Are rural residents incapable of understanding government's role in health care availability?

I don't know the answer to that question, but that is the conclusion suggested by two stories in the mainstream media today.  An alternative conclusion from what these stories present is that rural residents--at least some (or most?) of them--don't trust what they see as liberal messaging about how Medicaid and hospital finances work.  That is, many Republicans and other Trump supporters assume that progressives will misconstrue the impacts of, e.g., "the big beautiful bill" on healthcare and other services those voters value. 

First, Hannah Knowles reports from Curtis, Nebraska, for the Washington Post under the headline, "A clinic blames its closing on Trump’s Medicaid cuts. Patients don’t buy it."  That headline sums up the gist of the story--and the reason why Medicaid cuts won't have the political impact on rural Trump voters that Democrats are hoping for.  

Community Hospital, the nonprofit that runs the clinic known as the Curtis Medical Center and a couple of other facilities in the region, plunged into the center of that national story when it announced on July 2 — one day before the bill’s passage — that a confluence of factors had made its Curtis outpost unsustainable. It cited years-long financial challenges, inflation and “anticipated federal budget cuts to Medicaid,” the public health insurance program for lower-income and disabled Americans.

* * *  

The clinic has been here longer than many people in town can remember, and people are struggling to make sense of the shutdown. The changes coming for Medicaid are complicated, and some won’t take effect for years, which makes the timing even harder for residents to understand.

Many know that Trump’s bill will impose work requirements for Medicaid recipients, which seems reasonable to them, and some think — inaccurately — that the legislation was designed to end Medicaid coverage for undocumented immigrants.

* * * 

Community Hospital was already losing money, and officials said they are trying to make sure they remain financially viable for the 30,000 people they serve throughout their facilities. But the timing of their decision to announce the Curtis closure has stoked suspicions in the town, leaving some residents convinced their health provider was using the president as a scapegoat.

Here are key--and colorful--quotes from two different Curtis residents: 

“Anyone who’s saying that Medicaid cuts is why they’re closing is a liar,” April Roberts said, as she oversaw lunch at the Curtis Area Senior Center.

* * *

Arriving for lunch, retired Navy veteran Jim Christensen said he’d read an op-ed that “tried to blame everything on Trump.”

“Horse feathers,” he said, dismissing the idea.

Much more detailed re the consequences of the Medicaid cuts for rural hospitals is this episode of the New York Times "The Daily" headlined, "One Rural Doctor on the Real Costs of Medicaid Changes."  Natalie Kitroeff interviews that doctor, Shannon Dowler.  The story is a very detailed one of how North Carolina eventually came to expand Medicaid, providing health care to many folks who otherwise would not have had access to it.  Many rural characters--you could say stereotypes--are depicted in this story--most of them, I am assuming based on the western North Carolina locale, are white.  

It's only at the end of the lengthy interview when you get to the reasons, according to Dr. Dowler, that residents don't or won't blame Trump for their likely loss of health care under the "Big Beautiful Bill."  Here's the exchange between Kitroeff and Dr. Dowler: 

Kitroeff:  Do you think that your patients, for example, will blame the lawmakers who voted for this bill?

Dowler:   No.

Kitroeff:  Why not?

Dowler:  There’s just not enough of a direct correlation to people’s health care needs in the moment and what happened in DC 12 months before, 18 months before.

Kitroeff:  So you think there is a chance that the folks who voted for the people who voted for the bill that leads to them potentially losing coverage will not be seeing that those people are really responsible.

Dowler:  No. I had a patient come in the day after the election. And he said, it’s about time. We’ve got to get government out of health care. Well, ironically, he has Medicare. And he just

Kitroeff:  Wow,

Dowler:  ...doesn’t get it. And so this is not uncommon. This is a super complex system of health care. I was at Medicaid for five years. Every day, I learned something new around how Medicaid worked. It’s very, very complex. I’m not surprised that patients don’t understand all of this.

Kitroeff:  I’m wondering if you think they will blame anyone for the loss in care. And if so, who would get the blame?

 Dowler:  It’s hard to know. I think people often would get mad at the hospitals because the hospitals weren’t providing them some service that they felt they were due, not understanding how complex the system of health care is. So I just don’t think based on what I saw before, I don’t think the lawmakers are the ones that are necessarily going to bear the brunt of this, especially with the timeline where they have this stuff rolling out after the midterm elections.

This all reminds me of some of the reasons folks gave for not taking the Covid vaccine back in 2021, even as they came close to dying from the disease.  They nevertheless said that if they survived the disease, they still would not be vaccinated.  

That which sets rural search-and-rescue apart from the urban counterpart

The New York Times reports today from Kerrville, Texas, more than a week after last week's tragic flood.  This story pays attention to how the search and rescue along the Guadalupe River in the "hill country" is different from these processes when they occur in urban areas.  Christopher Maag and Edgar Sandoval write: 

The search for human remains is focused on an area of Texas that is unlike many of the places where recovery professionals are accustomed to looking, several experts said. Most major search operations in recent years have happened in large urban areas hit by hurricanes, said Mr. Koester and Scott Hammond, a professor in the Department of Management at Utah State University who studies search-and-rescue teams.

In the flood plain of Central Texas, by comparison, searchers are dealing with a relatively high number of people who are missing and presumed dead, spread across an expanse of mostly narrow, rural territory, spanning more than a hundred miles of shallow valleys along the river.

