Black women fearing covid-19 choose home birth, adding to their underlying risk of complication, especially in rural areas

Getty Images photo via Stateline

African American women are two to three times more likely to die from causes related to pregnancy than white women, regardless of income or education, but many of them are joining a national trend of having babies at home for fear of covid-19, reports April Simpson of Stateline.

"Black midwives could be part of the solution, especially during the coronavirus pandemic, but restrictions on midwifery make it difficult to practice in many states," Simpson reports. She begins her story by noting a booked-up midwifery center in Memphis, which serves Tennessee, Arkansas and Mississippi "rural areas far from hospitals and obstetrics units. The center’s clients are primarily black and other women of color."

“They’ve told us they’re going to risk it all and have an unassisted home birth,” Nikia Grayson, the center's director of perinatal services, told Simpson. “That’s very scary, and that’s what people are researching and seeing as a viable option. ... It can go left real fast.”

Simpson writes, "The stakes are especially high for rural black women soon to give birth in Southern states. They have less access to health care providers and travel longer distances to care, while systemic racism and health care inequities put their lives at risk."

EPA trims power-plant standards for mercury, other metals

"The Trump administration on Thursday weakened regulations on the release of mercury and other toxic metals from oil and coal-fired power plants," Lisa Friedman and Coral Davenport report for The New York Times. "The new Environmental Protection Agency rule does not eliminate restrictions on the release of mercury, a heavy metal linked to brain damage. Instead, it creates a new method of calculating the costs and benefits of curbing mercury pollution that environmental lawyers said would fundamentally undermine the legal underpinnings of controls on mercury and many other pollutants."

Friedman and Davenport write that the new method essentially makes pollution control look more expensive and less effective on paper, which could help justify loosening restrictions on pollutants that would be expensive for fossil-fuel companies to control.

"The proposed change is the latest in the Trump administration’s long-running effort to roll back environmental regulations and reduce regulatory burdens, particularly on the coal, oil and gas industries, they note. "Over the past few weeks as the nation struggled with the coronavirus, the administration has also rushed to loosen curbs on automobile tailpipe emissions, opted not to strengthen a regulation on industrial soot emissions and moved to drop the threat of punishment to companies that kill birds 'incidentally.'"

Environmental groups are suing EPA over a March 26 memo saying it wouldn't penalize companies that don't monitor their pollution output during the pandemic, Rebecca Beitsch notes for The Hill.

Rural voters moved to the left in Wisconsin primary

Daily Yonder map; click the image to enlarge it.

Results were slow in coming for the April 7 primary election in Wisconsin, but this much seems clear: Rural voters moved to the left, which has interesting implications for November.

The most important office on the ballot was a state Supreme Court seat. It's officially a non-partisan race, but each party had a favorite. Justice Dan Kelly, whom Trump endorsed, was widely favored to win, but he lost to liberal-backed Dane County Judge Jill Karofsky by more than 10 percentage points. Kelly won by 3 points among rural voters, much less than the 20-point they gave Trump in 2016, Tim Marema and Bill Bishop report for The Daily Yonder. Rural voters accounted for about a quarter of the votes cast on April 7.

Using the race "as a surrogate for the national presidential contest, we see broad movement toward the Democratic side of the ledger in Wisconsin, compared to 2016," Marema and Bishop report. Democrats or liberal candidates "improved their margins across the board in every category of county the Daily Yonder normally tracks," and though the gains were largest in small- and medium-sized metropolitan areas, "Karofsky improved on [Hillary] Clinton’s rural performance by about 10 points. She made rural a horse race in areas where Trump blew the doors off Clinton in 2016."

It's difficult to make an apples-to-apples comparison of the races, due to the pandemic and other reasons. Democrats sought to delay the primary and increase absentee voting, but Republican lawmakers and conservative-majority courts blocked that, and the state ran into problems getting enough absentee ballots issued early enough, Kendall Karson reports for ABC News.

Requiring in-person voting and limiting absentee ballots favored rural voters, who were less likely to face long lines or crowds on election day. Thousands of poll workers forsook their posts, fearing for their health. Milwaukee, which normally has 180 polling sites, only had five open, NBC News reports. That caused a 25 percent drop in the city's voter turnout from 2016, but overall voter turnout otherwise, including in rural areas, wasn't that different from 2016, the Yonder reports.

