decades and a requirement for Wisconsin’s utilities. It also is central to Democratic Gov. Tony Evers’ ambitious climate goals. Wisconsin seeks to operate a carbon-free electric grid by 2050. 

In 2023, 9% of net electricity generated within the state came from renewable sources, according to the U.S. Energy Information Administration.

The governor’s Task Force on Climate Change expects most future emissions reductions to come from large-scale utility projects, especially the replacement of aging coal plants with solar farms.

In 2016, the state generated just 3,000 megawatt-hours of electricity from utility-scale solar facilities. Seven years later, it increased to 1.2 million. Nearly two dozen more solar farms are in the pipeline.

Wisconsin’s utility regulator, the Public Service Commission, oversees the approval of large projects, but opponents say gaps in state oversight make Wisconsin attractive to private developers, who aren’t mandated to share project expenses or evaluate ratepayer impacts.

They don’t have to demonstrate the energy created by the new installation is even needed at all — requirements if a public utility were to construct the facility. (The commission considers costs when utilities want to purchase power or an energy facility.) But developers can sell solar and wind farms to Wisconsin utilities. Ratepayers shoulder the infrastructure costs and pay state-authorized rates of return.

The commission reports that, compared to the Midwest and national averages, Wisconsin residents pay higher rates but less on their monthly bills because they consume less energy.

Opponents of large-scale projects also criticize the state’s disclosure requirements, which enable developers to acquire land rental agreements, often confidential, before communities are officially notified.

Residents often accuse industry of minimizing their concerns over impacts to wildlife, roads, aesthetics, property values, utility bills, health, topsoil and water quality. 

Yet climate change jeopardizes those same things, and land rental and municipal payments can be a lifeline. The construction of solar and wind farms can divide towns and neighbors. Public hearings quickly get messy. 

Organizers have mounted challenges, playing out in boardrooms, courthouses and the Legislature. Several towns enacted restrictions on renewable energy projects, a push supported by Farmland First, a central Wisconsin advocacy and fundraising group. Last year, a developer sued two Marathon County towns over their wind farm rules.

President Donald Trump is the latest to seed doubt over the merits of large-scale renewable projects after issuing a Jan. 20 executive order that suspends federal permitting for any wind farm while agency officials review government leasing and permitting practices.

The bill: The proposal requires solar and wind developers to obtain approval from every city, village and town in which a facility would be located before the Public Service Commission could greenlight the project.

Senate Bill 3’s authors, Rep. Travis Tranel, R-Cuba City, and Sen. Howard Marklein, R-Spring Green, said the measure responds to constituents who feel their concerns over continued development in the Driftless Area continue to fall on deaf ears.

“We are hoping to kick-start a conversation because the way I view it now, renewable energy projects are essentially the wild wild West,” Tranel said. “People have figured out that they can profit exorbitant amounts of money off these projects, and they are just popping them up left and right, and our current attitude is long-term ramifications be damned, and I don’t think that that makes any sense.”

Currently, the commission reviews proposals for energy facilities with a capacity of at least 100 megawatts. For scale, an average wind turbine in 2023 had a capacity of 3 ½ megawatts. A megawatt of solar generation might cover 7 ½ acres.

Local governments review projects less than 100 megawatts in capacity, but municipalities can impose restrictions on solar and wind farms only in limited instances, such as demonstrating they will protect public health or safety — a tall order. Additionally, municipalities that enact siting restrictions on wind farms cannot impose criteria more stringent than commission rules.

The bill would apply to any solar or wind farm with a 15-megawatt capacity or more. If a municipality fails to take action within an allotted period, the proposed facility would be approved automatically. 

An identical proposal introduced during the previous legislative session, exclusively backed by GOP lawmakers, failed to receive a committee hearing.

Yea: Some of the bill’s backers view the influx of large energy projects as the harbinger of “utility districts” across Wisconsin’s rural spaces, primarily for the benefit of urbanites.

It’s not that proponents of local control snub clean energy, said Chris Klopp, a Cross Plains organizer who has joined challenges to transmission and solar projects. Rather, regulators could respond to climate change more equitably.

“This idea that you can just decide you’re going to sacrifice certain people, well, I think there’s a problem with that,” she said. “Who decides, and who gets sacrificed? None of that is a good conversation. It should be something that works for everyone.”

Nay: Representatives from EDP Renewables, NextEra Energy, Pattern Energy and Invenergy — developers with a Wisconsin presence — didn’t respond to requests for comment.