* * *

The destructive power arrived with little notice, in a relatively constrained river valley where there are few homes or other buildings to serve as likely search targets. The recovery efforts are therefore focused on the massive piles of debris.

That will continue to make the search especially slow, dangerous, painstaking and long.

Also reflecting this theme, NPR's report this morning observed that the "search area has an enormous footprint." 

Here is a quote in the NYT story from 38-year-old Kerrville resident, Amy Vanlandingham, who has been helping with the search.  Her comment suggests the nature of rural community and lack of anonymity, which fosters a certain solidarity:

It’s overwhelming to see so many people come and help in the search. This is our town. I do it so I can sleep.

Other posts about the Guadalupe River floods are here and here.   

Small-town government run amok (Part XIII): Is Kerr County partly to blame for the high death toll at Camp Mystic?

I've already written this week about the catastrophic flooding in Kerr County, Texas.  What I am going to highlight in this post is recent reporting from the New York Times on the 2019 decision by Kerr County to let Camp Mystic build additional structures--including cabins for campers--in places that were at risk of  flooding.  (This is on top of the county's decision not to invest in a warning system, which is discussed in my prior post).

Why would the county do that when, as one expert suggested, the proposal to construct more buildings was a good time to re-evaluate the risk level associated with the existing structures?  Perhaps what the journalists are suggesting here is Kerr County officials simply trusted the camp as a long-time landowner and patron of the county.  Perhaps what is being suggested is the turning of a blind eye.  I wonder what sort of property taxes and other types of revenues Mystic and the otter camps provided to the county? 

Here's an excerpt from the NYT story: 

In 2019, Camp Mystic...underwent a substantial expansion. Camp owners received approval from local authorities to build a new group of cabins over the hillside to the south, in an area known as Cypress Lake. But even there, flood maps show, some of the new cabins were in areas at risk of flooding.

* * *  

At the same time, Kerr County officials were considering how to manage floodway areas, including those at Camp Mystic.

The county said that floodways were to be considered “an extremely hazardous area due to the velocity of floodwaters which carry debris, potential projectiles and erosion potential.” It adopted rules in 2020 to limit new construction or substantial alterations in floodways to ensure that structures could better survive flood events, and that these buildings would not result in raising floodwater levels in other parts of the river.

This NYTimes piece gives a sense of the local lore around the Eastlands, who owned and ran Camp Mystic.  This New York Times podcast, The Daily, also gives a sense of the beloved status of the camp and its long-time owners; the title says it all, "A Love Letter to Camp Mystic."   

Postscript:  Here is a July 12, 2025 NYT story that suggests FEMA over-rode Kerr County on the designation of parts of Camp Mystic as a flood zone.  An excerpt from Mike Baker's reporting follows: 

In the years before floodwaters killed more than two dozen people at Camp Mystic in Texas, regulators approved a series of appeals that removed many of the camp’s buildings from official federal flood zones, records show.

Flood maps developed by the Federal Emergency Management Agency in 2011 had placed much of the camp within a 100-year flood zone, an area considered to be at high risk of flooding. Camp Mystic successfully challenged those designations, which would limit renovation projects and require flood insurance, citing elevation calculations of a series of buildings that allowed them to be exempted from the federal restrictions.

Sarah Pralle, an associate professor at Syracuse University who has researched federal flood mapping, said she found the exemptions granted to Camp Mystic, a girls’ camp on the Guadalupe River near Hunt, to be “perplexing.” Some of the buildings were still very close to expected flood elevations, she said.

“I think it’s extremely troubling that it’s a camp for children,” Ms. Pralle said. “You’d think you want to be extra cautious — that you’d go beyond the minimum of what’s required for flood protection.”

Here is the Washington Post reporting similar conclusions on the role of FEMA.  

Here is the WSJ reporting on what happened at Camp Mystic, cabin by cabin.   You'll see here featured some aspects of the impulse to secrecy regarding arguable failures of a revered Texas institution.  

This excellent episode of New York Times "The Daily" on July 15, 2025, asks if the floods had to be as deadly as they were.  It includes some attention to the rural context. 

My Rural Travelogue (Part XLII): Promoting local food, including wild edibles, in Japan

Ad for ice cream at a Teshikaga (Hokkaido) ramen house
features a photo of the family farm (4 children!) who produce the milk--
and, of course, one of the cows.

During my recent trip to Japan, I noticed a lot of promotion regarding food that played up the origin of food--usually its local origin. In this photo-dense post, I'm going to feature some of what I saw.  (All photos are (c) Lisa R. Pruitt 2025) 

I first noticed the attention to local food in Kanazawa, on the west coast of Honshu, where the breakfast place mats at our Hyatt Centric hotel noted local milk products and featured the label, "Kanazawa Local Style" (lower left quadrant)  

Breakfast placemat Hyatt Centric Kanazawa

Then, in Osaka, which is known as the food capital of the country, the cafe in a private library touted dairy products from Hokkaido, the northernmost island.  When I asked why an establishment in the southern part of the main island, Honshu, was promoting products from the north, I was told that Hokkaido has more space than Honshu--it's less crowded--and thus most of the nation's milk and dairy products are produced there.  Hokkaido seems to be associated with farm-fresh food, especially dairy.

live chickens outside a restaurant in Osaka; 
now that's local food

The next week, I visited northern Hokkaido and saw for myself many dairy farms.  Near Kushiro and the surrounding marshlands, which are habitat for Japanese cranes as well as dairy cows, the two species often share space. 

