Rural Dispatch: January 2025

A Program To Close Insurance Gaps for Native Americans Has Gone Largely Unused
By Jazmin Orozco Rodriguez
Health leaders say a tool to boost medical coverage for Native Americans, a population that has long faced worse health outcomes than the rest of the nation, has been underused by many states and tribes since it was written into the Affordable Care Act more than a decade ago.

Montana Eyes $30M Revamp of Mental Health, Developmental Disability Facilities
By Sue O'Connell and Mike Dennison
The moves under consideration include relocating a residential facility for people with developmental disabilities, renovating the state’s psychiatric hospital, and opening a new unit of the hospital in Helena.

For Homeless Seniors, Getting Into Stable Housing Takes a Village — And a Lot of Luck
By Aaron Bolton, MTPR
The number of unhoused seniors in the U.S. is expected to triple by 2030. About half of this population is becoming homeless for the first time. Homeless services struggle to help. Finding affordable housing that’s also accessible for older Americans with medical conditions is an extra challenge.

Midwives Blame California Rules for Hampering Birth Centers Amid Maternity Care Crisis
By Ronnie Cohen
Birth centers, where midwives deliver babies with emergency backup from hospitals, can offer an alternative for families as hospitals close maternity units. But the state’s stiff regulations and what many call a dysfunctional licensing process are hobbling new initiatives and forcing some facilities to shut down.

Can Medical Schools Funnel More Doctors Into the Primary Care Pipeline?
By Felice J. Freyer
More medical schools say they will no longer charge tuition, in hopes that more students, graduating free of debt, will choose lower-paying primary care careers. But evidence suggests it will take a lot more than a free ride to replenish the primary care pipeline.

Medicaid Expansion Debate Will Affect Other Health Policy Issues Before Montana Legislature
By Mike Dennison and Sue O'Connell
Legislative leaders say the decision whether to renew Montana’s Medicaid expansion program this year will loom over behavioral health spending and hospital regulation, among other topics.

For Many Rural Women, Finding Maternity Care Outweighs Concerns About Abortion Access
By Lillian Mongeau Hughes
A legislative effort to expand access to prenatal care in rural Oregon with mobile clinics was scuttled because those clinics would have provided abortions in rural areas. Opposition to the proposal shows that, even in states that ensure access to abortions, that care isn’t universally available or accepted.

Syringe Exchange Fears Hobble Fight Against West Virginia HIV Outbreak
By Taylor Sisk
Health workers and researchers say an HIV outbreak in West Virginia that three years ago was called “the most concerning” in the U.S. continues to spread after state and local officials restricted syringe service programs.

Listen: NPR and KFF Health News Explore How Racism and Violence Hurt Health
By Cara Anthony
KFF Health News Midwest correspondent Cara Anthony and Emily Kwong, host of NPR’s podcast “Shortwave,” talk about Black families living in the aftermath of lynchings and police killings.