But former Public Service Commission Chair Phil Montgomery said local governments lack the agency’s battery of professionals it takes to evaluate the merits of a renewable energy project.

Empowering Wisconsin’s 1,245 towns, 190 cities and 415 villages to weigh the facts against their own standards would spell disaster for ratepayers, he said.

Michael Vickerman, former executive director of RENEW Wisconsin, a renewable energy advocacy nonprofit, said the bill unfairly targets wind and solar.

“You’re deciding that this industry will no longer be welcome in this state,” he said. “It becomes such an arbitrary and mysterious, unstable, unpredictable process that the developer says, ‘Screw it. I’ll just go to Minnesota. I’ll go to Illinois.’”

What’s next? More than 20 co-sponsors, all Republicans, signed on to the bill, and it has been referred to a Senate committee. Klopp hopes to rally more lawmakers to obtain a two-thirds, veto-proof majority.

Montgomery said even if it leads nowhere, the bill certainly sends a message to investors.

Bill Watch takes a closer look at what’s notable about legislation grinding its way through the Capitol. Subscribe to our newsletters for more from Wisconsin Watch.

Republican bill seeks more local control over wind, solar farms is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

A legislative committee narrowly advanced a measure on Friday to repeal sales tax on electricity in the midst of rising electrical rates — a $43.4 million annual savings for ratepayers, according to the bill’s fiscal note.

But there’s a huge downside to Senate File 128, “Repeal of sales tax on electricity,” according to critics and even some supporters of the concept.

By far, Wyoming’s largest electrical consumers are industrial users: mines, oil and natural gas producers and refiners, and especially a booming data center industry in Laramie County. Many towns and counties rely on sales taxes from those industries — including from electricity — to support public services, including services those very industries necessitate.

For example, Evansville Police Chief Mike Thompson described the revenue base of his 2,700 person community as more industrial than residential. The Casper-adjacent town, home to an oil refinery and a multitude of other large industrial operations, is almost completely reliant on various sales taxes to support public services.

“It’s going to cripple our community,” Thompson said.

Likewise, Cheyenne has seen wild success in courting manufacturing and data facilities — enterprises whose primary net contribution to the city and county are taxes, Cheyenne Mayor Patrick Collins testified before the Senate Revenue Committee.

“I see data centers as our Jonah field,” Collins said, referencing Sublette County’s famed oil and gas development. “I see them as our Campbell County coal mines. We don’t have great mineral wealth here in Laramie County to fuel our economy, as many parts of our state do.”

Demand for electricity in and around Cheyenne is projected to increase from about 350 megawatts today to 1,200 megawatts by 2030, based on anticipated growth in manufacturing and data centers, according to Collins. “So in today’s dollars, that would cost Cheyenne about $4.4 million if we take the sales tax off electricity,” he said.

Those concerns were echoed by the Wyoming Association of Municipalities and Wyoming County Commissioners Association. They noted that proposed tax reductions for homeowners, as well as a wide range of pending tax reductions for extractive industries, will likely starve small governments of the revenue they need.

All of those anxieties might be assuaged, however, according to the bill’s proponents, including lead sponsor Republican Sen. Troy McKeown from Gillette. Lawmakers are working to partially negate the revenue loss from property tax relief for towns and counties McKeown said. Plus, according to Sen. Cale Case, R-Lander, there are plans in the works to offset local governments’ losses from SF 128 with a new tax that taps electric utilities and their customers outside Wyoming.

“We would export a very large amount of tax burden and we would collect more than the sales tax we’re giving up,” Case said.

Lawmakers discussed such a strategy in April, noting Wyoming is particularly suited to shift the tax burden because it exports more electricity than it uses — although the volume of that export of electrons has been declining in recent years, according to Power Company of Wyoming Director of Communications and Government Relations Kara Choquette, who testified before the committee and participated in interim deliberations on the topic.

Nonetheless, a bill to implement a new tax to offset the revenue loss of SF 128 had yet to materialize by Friday afternoon.

“There’s a bill to be filed in the House that accomplishes — kind of looks at these things so they have to all fit together,” Case said. “It’s complicated.”

Underpinning that potential bill is a report by a legislative “electric tax subcommittee,” which was appropriated $50,000 to hire a law firm to analyse the legality of imposing taxes that extend beyond Wyoming’s borders. The Senate Corporations, Elections and Political Subdivisions Committee, chaired by Case, met behind closed doors with the hired lawyers at the Capitol on Thursday to hear their analysis.