I also saw, on the northeastern side of the island near Kushiro, greenhouses where strawberries were grown.

To the northwest of the Kushiro area, closer to Shire and en route to Shiretoko National Park, I was driven past fields of yams and sugar beets.  A sugar beet processing facility was also pointed out.  

Then, between Shiretoko and Memanbetsu, I saw apple and cherry orchards, as well as the Okhotsk Bean Factory storage tower/elevator.  

A wild fox crossed my taxi's path very near there, just a few miles from the Memanbetsu airport.  This was striking because I'd not seen one in the far more remote and wild Shiretoko National Park. 

Fried sweet potato balls are associated with Bihoro Pass, above Lake Kussharo, and are sold at the roadside station there.  I can attest to their deliciousness, as well as their greasiness.  

Raised beds for student gardening at a primary school at Wakoto, on the shores of Lake Kussharo, in rural northeastern Hokkaido.
 

This woman is preparing bracken, a wild, fern-like plant, outside a restaurant at Lake Akan.  I noticed a significant focus on wild edibles, including fiddle-head fern, at restaurants in Japan, especially when outside major cities.  I had wild edibles as part of tempura meals in Takayama and on Hokkaido.  Hokkaido guides also pointed out to me places (some of them at relatively high elevation) where wild edibles were growing.  Collecting these seemed almost a hobby, especially among older residents (as my Hokkaido guides and drivers were)

Below is a Japanese Crane across the road from the cattle pictured in the lower photo.  These were taken  near Tsurui village, in northeastern Hokkaido.  I found that the iconic cranes frequently occupied the same habitat as cattle in the region's marshes.  In fact, a barely visible crane is behind the cattle in the lower photo.  

 

A Sapporo Co-op delivery truck in Utoro, a rural region at the entrance to Shiretoko National Park.  Sapporo is the seat of Hokkaido prefecture and its largest city.  The co-op sells both groceries and daily essentials, e.g., detergents, toiletries.  

I enjoyed a lovely lunch at Heart 'n Tree guest house and restaurant in Tsurui Village, Hokkaido.  I also took a cheese-making class there, where I made string cheese.  The website says it is "a supporter of dairy farmers" and that its "menu lets you enjoy fully the deliciousness of milk and vegetables."   I had a delicious soup curry with shrimp; pizza and a pork stew were also on offer.  Among items you can get for breakfast is "fresh squeezed milk."  

Here is a placard promoting local dairy products, with Holstein cow stylized art, at a hotel buffet in Utoro, near entrance to Shiretoko National Park, Hokkaido.

Okhotsk Bean Factory products for sale, Utoro, near Shiretoko National Park, Hokkaido.  (This area is adjacent to the Sea of Okhotsk). I saw the storage tower for this company near the Memanbetsu Airport when I was leaving the region. 

My prior post about my May 2025 trip to Japan is here.

Recognizing the barrier of distance, transportation in high school vocational training programs

Kavitha Cardoza reported for the Washington Post a few days ago on an innovative apprenticeship program in Elkhart, Indiana.  An excerpt follows:  

Elkhart County is at the forefront of a movement slowly spreading across Indiana and the nation to make apprenticeships a common offering in high school.

In April, President Donald Trump signed an executive order calling for the creation of 1 million new apprentices, the latest step in a bipartisan push for apprenticeships that began during the Obama administration. The “earn and learn” model is taking hold in more than 30 states alongside growing disillusionment with the concept of the four-year college and the fact that well-paying jobs that don’t require bachelor’s degrees are going unfilled nationally.

But in the United States, the number of apprenticeships for high-schoolers is still tiny, just over one-tenth of a percent of students, according to an estimate by the think tank New America. 

In contrast, 70% of high school students in Switzerland--often held out as a model for such training schemes--participate in these programs. 

What I want to highlight here is the recognition that rural locations pose natural limits to these programs. 

Transportation has been a limiting factor, too. There’s no public transit system, and students who can’t rely on their parents for rides are often out of luck. “We’d love to offer a bus to every kid, to every location, but we don’t have people to run those extra bus routes,” [said a high school principal in Elkhart County].

I also appreciate this comment--not rural specific--from the woman who oversees college and career programs at one Elkhart high school: 

apprenticeships help convince students of the importance of habits such as punctuality, clear communication and regular attendance. “It’s not from a book,” she said. “They’re dealing with real life.”

Risks to rural hospitals grab big headlines in Arkansas

The lead story in today's Arkansas Democrat-Gazette is about the perils that Trump's "One Big, Beautiful Bill Act" poses to rural hospitals in the state.  Here's an excerpt from the feature by Neal Earley, which provides some excellent explanatory reporting: 

Rural hospitals in Arkansas will have to ready themselves for some major changes coming in the next few years that could mean savings for the federal government but fewer people with health care coverage.

The changes are part of the One Big, Beautiful Bill Act the U.S. House of Representatives passed on Thursday. It includes key changes to Medicaid and health care for low-income Americans that are projected to reduce federal spending on the program by $1 trillion over 10 years and lead to an increase in the number of uninsured people...