Karofsky's win will shift the conservative-liberal split on the court from 5-2 to 4-3. That could be significant as state lawmakers redraw legislative boundaries after this year's decennial census. The political boundaries drawn by Republicans heavily favor rural, conservative voters, and have helped the party keep a majority in the state legislature without a majority of popular votes. "During the 2018 election, Democratic candidates won 190,000 more votes for State Assembly seats, but the GOP held a 64-35 advantage in the chamber," Reid Epstein reports for The New York Times.

Quick hits: Amtrak gets $1 billion, some for rural; dispatches from rural hospitals, Appalachia; Ken Ward profiled

Here's a roundup of stories with rural resonance; if you do or see similar work that should be shared on The Rural Blog, email us at heather.chapman@uky.edu.

For rural Texas hospitals, beating coronavirus is personal: 'We feel responsible for one another.' Read more here.

Florida issues 32,000 laptops to rural school districts amid spread of covid-19. Read more here.

The submission deadline for the Society of Environmental Journalists' 2020 Awards is April 24. Read more here.

Ken Ward Jr.

Environment and Energy News profiles Tom and Pat Gish Award and MacArthur Foundation winner Ken Ward Jr. on covering coal with "sustained outrage." Read more here.

Profit over people: Inside an Appalachian struggle to save rural health care. Read more here.

"We Belong to Each Other": Appalachian youth build support amid the uncertainty of the pandemic. Read more here.

10 pioneer-era apple types thought extinct are found in the Western U.S. Read more here.

Amtrak is getting $1 billion in emergency funding from the coronavirus relief bill, and much of it will benefit routes running through rural areas. Read more here.

Pandemic hits Navajo Nation hard. Read more here.

Pandemic shows need for new rural policy, analysts write

The rapid economic crash during the covid-19 pandemic shows how vulnerable many parts of the nation are, and highlights the need to change federal policy in rural and tribal areas, Katharine Ferguson, Anthony Pipa, and Natalie Geismar write for the Brookings Institution.

Ferguson is the associated director of the Aspen Institute's Community Strategies Group, Pipe is a Brookings senior fellow in global economy and development, and Geismar is a global economy and development project coordinator at the Center for Universal Education.

"The virus is now reaching into rural communities and Native American nations where, in many places, the compounding forces of race, poverty, and geographic isolation hits hard," they write. "When the nation turns to the work of recovery, our goal must be to expand the number and breadth of healthy communities, jump-starting a more equitable and diverse landscape of resilient local and regional economies. The relief funds already allocated and being contemplated by Congress must be designed to enable every community to thrive."

The pandemic will likely cast a long shadow in rural America, where many areas have barely recovered from the 2008 recession. Hospitals and the recreation economy in particular are already being hit hard, they write.

The analysts suggest five broad principles the federal government should follow to best help rural and tribal communities: support local ownership and strategies; invest in people and institutions; increase flexibility and align federal and state funds to meet local needs; measure and reward outcomes; and embrace a regional mindset.

Five-part discussion panel series explores issues of the agricultural and food supply chains during the pandemic

Agriculture and biotechnology company Alltech has released a free five-part video series exploring the global food supply chain and how the pandemic and other crises affect it. In "Forging the Future of the Farm & Food Chain," a panel of experts from across the globe discuss a wide range of topics.

In the first video, "Cultivating Optimism & Opportunity: Leadership in Times of Crisis," Alltech CEO Mark Lyons talks about how business leaders can shepherd their teams through tough times. 

The second video, "From the Frontlines of Food Production," examines the experiences of people working in the food sector during the pandemic.

In the third video, "The Post-Covid Consumer: A Remaking of the Market?" economists and business leaders discuss the lasting impact the pandemic could have on consumer trends and the global economy.

The fourth video, "Keep Calm & Carry On: The Essential Business of Agriculture" looks at how the pandemic is reshaping the agriculture sector.

In the fifth video, "Planet of Plenty in a Post-COVID World," Lyons wraps up the series with an overall look at the issues discussed, and considers how the pandemic could change the way we grow and distribute food.