“The purpose of the briefing yesterday was to hear from our lawyers that we hired,” Case told the Revenue Committee on Friday. “So it was privileged lawyer communications.”

Based on that briefing, “It’s clear that we can do that,” Case added. “We absolutely can do that.”

Whether or not such a bill materializes in time to offset revenue losses from SF 128, a bevy of lobbyists, who regularly comment on legislation, said they emphatically support the bill, including those representing Wyoming rural electric co-ops, Wyoming agricultural industries, the Petroleum Association of Wyoming and Wyoming Mining Association. Monthly electricity bills are one of the top expenses for doing business, they testified.

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“We have a far larger industrial load in Wyoming than you do residential — that’s not true for most states,” Jody Levin told lawmakers on behalf of the trona industry and the Wyoming Mining Association. “So the increases that we have seen in electricity have been borne largely by your industrial consumers.”

McKeown tested Evansville Police Chief Thompson’s claims regarding the potential impact to his community, and bristled at his pleas for more careful scrutiny of the measure. “It’s actually pretty simple. It just takes the sales [tax] off electricity,” McKeown murmured to a fellow committee member before asking for a vote.

The measure advanced with a 3-2 vote.

The post Electricity sales tax cut advances, to delight of industry and chagrin of Wyoming towns and counties appeared first on WyoFile .

Denise Smith sat with her legs crossed on a blanket-covered sofa in her Rocky Gap home, reflecting on a life shaped by hard work and financial struggle. The 66-year-old woman has held jobs at factories, restaurants, museums and a pharmaceutical company. She recalled having employer-provided health insurance only three times before transitioning to disability coverage. 

Smith frequently avoided seeking health care due to the cost. She remembered when medical debt nearly forced her and her then husband into homelessness. When her son, Josiah, became critically ill, she saw firsthand what can happen when people don’t have access to health care. 

With President Donald Trump returning to the White House, and Republican majorities in both houses of Congress, conversations have begun in Washington about cutting Medicaid funding. Such cuts could trigger a state law that would reverse Virginia’s 2019 expansion of the insurance program if federal funding drops by even 1%, leaving hundreds of thousands of Virginians without health insurance.  

Many rural hospitals depend heavily on Medicaid expansion patients to stay financially viable. Without this funding, these hospitals could face financial strain, risking the services they provide to underserved communities.

Efforts are underway in Richmond to safeguard expansion. A budget amendment introduced by Sen. Creigh Deeds, D-Charlottesville, and another by Sen. Ghazala Hashmi, D-Chesterfield County, seek to remove the trigger law and establish a committee to explore alternative funding options for Medicaid expansion.

For Virginians like the Smiths, Medicaid expansion has been a lifeline. 

Josiah Smith was 32 years old when he woke up one morning in 2014 with painfully swollen knees. 

He had worked since he was 16, but he never had a job that offered health insurance. And this was before Virginia had expanded Medicaid to include low-income adults like him. 

Unable to walk and rapidly losing weight, he went to a clinic near his Bland County home. He paid out of pocket for antibiotics, but the symptoms kept getting worse. 

His mother sought out low-income clinics and applied for charity programs. It took months to get testing done as she tried to figure out how to pay for the care and the doctors her son needed. 

He eventually was diagnosed with ankylosing spondylitis, an autoimmune disease that causes inflammation in the joints and at the base of the spine. Without treatment, it can lead to organ damage and vision problems.

That’s exactly what happened to Josiah. His family could only afford to buy the cheapest medications, and none of them worked. He lost sight in his right eye, and when he walks, his steps are slow and measured. 

His disease progressed. In 2015, he was approved for disability benefits, which included access to Medicaid. He found a monthly infusion that kept the swelling down, accessible to him only through Medicaid. 

“We have lived without Medicaid, so I can tell you what happens to people when they don’t have access to health care,” his mother said. It angers her, she says, because “they tell me that if they had caught it early enough it wouldn’t be this advanced.”

Hundreds of thousands of Virginians could lose coverage if Medicaid expansion is rescinded

In the western half of the state, more than 178,000 Virginians have received health care coverage under Medicaid expansion since the commonwealth implemented the program in 2019, according to data from the Virginia Department of Medical Assistance Services. Statewide, the number totals more than 630,000.