But some hospital officials worry the work requirements and bi-annual eligibility checks would mean a drop in coverage for many, shifting the cost burden to providers.

“You can take people off the rolls, but they’re still going to come to the (emergency room),” said Shelby Brown, administrator of Southwest Arkansas Regional Medical Center in Hope. “And small rural hospitals like we are in Hope, Arkansas — we don’t have the volume to absorb more people without insurance.”

The Kaiser Family Foundation says 813,000 Arkansans are enrolled in Medicaid, and 41% of those live in rural areas. 

Cuts to Medicaid would be felt more acutely by rural hospitals, as they don’t have the type of patient volume that suburban and urban hospitals have that could help them absorb a drop in revenue, Brown said.

* * *

Arkansas already attempted to implement work requirements in 2018, but it led to about 18,000 Arkansans losing coverage. In 2019, a federal judge struck down the requirement.

While the new requirement is designed to eliminate waste and force those who are able to seek health insurance through their work, Bo Ryall of the Arkansas Hospital Association said prior experience has shown health care providers are the ones who will observe the financial hit, saying, “Arkansas’s prior experience with work requirement enforcement and frequent re-determinations increased uncompensated care in hospitals.”

The story also quotes Stacy Harberson, CEO of Howard Memorial Hospital in Nashville, AR:

[R]ural hospitals (are) already operating at such a thin margin it could be very detrimental.

Deficits in warning systems exacerbate losses as historic floods strike Texas rural hill country

Dozens, including a number of children, were killed on July 4 by a flash flood in central Texas' hill country, primarily due to flooding of the Guadalupe River, whose headwaters are there.  One hard hit area was Camp Mystic, a camp for young and adolescent girls on the river's banks, near Kerrville (population 24,000) in rural Kerr County.  Christopher Flavelle of the New York Times is now reporting on the consequences of the area not having a better early-warning system--and on the fact that local taxpayers are unwilling to pay for that system. Here are salient excerpts: 

Texas officials appeared to blame the Weather Service for issuing forecasts on Wednesday that underestimated how much rain was coming. But former Weather Service officials said the forecasts were as good as could be expected, given the enormous levels of rainfall and the storm’s unusually abrupt escalation.

The staffing shortages suggested a separate problem, those former officials said — the loss of experienced people who would typically have helped communicate with local authorities in the hours after flash flood warnings were issued overnight.

The shortages are among the factors likely to be scrutinized as the death toll climbs from the floods. Separate questions have emerged about the preparedness of local communities, including Kerr County’s apparent lack of a local flood warning system. 

* * * 

In an interview, Rob Kelly, the Kerr County judge and its most senior elected official, said the county did not have a warning system because such systems are expensive, and local residents are resistant to new spending.

“Taxpayers won’t pay for it,” Mr. Kelly said. Asked if people might reconsider in light of the catastrophe, he said, “I don’t know.”  (emphasis added)

The National Weather Service’s San Angelo office, which is responsible for some of the areas hit hardest by Friday’s flooding, was missing a senior hydrologist, staff forecaster and meteorologist in charge.

* * * 

The Weather Service’s nearby San Antonio office, which covers other areas hit by the floods, also had significant vacancies, including a warning coordination meteorologist and science officer, Mr. Fahy said. Staff members in those positions are meant to work with local emergency managers to plan for floods, including when and how to warn local residents and help them evacuate.

That office’s warning coordination meteorologist left on April 30, after taking the early retirement package the Trump administration used to reduce the number of federal employees, according to a person with knowledge of his departure.

The vacancy rate in these federal offices is roughly twice what it was when Trump returned to office earlier this year.

Other posts about rural local governments unwilling to pay for services some might find critical--or at least important--are here and here.   This post discusses how reliant nonmetro counties and rural local governments are on higher scales of government for assistance in financing emergency management.   

Postcript:  This follow up story in the New York Times was published later on July 6, 2025.  

Eight years ago, in the aftermath of yet another river flood in the Texas Hill Country, officials in Kerr County debated whether more needed to be done to build a warning system along the banks of the Guadalupe River.

A series of summer camps along the river were often packed with children. For years, local officials kept them safe with a word-of-mouth system: When floodwaters started raging, upriver camp leaders warned those downriver of the water surge coming their way.

But was that enough? Officials considered supplementing the system with sirens and river gauges, along with other modern communications tools. “We can do all the water-level monitoring we want, but if we don’t get that information to the public in a timely way, then this whole thing is not worth it,” said Tom Moser, a Kerr County commissioner at the time.

In the end, little was done.

And here is coverage of the issue from the Wall Street Journal. 

A former sheriff pushed Kerr County commissioners nearly a decade ago to adopt a more robust flood-warning system, telling government officials how he “spent hours in those helicopters pulling kids out of trees here (in) our summer camps,” according to meeting records.

Then-Sheriff Rusty Hierholzer was a proponent of outdoor sirens, having responded as a deputy to the 1987 floods that killed 10 teenagers at a camp in nearby Kendall County. He made the comments in 2016, after deadly floods ravaged a different part of Texas the year before.

“We were trying to think of, what can we do to make sure that never happens here?” Hierholzer, who served as Kerr County sheriff from 2000 to 2020, recalled in an interview Sunday with The Wall Street Journal. “And that’s why we were looking at everything that we could come up with, whether it be sirens, whether it be any other systems that we could.”