Publishers and editors to discuss to discuss pandemic effects on news industry in webinar at 6 p.m. ET today

The California News Publishers Association will host a webinar today at 3 p.m. PT (6 p.m. ET) to discuss how the pandemic has affected the news industry. A panel of publishers and editors will talk about how they're fighting to serve audiences and customers during the crisis and share strategies to cope with an unprecedented increase in demand for news even as ad revenue drops.

Click here for more information or to register.

Stimulus provisions to protect low-income renters may not be enough; some call for temporary rent moratorium

The stimulus package included provisions meant to protect low-income renters from eviction and allow cash-strapped homeowners a grace period on their mortgage payments, but it may not be enough. Rural renters could be hit especially hard, since housing crunches in nearby urban areas have contributed to higher rural rents.

"The March legislation to rescue the economy from the covid-19 pandemic addresses, among others, two housing programs run by the Agriculture Department: the Rural Housing Service's Section 515 program that provides low-interest direct loans to build rental and cooperative housing in rural areas and the service's Section 502 program that directly lends to low-to moderate income borrowers and guarantees against default," Ellyn Ferguson reports for Roll Call.

Temporary eviction bans at the federal, state and municipal levels can help, but many of them have significant limitations, and not every state or county has passed such a ban. "Thirteen states — including Florida, Nevada, Mississippi, Ohio, South Dakota, Utah, Vermont and Wyoming — allow cities and towns to set their own eviction policies," Alieza Durana and Matthew Desmond report for The Washington Post. "Some cities (Miami is a notable example) have responded by issuing moratoriums, but suburban and rural communities have been much slower to act. The problem is that housing insecurity affects communities large and small across the country. In fact, some rural towns have eviction rates that rival the highest-evicting cities."

Many affordable-housing advocates are calling for a national rent moratorium, "essentially relieving people of the responsibility to pay rent for some period of time instead of just allowing tenants to put off payments," Emma Coleman reports for Route Fifty. "This will free up cash for households that are already rent-burdened, allowing them to spend money on groceries, medicine, and other essential needs, they argue." Under such a plan, landlords would receive rent reimbursements from the government.

Study shows county-level data on pandemic preparedness

The covid-19 pandemic "could take a crushing toll on rural areas that are less prepared than many of their urban counterparts," reports Stat, the medicine-and-science publication of The Boston Globe.

Andrew Joseph reports on a newly published data project, produced by a collaboration among Stat, the Center on Rural Innovation, and Applied XL. The data show county-level pandemic preparedness across the nation according to five variables: the number of licensed hospital beds within a 40-minute drive; the number of critical care staff within a 40-minute drive; the percentage of the population age 65 and older; ICU bed shortage estimates from the University of Washington's Institute for Health Metrics and Evaluation's covid-19 model; and the county's score on the Center for Disease Control and Prevention's Social Vulnerability Index, which measures resiliency to outbreaks and disasters based on factors such as poverty, transportation access, and housing.

Big cities account for most covid-19 cases, but the infection rate is slightly higher in rural counties as of April 14, The Daily Yonder reports.

Some rural areas are less equipped to handle the pandemic than others, including parts of the Deep South and West. Though some urban areas scored poorly on the preparedness scale and some rural areas scored well, rural areas are overall more vulnerable because they have older populations, higher rates of underlying medical problems, and less access to health care, Joseph reports.

"Long distances to hospitals and labs can spell the difference between life and death with an unpredictable disease that can rapidly turn critical. Rural grocery stores, pharmacies and even hospitals are last in line for supplies that chains and big box stores have special access to," Eric Scigliano reports for Politico.

Rural hospitals, already financially troubled before the pandemic, are particularly vulnerable right now. "Before, if a local disaster or disease outbreak overwhelmed their resources, they could turn to neighbors and big-city medical centers for relief. Now, they find themselves competing, at a disadvantage, with their larger counterparts for scarce test kits and protective gear," Scigliano reports.

Big cities have most covid-19 cases, but rural infection rates are slightly higher; see recent county-level data

Coronavirus infections as of April 14. (Daily Yonder map; click to enlarge it or click here to view the interactive version.)