In all states, a person can qualify for Medicaid if they meet criteria based on income, household size, disability, family status and other factors, though eligibility rules can differ between states, according to Healthcare.gov. In states that have adopted Medicaid expansion, a person can qualify for Medicaid if their income is below 138% of the federal poverty level. 

Deeds expressed concern about the possibility that the 119th Congress could rescind Medicaid expansion.

“We’re going to be way up a creek without a paddle if that happens,” he said. 

Since the November election, Congressional Republican leaders have been increasingly open about their intent to make cuts to Medicaid, according to a health policy blog post by the Georgetown University McCourt School of Public Policy. 

U.S. Senate Republicans also attempted to dismantle the Affordable Care Act in 2017, under Trump’s first term, but they failed when Sen. John McCain, R-Arizona, voted against the effort for a 51-49 majority in opposition of the effort. This year, with Trump back in the White House and a Republican majority in both the U.S. Senate and House of Representatives, Congress appears poised to try again. 

Trump has already signaled his willingness to sign a bill that could end Medicaid expansion. In an executive order signed on his first day back in office, he rescinded an order by the Biden administration aimed at strengthening the Affordable Care Act and Medicaid. 

Expansion of the Medicaid program was introduced in the Affordable Care Act, passed by Congress and signed by former President Barack Obama in 2010. Since then, Medicaid expansion has been adopted on a state-by-state basis. As of November, 41 states had adopted it. 

Del. Terry Kilgore, R-Scott County, was one of a number of General Assembly Republicans who broke from the party to vote in favor of expanding Medicaid in Virginia in 2018. In the end, 36 House Republicans and four Senate Republicans voted for the 2018 biennial budget that established Medicaid expansion in Virginia. 

“In Southwest Virginia, we had hospitals closing and folks who didn’t have health care opportunities having to drive two and three hours. People were actually dying because hospitals were closing,” Kilgore said. 

Kilgore saw expansion as a way to close a gap in services in his district and to support the health care needs of his constituents. 

“It was a tough time [to support expansion], and tough within the caucus, but other states were doing it — other Republican-led states were doing it and they were seeing great results from it. At the end of the day I thought it was best for a few of us to move forward with Medicaid expansion,” he said. 

A domino effect that may cause hospitals to shutter

Hospitals, particularly those in rural areas, rely heavily on revenue from patients covered under Medicaid expansion.

“Leading up to expansion, hospitals were mostly cutting back on services,” said Deepak Madala, director of Virginia’s insurance marketplace called ENROLL Virginia.

About 39% of the patients who stay at Russell County Hospital in Lebanon for 24 consecutive hours or more are covered by Medicaid, according to data from Virginia Health Information. 

At Twin County Regional Hospital in Galax, the number is 33%. At Carilion Roanoke Memorial Hospital, 26.4%. 

The federal government currently covers 90% of Medicaid’s operating costs, with Virginia covering the remaining 10%. A portion of Virginia’s share comes from a tax on hospitals.

Deeds noted that if expansion coverage is rolled back, it could result in the closure of smaller hospitals across the state. 

The Virginia Poverty Law Center, a nonprofit organization that advocates for low-income residents, has raised similar concerns. 

If federal funding for Medicaid were reduced, hospitals might need to shoulder a larger share of the program’s costs, said Emily Hardy, deputy director of the Center for Healthy Communities at the Virginia Poverty Law Center. 

But Deeds noted that the state is not financially prepared to pick up the 90% share currently paid by the federal government for the program. 

“Hospitals couldn’t afford to pick up the 90% that the feds are paying right now any more than Virginia could,” Deeds said. “Where’s that money going to come from?”

The federal government paid about $6.2 billion in fiscal year 2023 to fund Medicaid expansion in Virginia. The state was responsible for about $693 million in the same time frame. 

Before Medicaid expansion, Virginia had one of the highest uninsured rates in the country. In the year prior to expansion, about 27.6% of residents under 65 years old lacked health insurance. That’s about 5 percentage points above the national average, according to data from the National Institutes of Health.  

Many individuals could lose health insurance if Medicaid funding is reduced, and not all of those people would get coverage other ways, Madala said. 

When parents are enrolled in health insurance, their children are more likely to be covered as well. But if parents lose coverage, the whole family often loses it, Madala said. 

Funding cuts could also jeopardize Medicaid waiver programs, which are often the first to face reductions, Madala said.