"Minutes of their public meetings showed an inability to get state and federal funds has been a delaying factor," even as other counties on the Guadalupe River have adopted the systems.

P.P.S.  On July 7, Texas Lt. Governor Dan Patrick announced that a warning system would be in place on the Guadalupe River by next summer and that, if the local government cannot afford the system, the state will pay for it.  

P.P.S. on July 11, the Washington Post reports under the headline, "Kerr County did not use its most far-reaching alert system in deadly Texas floods."   The lede follows: 

The Texas county where nearly 100 people were killed and more than 160 remain missing had the technology to turn every cellphone in the river valley into a blaring alarm, but local officials did not do so before or during the early-morning hours of July 4 as river levels rose to record heights, inundating campsites and homes, a Washington Post examination found.

 On July 10, I was listening to a podcast (probably from New York Times or NPR) that mentioned a local Kerr County politician who, a decade ago, railed against an alarm system along the river because of its deleterious impact on the place's tranquility.   The politician got his way, and the system was nixed.  He died a few years ago.  

Wisconsin Supreme Court details rural lawyer shortage in matter where criminal trial delayed 46 months

The Wisconsin Supreme Court decided State v. Ramirez last week, a matter about a criminal defendant who experienced a 46-month delay in being tried for an alleged crime. The court upheld his conviction, in part because he waited 32 months to assert his right to a speedy trial. This is one of the first cases in which I've seen a court acknowledge the legal relevance of the rural lawyer shortage.  Some excerpts follow:

¶1 Our federal and state constitutions guarantee criminal defendants the right to a speedy trial. The Sixth Amendment of the United States Constitution provides, "[i]n all criminal prosecutions, the accused shall enjoy the right to a speedy and public trial," and Article I, Section 7 of the Wisconsin Constitution says, "[i]n all criminal prosecutions the accused shall enjoy the right . . . in prosecutions by indictment, or information, to a speedy public trial." Luis A. Ramirez, as an inmate already serving a lengthy sentence for felony convictions, attacked and injured a corrections officer.  After a series of continuances and rescheduled trial dates, Ramirez was finally tried and convicted by a jury 46 months after he was criminally charged for the attack.

¶2 Ramirez moved for postconviction relief, alleging the 46-month delay violated his constitutional speedy trial right. The postconviction court denied his motion, and Ramirez appealed. The court of appeals reversed and ordered the only remedy available for constitutional speedy trial violations—dismissal of the charges. The State sought this court's review of a single issue: Whether Ramirez's constitutional right to a speedy trial was violated. We conclude it was not and reverse the court of appeals.

What follows is an excerpt from the concurrence by Chief Justice Ann Walsk Bradley, with whom Judge Janet Protasiewicz joined.  

¶80 In this case Ramirez's claim was doomed by his 32-month delay in asserting his speedy trial right and his failure to persuade that the 14-month duration from his assertion of the right to his trial violates the constitution. However, I cannot join the majority's approach because it could give the State a pass in cases involving delays even longer than the 46 months at issue here.

¶81 At a time where defendants are experiencing significant delays in appointment of counsel, this concern is especially acute.[5] Delays due to the lack of available attorneys can stretch into the triple digits. See Lee, 401 Wis. 2d 593, ¶6 (Dallet, J., dissenting) (setting forth that the defendant was held in custody "for 113 days before a preliminary examination, 101 of which were prior to the appointment of counsel").[6] In 2022, the state public defender opined that it would "take several years to clear a backlog of roughly 35,000 cases because of a shortage of public defenders."[7]

¶82 In Wisconsin's vast rural areas, especially in the northern part of the state, the problem has reached crisis levels. Although the data is admittedly at least seven years old, an article published in 2018 describes how "[o]ver 60% of the state's attorneys practice law in major urban areas, leaving some counties in rural Wisconsin with attorney-to-resident ratios as high as 1:4,452." Lisa R. Pruitt et al., Legal Deserts: A Multi-State Perspective on Rural Access to Justice, 13 HARV. L. & POL'Y REV. 15, 81 (2018) (footnotes omitted). In comparison, the statewide ratio is about 1:389.[8]

¶83 Additionally, the population that is practicing law in the rural north is rapidly aging. As of 2018, "[a]cross the northern half of the state, only six of the forty attorneys in Vilas County are under the age of fifty, and Florence and Pepin counties have no lawyers under fifty. Oconto County has two, and no new attorneys have moved into the county in the last decade." Id. at 81-82 (footnotes omitted). In total, as of that time, "[n]ine counties in northern Wisconsin ha[d] ten or fewer active attorneys." Id. at 82 (footnote omitted). Although this data is now seven years old,[9] the problem has certainly not abated. In fact, it has only worsened.[10]

¶84 As of 2024, the number of active attorneys in Wisconsin had dropped four percent over the last four years, while the number of attorneys in rural Wisconsin had plummeted by seven percent.[11] Eight counties have no certified private bar attorneys to take cases when the state public defender cannot represent a defendant.[12] Such a shortage "not only impacts the constitutional rights of defendants—it also affects victims and our communities."[13] Despite intervening attempts to address the root causes of the shortage, the problem persists.[14]

¶85 The shortage of lawyers in rural areas is a systemic problem, not an intentional one, putting it at risk of being termed "neutral" in the parlance of the majority's speedy trial analysis.[15] It is possible that a defendant could spend months or even years awaiting the appointment of an attorney, a necessity for any trial, much less a speedy one. And as the majority opinion demonstrates, when a delay is termed neutral, good luck to a defendant in succeeding on a speedy trial claim.