The covid-19 infection rate was about one-fifth that of major cities as of April 14, but the infection rate is increasing more quickly in rural areas, Bill Bishop, Tim Marema, and Jan Pytalski report for The Daily Yonder.

According to data compiled from USA Facts, more than three-fourths of rural counties had a confirmed covid-19 case and one in five rural counties (about 20 percent) had reported a death from the virus by April 14, the Yonder reports.

"Nonmetropolitan (or rural) counties contain about 15% of the U.S. population but account for only 4% of the nation’s 600,000 cases of Covid-19. Just over 3% of the nation’s deaths from coronavirus infection are in rural areas," the Yonder reports. "The rate of increase in coronavirus infections was slightly higher in rural areas from April 7 to 14. Cases increased by about 65% in nonmetropolitan counties during the period, while the rate of increase in large metros was 52%. But in raw numbers, that means rural areas added about 1,000 cases, while the number of cases in major metropolitan areas jumped by 165,000."

Virginia teen pilot flies medical supplies to rural hospitals

TJ Kim loads medical supplies into a plane.
(Photo provided to the AP by Thomas Kim)

Like many high school students, TJ Kim wanted to find a way to help out during the covid-19 pandemic. So the 16-year-old sophomore, who lives in McLean, Virginia, decided to make use of his flying lessons to bring badly needed medical supplies to rural hospitals.

"Each week, he carries gloves, masks, gowns and other equipment to small hospitals. When he made his first delivery, on March 27 to a 25-bed hospital in Luray, he was taken aback by the reception," Matthew Barakat reports for The Associated Press.

"They kind of conveyed to me that they were really forgotten about. Everyone was wanting to send donations to big city hospitals," Kim told Barakat. "Every hospital is hurting for supplies, but it’s the rural hospitals that really feel forgotten."

Kim and his family dubbed the effort "Operation SOS" (Supplies Over Skies). His goal is to deliver supplies to all seven critical-access hospitals in rural Virginia, Barakat reports. Kim has been flying since he was 15; he hopes to attend the Naval Academy and become a pilot.

Anonymous person buys $82,000 in gift cards from Iowa town's grocery and restaurants, gives to all 549 households

Earlham, in Madison County, Iowa.
(Wikipedia map)

Talk about buying local.

Earlham, Iowa, a town of about 1,450 near Des Moines, has been hurting like much of the nation. Residents have been laid off or furloughed from their jobs because of the pandemic, and many are struggling to pay the bills, Cathy Free reports for The Washington Post.

But on March 26, someone called Mayor Jeff Lillie and said he had a friend who wanted to remain anonymous and pump money into the local economy. The donor bought $82,350 in gift cards from the local grocery and the two local restaurants, and sent them to every one of the 549 homes in the town. That breaks down to $150 per household, with $50 each for the grocery and restaurants.

In the days after the call, city employees stuffed envelopes with the gift cards, and Lillie included a letter explaining the situation and promising it wasn't a scam. He also thoughtfully invited residents who didn't need the cards to drop them off at City Hall to be given to families who live in the school district but outside the city limits, Free reports.

Assistant City Clerk Amy Willem, a single mother of three who helped distribute the gift cards, told Free that the gesture meant a lot to her. "Like everyone, I've had to cut back a little," Willem said, "and getting some takeout for dinner is a treat. To know that there's somebody out there who wanted to anonymously help everyone in town just warmed my heart."

Trump says Postal Service should raise its charges for delivering packages for Amazon etc. in remote rural areas

President Trump threatened to veto the $2.1 trillion stimulus package if it included any money to bail out the U.S. Postal Service, according to a senior administration official. "Instead, Sens. Gary Peters (D-Mich.) and Ron Johnson (R-Wis.) added a last-minute $10 billion Treasury Department loan to the CARES Act to keep the agency on firmer ground through the spring of 2020, according to a Democratic committee aide," Jacob Bogage reports for The Washington Post. Without the loan, lawmakers were told USPS would be inoperable by the end of September.

Rural America disproportionately relies on the service for mail, medications, food, and other staples. It also went for Trump in the 2016 election, but "On Friday, Trump advocated, as he long has, for the Postal Service to raise the prices it charges online services like Amazon to deliver goods, often to hard-to-reach rural areas," Allison Pecorin reports for ABC News.