Medicaid waivers provide coverage for services not typically included in standard Medicaid, such as long-term care and support for individuals with disabilities or chronic illnesses. These programs are already limited, with few providers available, and potential funding cuts could make access even more difficult. 

Virginia is already experiencing a shortfall in funding for Medicaid

A presentation by staff of the Virginia Senate Finance and Appropriations Committee to members during a November retreat outlined a shortfall of hundreds of millions of dollars in the state’s current Medicaid funding forecast. Three primary drivers in the increase in cost to fund Medicaid include a rate of enrollment that is 30% higher than pre-pandemic numbers, an increase in care costs and an increase in services. 

Gov. Glenn Youngkin said during a presentation to the joint House and Senate money committee in December that he plans to meet the state’s current shortfall to fund Medicaid through a budget amendment request of over $687 million.

When asked repeatedly by reporters about his plan in January, should Congress roll back Medicaid expansion, Youngkin declined to answer and said the question was based on supposition.

Instead, Youngkin said that his job is to fully fund the state’s current Medicaid responsibilities. He noted that there has been a “rapid increase” in Medicaid costs in Virginia. 

Deeds pointed out that there would be recurring funding needs. Even if the state put all of its current budget surplus — forecast to be roughly $4.7 billion — toward fully funding Medicaid expansion, that money would need to be paid again the following year. 

Kilgore recalled the 2018 vote when the General Assembly adopted Medicaid expansion with the trigger language caveat that would roll back expansion in Virginia should the federal cost share ever dip below 90%. That language was included as a negotiation tactic to get the votes necessary to adopt the program’s expansion, he said. 

It won over enough Republicans to get the bill passed, but many remained steadfast in their opposition. 

“I voted against it,” said Sen. Mark Peake, R-Lynchburg. “You’re seeing why, now.”

Peake said he has not seen a government program that hasn’t expanded “exponentially” beyond what the legislative body discussed at the time of passage. He said he was also concerned, in 2018, about the possibility of Medicaid expansion being rolled back by Congress after it was adopted at the state level. 

“You do not want to count on the federal government keeping up with commitments that it made to us on spending. It’s never guaranteed,” he said. 

Peake said he is sympathetic to people who do not have access to health care, but he said he believes going through the private sector is better than relying on a program that now finds itself in a precarious position. 

What legislators are doing

Deeds introduced a budget amendment this year that would remove the trigger language from state law. Under the amendment, should the federal match rate change, a legislative committee would be established to consider ways to adjust to the federal action while preserving access to health coverage for as many Medicaid enrollees as possible.

“At this point, to a large extent, it is supposition. It is just speculation in terms of what’s going to happen in Congress, what’s going to happen in Washington,” he said. “I worry about it a lot — I guess you can’t worry about what you can’t control; you just have to be prepared for whatever’s going to happen.”

Representatives Morgan Griffith, R-Salem; Ben Cline, R-Botetourt County; and John McGuire, R-Goochland County, did not respond when asked about whether Congress would attempt to roll back Medicaid expansion.

Sen. Tim Kaine, D-Va., said he plans to strongly oppose any proposal to cut Medicaid funding. He, and his Democratic counterparts in Congress, are in the minority for at least the next two years. 

Kilgore said he isn’t concerned about expansion being rescinded under the 119th Congress. 

“It’s a way that we provide health care services to those in need. I think it’s going to continue,” he said. “I don’t see much appetite for that in folks I’ve talked to.”

Kilgore also said he would have to see a fiscal impact study on how Deeds’ budget amendment to do away with trigger language in the 2018 biennial budget could affect the state budget before he was able to support it. 

A collage of pictures rests on the mantel behind the wood-burning stove in Denise Smith’s home. A bearded man with a banjo under his arm is pictured; his name was Eddie Atwell. 

“He was my fella,” Smith said. The couple spent 20 years together, but Atwell died last year at the age of 70. 

Years earlier, Atwell had suffered a heart attack but avoided going to the doctor because he didn’t have health insurance. When he experienced a second heart attack, he finally had insurance, but it was too late. Doctors told him they couldn’t repair his heart due to the damage caused by the first heart attack. He died shortly after, Smith said.

“[Health care] isn’t something you can choose to live without,” Smith said. “You can choose to live without a car. You can ride a bicycle, you can walk, you can take the bus. It’s not going to kill you not having it. But not having health care can kill you.”

The post Hundreds of thousands of Virginians could lose insurance coverage if Medicaid expansion is rolled back appeared first on Cardinal News.