¶86 This court should not give its seal of approval to such an approach. Rather, the court of appeals approached this case the right way by breaking down the periods of delay and determining the reasons behind them and the weight to be given in the Barker analysis. The analysis conducted by the court of appeals represents a more nuanced approach that is better suited to the fact-specific nature of a speedy trial determination. See Urdahl, 286 Wis. 2d 476, ¶11.

"Rural" all over the news as Senate passes "Big Beautiful Bill" that will undermine rural services, especially health care

Analysis of what Trump's "Big Beautiful Bill" would do to rural health care has been in the news for several weeks, and it stayed there today as the Senate passed the Bill by a vote of 50-50, with Vice President J.D. Vance breaking the tie.  

What follows appeared on the Ezra Klein Show today, July 1, but much of it was recorded in advance in anticipation that the bill would pass.  Here, I'm just going to highlight the bits about rural health care, including as they relate to "red state" voters: 

Klein: [T]hey are very substantially cuts to the Republican Party’s voters. They’re cuts to Republican states. They’re cuts to Republican hospitals — rural hospitals in areas that vote for Republicans and are very dependent on the care that gets financed by Medicaid in order to stay open.  (emphasis added)

This is the Republicans’ old ideology coming into conflict with their new coalition.

Yglesias:  Absolutely. If you look at the share of people who are on Medicaid by state, there are seven states where more than a quarter of the population is on Medicaid.

One of them is New York, and one of them is California. But the other five are New Mexico, Louisiana, Arkansas, Kentucky and West Virginia.

And then you look at states like Mississippi and Alabama: If they would accept Medicaid expansion funding, there’s a huge, potentially eligible population share in those states.

It’s a big conflict inside the heart of Republican politics. [Details about Mitch McConnell and Kentucky] 

There’s just a conflict between the Republican Party electorate and their ideology, which has shifted in some ways but really remains focused on low taxes, on investment income, low corporate taxes and wanting to cut spending on programs for the poor.

About work requirements and how they've worked out so far, Klein and Yglesias shared this conversation:

The most conservative states don’t accept Medicaid expansion funds. They have tried to impose work requirements in Arkansas, for example.

(Read more about the Arkansas experiment here and here.) 

So we ran the experiment: Does putting work requirements on Medicaid increase employment? And the answer was no. When they did it, employment didn’t go up. People did lose coverage, but employment didn’t go up.

And Republicans didn’t reverse course after that. They didn’t say to themselves: Oh, our goal here was to get more people working, but we didn’t succeed at that. They said: You know what? This cut the rolls. It cut spending. We’re happy with that.

That’s a free market view: If you want a television, you’ve got to pay for it yourself. If you want chemotherapy, you’ve got to pay for it yourself.

On work requirements, I published this three years ago in Politico.   

Here's more from Yglesias, on perverse incentives: 

There’s this threat that hospitals will go out of business. I’m in Maine right now in a very rural area, and hospitals don’t have a ton of customers here. If they lose let’s say 10 percent or 15 percent of their customer base and have higher uncompensated care burdens — some of the facilities will just close.

Senate Republicans have discussed creating a hospital bailout fund to prevent this, but it seems crazy to me to address hospitals’ business model problems by giving them direct payments to stay in business even though they’re not treating patients, rather than just letting people get the treatment they need.  (emphasis added)

Senator Lisa Murkowski of Alaska ultimately voted for the bill, but only after she was offered big concessions for her state.  Read more about those here.  Apparently, one of those concessions was to double to $50 billion (from an initial $25 billion) the amount in a fund that would support rural hospitals.  Another related to how SNAP will be administered in Alaksa. 

Also instructive is this interview by NPR with Kaiser Health News reporter Sarah Jane Tribble, published yesterday, leading with Juana Summers questioning Tribble: 

SUMMERS: Rural America is poised to be greatly impacted by these proposed cuts. Roughly 20% of the U.S. population lives in rural areas where Medicaid covers 1 in 4 adults. Here to talk about what could be at stake for those communities is Sarah Jane Tribble. She's the chief rural correspondent for KFF Health News. ...

Sarah, just start if you can by telling us a bit about what you have been hearing from people in rural communities across this country about these proposed cuts.

TRIBBLE: Yeah, I'm not hearing good things. They're very concerned, because Medicaid rates are so high in rural America, that these cuts will be very detrimental, they'll cause more hospitals to close, they'll tax rural health clinics. I was sitting next to a CEO of a rural hospital from Colorado. He has a 25-bed critical access hospital, the only hospital between the Kansas border and Denver on the Colorado I-70 corridor. And he had been talking about the cuts and not happy about them. And then we heard about the rural transformation fund that the Senate has been working on to sort of help offset the cuts. And he leaned over and he just scoffed. He just said, that's just not going to be enough. So I think that there's a lot of concern out there in rural America.  (emphasis added) 

Here's a late June NPR story about the ripple effects the cuts are likely to have on hospitals in rural Colorado, this one focused on the San Luis Valley in the southwest part of the state.  Here is a key excerpt from the story by John Daley: 

"I'm trying to be worried — and optimistic," said Konnie Martin, CEO of San Luis Valley Health in Alamosa. It's the flagship health care facility for 50,000 people in six agricultural counties — Alamosa, Conejos, Costilla, Mineral, Rio Grande and Saguache.