USPS, already in the red before the pandemic, is in dire need of help due to the sudden drop in mail volume and sales of its products and services. In an open letter April 10, Postmaster General Megan Brennan said the pandemic will increase its net operating loss by an estimated $22 billion in the next 18 months. She asked lawmakers for "$25 billion to offset lost revenue from declining mail volume due to the coronavirus and $25 billion for 'modernization' — plus another $25 billion Treasury loan and a mechanism to pay down $14 billion in existing public debt," Bogage reports.

"Much of Trump’s invective on the Postal Service is aimed at Amazon founder and chief executive Jeff Bezos, who owns The Washington Post," Bogage reports. Last week, Trump criticized Amazon and other shippers for not paying the Postal Service enough to deliver packages. That mainly happens in rural areas, where private shippers find it less profitable to operate. In urban and suburban areas, private shippers like Amazon, FedEx, and UPS find it cheaper to hire their own delivery drivers.

It's unclear whether Postal Service aid will be included in the next stimulus package. "The agency’s troubles have renewed conservative conversations about structural changes that would force the Postal Service to act more like a corporation, with steps such as eliminating the prepaid pension requirement and easing its universal service obligation to deliver to every address in the United States, including ones so remote," Bogage reports.

Study: Some social distancing may be needed through 2022

Intermittent social distancing may be needed through 2022 to keep covid-19 spikes from overwhelming the U.S. health care system, but much more testing is urgently needed to know more about how the virus might behave, says a newly published study in the journal Science.

Harvard University researchers examined a range of scenarios for how the virus will spread over the next five years. "The authors suggest a number of factors will play a major role in the path the disease will take over the coming years — if transmission subsides in summer and resurges in winter, if there is some immunity induced by infection and how long it lasts, and whether people get any cross-protective immunity from having been infected with related human coronaviruses that cause common colds," Helen Branswell reports for Stat. "Overall, the research concludes it is unlikely that life will return any time soon to the way it was before the virus’ emergence."

Their models predict that a one-time social distancing effort—such as what is happening now in the U.S.—won't stop transmission of the virus. The researchers see two ways that officials could loosen social distancing measures sooner: if a vaccine is developed, and/or a treatment that keeps cases from getting too serious, Branswell reports.

The researchers stressed the need to study blood samples over time to map out human immune responses to the virus and discern it behavior. Mark Lipsitch, the lead author, told Branswell that that's doubly important because some evidence indicates that not all covid-19 survivors develop a strong immune response, which means herd immunity will take longer to build up.

On Tuesday, President Trump announced a task force to help him decide when and how to end social-distancing measures; the list included business and sports leaders, but no health officials so far. Trump has been under heavy pressure from business leaders and some conservative politicians to reopen the country in order to avoid another expensive stimulus package. Governors in many states have pushed back though, asserting that they will choose when to end social distancing, Annie Karni and Maggie Haberman report for The New York Times.

Rural Assembly livestreams Thurs. and April 22 will address concerns about broadband and government response

Two Rural Assembly livestreams will address rural broadband access during the pandemic.

The Daily Yonder will host the first livestream at 4 p.m. ET Thursday, April 16 on its YouTube page. A panel of rural stakeholders will discuss how broadband disparities affect social-distancing measures for rural people who have been obliged to work and learn from home, and to increasingly rely on telehealth. Click here for more information about the livestream and a list of the panelists.

The second livestream, at 4. p.m. ET Apri1 22, will discuss the government's response to rural broadband disparity, and what further actions need to be taken. Panelists will include a representative from the Federal Communications Commission.

Registration is not required for either livestream, but registrants will receive an email notifying them when the discussion is about to begin. The Rural Assembly and the Yonder (both products of the nonprofit Center for Rural Strategies) are planning future livestreams to explore policy responses for expanding rural broadband and helping communities in need during the pandemic.

Farm economy roundup includes prediction of $11.8 billion drop in crop income, $20.2B in livestock receipts in 2020

Farm Policy News from the University of Illinois has an excellent roundup of how the pandemic is affecting the agricultural economy. Some of the highlights:

An updated economic analysis predicts that the pandemic will cause an $11.85 billion decline in crop farmers' income this year, and a $20.24 billion drop in receipts for all livestock sectors combined. Overall, that's a $32 billion decrease. Net farm income in 2020 is projected to drop by $20 billion, after higher government payments and lower input prices are factored in.