The numbers out of the bill about deep Medicaid cuts were "incredibly frightening," Martin said, "because Medicaid is such a vital program to rural health care."

Martin's hospital is not alone. "I think in Colorado right now, nearly 70 percent of rural hospitals are operating in a negative margin," in the red, Martin said.

Here's a late June Washington Post story about Medicaid as a "lifeline" in West Virginia.  

iPhone factory rises in rural India. Does it provide rural development lessons for the United States?

Alex Travelli and Hari Kumar report from Devanahalli, India in yesterday's New York Times on the pending opening of an iPhone factory.  The story features many descriptors suggesting the remoteness and rurality of the place and concludes with a brief comparison to rural development efforts in the United States.  The plant, which will be fully functioning and employing 40,000 people by the end of this calendar year, responds to Prime Minister Narendra Modi's “Make in India” policy, announced in 2015.  The Modi government has committed $26 billion to subsidizing strategic manufacturing goals since 2020. 

A new iPhone factory in an out-of-the-way corner of India looks like a spaceship from another planet. Foxconn, the Taiwanese company that assembles most of the world’s iPhones for Apple, has landed amid the boulders and millet fields of Devanahalli. 

* * *

By the end of 2025, with the Devanahalli plant fully online, Foxconn is expected to be assembling between 25 and 30 percent of iPhones in India.

* * *

The effects on the region are transformative. It’s a field day for job-seekers and landowners. And the kind of crazy-quilt supply chain of smaller industries that feeds Apple’s factory towns in China is coalescing in India’s heartland. 

* * *

India’s most urgent reason for developing industry is to create jobs. Unlike the United States, it does not have enough: not in services, manufacturing or anything else. Nearly half its workers are involved in farming.

* * *

India is thick with people. A five-minute walk away, a village called Doddagollahalli looks the same as it did before Foxconn landed. Nearly all the houses clustered around a sacred grove belong to farming families growing millet, grapes and vegetables.

Some villagers are renting rooms to Foxconn workers. Many more are trying to sell their land. But Sneha, who goes by a single name, has found a job on the Foxconn factory’s day shift. She holds a master’s degree in mathematics. She can walk home for lunch every day, a corporate lanyard swinging from her neck.

It is people like Sneha, and the thousands of her new colleagues piling into her ancestral place, who make Foxconn’s ambitions for India possible. Mr. Trump wants to revive the fortunes of left-behind American factory towns, but the pipeline of qualified young graduates is not there.

Thus, while Trump wants this to happen in the United States, it probably won't, "without sustained government financial support to revive U.S. manufacturing and training to expand the pool of qualified factory workers."   

Op-ed by Alaska legislators decries likely effect of "Big Beautiful Bill, "especially in rural areas

Bryce Edgmon and Cathy Giessel of the Alaska legislature have published an op-ed in today's New York Times, "Our State Cannot Survive this Bill:"  One of the legislators is a Republican and the other an Independent, and they focus on their bipartisanship.  In some ways, this piece echoes analysis we are seeing about how many "red states" will suffer particularly under Trump's "big beautiful bill," but it also features some Alaska specifics.

Here's the lede: 

Across the country, state lawmakers like us are bracing as the federal government considers a bill that will throw state budgets into chaos and add red tape that our social service agencies do not have the capacity to administer. If the budget reconciliation bill passes Congress in anything like its current form, we will be left to deal with the fallout.

The likely impacts from the “big, beautiful bill” are particularly ugly for our home state, Alaska: Nearly 40,000 Alaskans could lose health care coverage, thousands of families will go hungry through loss of benefits from the Supplemental Nutrition Assistance Program, or SNAP, and the shift in costs from the federal government to the state will plunge our budget into a severe deficit, cripple our state economy and make it harder to provide basic services.

And in these paragraphs, the writers get around to the rural angle: 

The benefits of Medicaid and the SNAP program permeate the entire fabric of the Alaska economy, with one in three Alaskans receiving Medicaid, including more than half of the children. In remote Arctic communities, Medicaid dollars make medical travel possible for residents from the hundreds of roadless villages to the communities where they are able to receive proper medical treatments.

We fear that if this bill passes, a village in rural Alaska might lose its one and only grocery store because of a drastic decline in SNAP dollars. It might also lose its sole health care clinic or hospital because it cannot sustain its services with decreased Medicaid reimbursements. The reconciliation bill does not take into account the uniqueness of Alaskan lifestyles and geographic remoteness.

The legislators explain that the federal cuts will cause costs for many services to be shifted to the state budget, which will cause great strain.  It also takes up the fact that work requirements for public benefits are an ill fit for rural Americans.

Alaska cannot afford to lose health care funding. Our state is near the top of the list for the highest rates of suicide, tuberculosis and sexually transmitted infections in the nation. It is also severely lacking in adequate behavioral health services. The cuts will only make these problems worse.

Work requirements instituted in Medicaid are untenable for rural Alaska, with many communities facing limited broadband access and job opportunities.

Here's a piece in The Atlantic, by Russell Berman, suggesting that Kentucky Republicans are not afraid to stand up to Trump. 