Corn and soybean prices are down, but for different reasons. Soy prices are down because meatpacking-plant shutdowns have led to fears of lowered demand for soybean meal, a major livestock feed. Corn prices are down largely because demand for ethanol is down.

China's ambassador to the U.S. said his country is still implementing the first phase of the trade agreement the two countries signed in January, but said the pandemic might require some changes. Agricultural economists have been skeptical that China will fulfill its obligations under the agreement, which has no mechanism for compliance.

Federal court in Maryland halts Trump administration's rollback of nutrition standards for school meals

"The Trump administration violated federal rules when it rolled back heavily debated nutrition standards for school meals programs in 2018, a federal court ruled Monday," Evie Blad reports for Education Week. "The U.S. District Court in Maryland vacated the rule changes and sided with plaintiffs, children's health advocacy groups that had argued the U.S. Department of Agriculture violated the Administrative Procedures Act, which agencies must follow in changing federal regulations."

The plaintiffs, the Center for Science in the Public Interest and Healthy School Food Maryland, represented by attorneys from Democracy Forward, sued USDA in April 2019. They argued that it essentially pulled a bait-and-switch. The final rule, which allowed higher salt levels and eliminated the requirement for more whole-grain items in school meals, was too different from the draft USDA published for public comment, they said. "That earlier draft would have delayed those regulations and allowed some exemptions, rather than eliminating the standards altogether," Blad reports.

Virginia governor signs sweeping gun-control laws

Virginia Gov. Ralph Northam signed sweeping gun-control measures into law Friday, realizing the fears of many rural constituents.

The newly signed package requires background checks on all firearm sales; allows law enforcement to temporarily take someone's guns away if they're deemed a danger to themselves or others; limits Virginia residents to buying one handgun a month; requires people to report lost or stolen guns in 48 hours; and increases the penalty for leaving firearms out around children, according to a press release.

Northam proposed an amendment to a bill that would allow local governments to regulate where firearms are allowed; his amendment clarifies that colleges and universities would be exempt from local laws. He also proposed an amendment to a bill that would require people with protective orders against them to turn over their guns; the amendment would allow judges to hold the person in contempt of court if they fail to comply.

Some of the gun-control bills were watered down to pass the state Senate, Gregory Schneider reports for The Washington Post. Though Democrats control both chambers of the legislature, the Senate has been more concerned about the repercussions for rural constituents: a bill banning "assault weapons" died in the Senate in February. but House Speaker Eileen Filler-Corn worked with senators to find a happy medium. Seven of the eight gun-control bills passed the legislature in some form. 

"Guns became a divisive issue in Virginia after Democrats won full control of the state's General Assembly in November, and Northam, a Democrat, promised to pass the host of restrictions," reports Ryan Miller of USA Today. "The signing comes almost three months after more than 20,000 gun owners descended on the state capitol in Richmond to protest the measures. It's also been almost a year since the deadly Virginia Beach shooting left 12 people dead plus the shooter."

Rural Virginia has acted, too. In the months after the election, most rural counties declared themselves Second Amendment sanctuaries, asserting that local law enforcement would not comply with state laws. And in January, Liberty University President Jerry Falwell Jr. and West Virginia Gov. Jim Justice invited conservative Virginia counties to secede and join West Virginia.

Gun sales are at an all-time high in Virginia (and in the U.S. overall) in recent weeks. Most of that is attributed to the pandemic, but in Virginia some of it was probably because of fears about gun legislation, Mark Bowes reports for the Richmond Times-Dispatch. 

In addition to gun-control laws, Northam also expanded protections for LGBT Virginians, loosened restrictions on abortion, made it easier to vote, and decriminalized possession marijuana (those caught with the drug would pay a $25 civil fine).

Thursday Poynter webinar to share covid-19 data and fact-checking resources for reporters, discuss reporting pitfalls

The Poynter Institute will host a free 30-minute webinar at 2 p.m. ET Thursday, April 16, to help journalists cover covid-19 as accurately as possible. Click here to get more information or register.

Senior multimedia reporter Alex Mahadevan will share data sources your newsroom can use immediately for reporting and fact-checking, tools and resources to help you interpret pandemic data, and advice on how to avoid common pitfalls in reporting covid-19 data.

One resource you can use (and which the webinar will likely highlight) is the #CoronaVirusFacts Alliance, a Poynter-led group of more than 100 fact-checkers from all over the world that publishes a frequently updated searchable database of covid-19 fact-checks.

Stimulus package bars hospitals and doctors from engaging in surprise billing

The recently signed stimulus package bars hospitals and doctors from sending "surprise billing" to covid-19 patients, Ricardo Alonso-Zaldivar reports for The Associated Press. The government has also pledged that all covid-19 testing and treatment will be free.

The measure, which was not included in the stimulus package, addresses a loophole that has been deviling many patients. On March 11, President Trump announced that health insurers had agreed to waive co-pays for covid-19 treatment, but many people were still getting hit with sky-high ER and lab testing bills since that treatment happened before the patient was diagnosed. One woman was charged $28,000 for a throat swab sent to an out-of-network lab, Elisabeth Rosenthal and Emmarie Huetteman report for Kaiser Health News.

The issue highlights the financial risk that many patients undertake when they go to the ER, mostly because of out-of-network doctors or testing labs at in-network hospitals, Sheelah Kolhatkar reports for The New Yorker. Kolhatkar's piece, though lengthy, is well worth a read, as it shows how private equity firms are largely behind the phenomenon of surprise billing.

Specific language barring surprise billing may be included in the next stimulus package. Some lawmakers wanted to included such language in the first package, but the notion "triggered expensive lobbying campaigns by moneyed health interests and private equity companies with stakes in firms that staff hospitals with physicians," Susannah Luthi reports for Politico.

The air ambulance industry, which rural areas rely on heavily, was involved in efforts to keep surprise billing language out of the final package. Lobbyists "played what a person familiar with the negotiations, who spoke on the condition of anonymity, called 'the COVID card': 'How could you possibly ask us to deal with surprise billing when we’re trying to battle this pandemic?'" Rosenthal and Huetteman report.

Trump administration plans to expand hunting and fishing on public lands

"The Trump administration plans to open 2.3 million acres of land for hunting and fishing at more than 100 national wildlife refuges and fish hatcheries under a proposal unveiled Wednesday that is aimed at giving Americans more recreational access on public lands," Brady McCombs reports for ABC News. "The plan earned applause from several hunting and fishing groups, but criticism from one conservation organization that called it 'tone deaf' to focus on this during the covid-19 pandemic."

USDA may reduce minimum pay requirements for foreign farm workers to help farmers struggling during pandemic

"New White House Chief of Staff Mark Meadows is working with Agriculture Secretary Sonny Perdue to see how to reduce wage rates for foreign guest workers on American farms, in order to help U.S. farmers struggling during the coronavirus, according to U.S. officials and sources familiar with the plans," Franco Ordoñez reports for NPR. "Opponents of the plan argue it will hurt vulnerable workers and depress domestic wages."

The USDA is pushing the measure to help farmers who were already hurting because of the Trump administration's trade war with with China. President Trump said Friday that he is directing Perdue to provide at least $16 billion in relief for farmers and ranchers hurt by the coronavirus, including direct payments. That's on top of the $23 billion earmarked for agriculture in the first stimulus package, Ordoñez reports.

"The nation's roughly 2.5 million agricultural laborers have been officially declared 'essential workers' as the administration seeks to ensure that Americans have food to eat and that U.S. grocery stores remain stocked. Workers on the H-2A seasonal guest-worker program are about 10% of all farmworkers," Ordoñez reports. "Last month, the U.S. State Department said it will start processing more applicants seeking H-2A temporary guest worker visas to ensure U.S. farmers have foreign workers in time for spring planting."

Sioux Falls pork processing plant closes because of coronavirus; it and other closures threaten supply chain

After more than 230 of its workers were found to be sick with covid-19, Smithfield Foods announced on Sunday that it's shuttering its pork processing plant in Sioux Falls until further notice, Tom Polansek reports for Reuters. The closure and others like it could cause food chain problems; they also highlight the poor work conditions at many meatpacking plants that encourage the spread of infectious diseases.

The Sioux Falls plant is one of the nation's largest pork processing facilities, employing about 3,700 and accounting for 4 to 5 percent of U.S. pork production. South Dakota Gov. Kristi Noem said Saturday that sick Smithfield employees account for 55% of the state's total active covid-19 cases.

The company originally said it would close for three days to clean, after health officials confirmed more than 80 sick workers on Thursday, Makenzie Huber reports for the Argus Leader in Sioux Falls. Smithfield offered employees a one-time $500 "responsibility bonus," but employees and union representatives told Huber they felt unsafe and wanted hazard pay. 

Smithfield isn't the only meatpacker to shutter because of the pandemic. Tyson, Cargill, and JBS USA have all temporarily closed plants because of infected employees, Danielle Wiener-Bronner reports for CNN Business.

The closures highlight working conditions in meatpacking plants that often encourage the spread of infectious diseases. Workers are frequently required to work in close quarters, and, except for unionized plants, workers rarely get sick pay. "At many companies, including Tyson, workers receive disciplinary points for calling in sick. Because points lead to termination, workers told ProPublica, they and some of their colleagues have continued to work even when sick, despite the coronavirus." Michael Grabell reports.

In a statement Sunday, Smithfield CEO Ken Sullivan warned that meatpacking closures will hurt livestock farmers and cause shortages in grocery stores.

Beyond the supply chain problems, the closures could affect trade with China, which has a huge appetite for pork, and is expected to expand pork purchases from the U.S. in 2020 after its own herds have been decimated by disease. U.S. pork processing plant closures could jeopardize that.

USDA publishes comprehensive guide to rural pandemic aid

The U.S. Department of Agriculture has published a handy page with descriptions and links to federal resources for rural residents and communities affected by the coronavirus pandemic. Click here to access the guide.

The resources listed aren't just those administered by the USDA. Links are included for information, measures and programs by the Federal Communications Commission, the Small Business Administration, the Centers for Disease Control and Prevention, the Department of Veterans Affairs, and more.

Resources are broken down by what kind of "Rural Customer" can access them (businesses, hospitals, farmers, veterans, local governments, etc.) and category: Technical assistance/training/management; Financial assistance; and General state/local resources.

Kansas Supreme Court preserves governor's ban on large church services; Kentucky church defies similar ban

In an eleventh-hour move Saturday, the Kansas Supreme Court upheld Democratic Gov. Laura Kelly's ban on gatherings of more than 10 people, including worship services, Jim McClean reports for NPR affiliate KCUR.

The Republican majority on the state Legislative Coordinating Council overturned the order on Tuesday, saying that social distancing is a good idea, but the order unconstitutionally violates personal freedom.

The high court was careful to note that it was not ruling on that issue, but how much power the legislature ceded to the governor during a state of emergency, and whether the LCC had overstepped its authority during an emergency, McLean reports.

The state Department of Health and Environment secretary told the LCC on Tuesday that three covid-19 clusters in Kansas had been traced to church gatherings, The Wichita Eagle reports. The same thing has happened in other states, including Kentucky.

Kentucky's governor, Democrat Andy Beshear, faced some pushback from Republicans on Easter weekend after enforcing his own ban on mass gatherings by having state police get license-plate numbers and have health departments ask church attendees to quarantine themselves for 14 days. "This is the only way we can make sure that your decisions doesn't kill someone else," he said Friday.

At Maryville Baptist Church in the Louisville suburb of Hillview, about 50 worshipers showed up on Sunday—two from pandemic hotbed New Jersey, on their way to Nashville reports WDRB-TV of Louisville. Many covered their license plates. Some in the community weren't happy about the service: a large bucket of nails had been strewn across the parking lot.

Troopers put notices on vehicle windshields saying they had to sign and obey a self-quarantine agreement or face "further enforcement measures." Several attendees told a reporter they would not
obey. Asked if the state would impose ankle monitors on them, Beshear said "It's not going to come to that," because their neighbors would "suggest that all of these folks need to stay home for 14 days."