Supreme Court decision on Planned Parenthood and Medicaid will undermine rural health

The U.S. Supreme Court today ruled (quoting the Associated Press) that 

States can block the country’s biggest abortion provider, Planned Parenthood, from receiving Medicaid money for health services such as contraception and cancer screenings.  

 The case rose to the Supreme Court from South Carolina.  The Associated Press explains: 

South Carolina Gov. Henry McMaster, a Republican, said Planned Parenthood should not get any taxpayer money. The budget bill backed by President Donald Trump in Congress would also cut Medicaid money for the group. That could force the closure of about 200 centers, most of them in states where abortion is legal, Planned Parenthood has said.

Several news outlets have mentioned the impact that this decision will have on rural healthcare.  NPR brings us this: 

Planned Parenthood's president and CEO, Alexis McGill Johnson, in an interview with NPR, said the decision would have widespread ramifications and would allow seventeen states to strip Planned Parenthood clinics of the ability to provide non-abortion medical services to rural and low income people.  (emphasis added)

The story further quotes Johnson:  

It's a dark time [when] a health center has to close, any time a patient is not able to get the care that they need.  That is a dark time because we can provide that care for our nation's most vulnerable. 

A distinctive angle on shifting rural livelihooods

Marketplace (American Public Media) reported this week on the impact of the rising price of silver on the livelihoods of indigenous silversmiths.   The story by Savannah Peters features a Navajo and Hopi silversmith, JJ Otero.  Here's a key quote that touches (at the end) on the implications  for rural livleihoods of the rise in price for raw materials: 

Otero recently raised the price of his jewelry by about 10% across the board to account for his rising material costs. He said he can do that because he’s been smithing for over a decade and has curated a loyal following on social media, where he markets his work to wealthy clients all over the country.

“The folks that have the means, they’re not bothered by the increase in price,” Otero said.

Business is moving a bit slower, but Otero said he’s still able to find a home for his pricier work. But not all Indigenous artists have the social media prowess or even internet access that would allow them to follow Otero’s business model. He said those who sell roadside or via middle-men like trading posts and galleries have less pricing flexibility.

“I’m always reminded of what my dad told me that first year when I started making jewelry,” Otero said. “He would say it in Navajo, that my tools and the things I make with my tools are gonna take care of you.”

Today, Otero’s jewelry business takes care of him and his family. It allowed him to leave his career in IT and move from Albuquerque home to Torreon, on the eastern edge of the Navajo Nation, and support his parents as they grow older. But for Indigenous artists just now getting their start, he worries that parh to a rural livelihood could be slipping out of reach.

Buffalo National River watershed finally gets permanent protection from industrial agriculture

I've written a great, great deal about the Buffalo National River over the years, including when a hog CAFO was sited on the banks of one of its tributaries in 2012.  After a great deal of wrangling, that CAFO was ultimately bought out by the State of Arkansas for $6.2 million under former governor Asa Hutchinson.  

Here's an excerpt from a post about these recent events on Arkansas Outside, which explains that .  

The Arkansas Legislative Council on Friday gave final approval to a permanent moratorium on medium- and large-scale hog concentrated animal feeding operations (CAFOs) within the Buffalo National River watershed, cementing over a decade of advocacy from conservation groups and marking a significant milestone in the state’s environmental policy.

The decision, passed without debate, follows years of temporary protections and stems from heightened concerns about the impact of industrial swine farms on water quality in the nation’s first designated national river. The new rule permanently bans CAFOs, as defined by the Environmental Protection Agency, that are medium or large in size, based on animal count and waste production.

Environmental groups, including the Buffalo River Watershed Alliance, the Ozark Society, and the Arkansas chapter of the Sierra Club, hailed the decision as a crucial step to safeguard the river’s karst terrain, which is particularly vulnerable to groundwater pollution.

The move follows years of public outcry sparked by C&H Hog Farms, a large-scale swine operation permitted in 2012 under a general permit process that lacked public input. The farm, located near the town of Mount Judea, drew criticism and concern after manure from thousands of hogs was applied to fields near tributaries that feed the Buffalo.

* * * 

Agricultural interests, including the Arkansas Farm Bureau and the Arkansas Cattlemen’s Association, opposed the permanent moratorium. In comments to the state, they argued the ban was based on public perception rather than scientific evidence, and they warned of regulatory overreach that could limit farmers’ land use rights.

* * *

The rule change came under the broader context of Senate Bill 290, legislation initially intended to overhaul the state’s rulemaking process. The bill was amended during the legislative session to preserve moratoriums on CAFOs in the Buffalo River and Lake Maumelle watersheds. Future bans will now require legislative approval, reducing the ability of state agencies to act independently.

Governor Sarah Huckabee Sanders, who has expressed support for protecting the Buffalo River, reportedly threatened to veto the original version of the bill until amendments preserving the moratorium were included.

Read more about this year's legislative wrangling over the Buffalo and CAFOs here.  

Black lung spreads to younger miners due to complications from silica

Kate Morgan reports from the New York Times from a trip across Appalachia to learn about black lung disease's newest manifestation, which implicates silica and is affecting younger miners.  Some key excerpts follow:

Modern miners are contracting [black lung disease] at younger ages and at rates not seen since the 1970s. For 20th-century miners, it could take decades to develop severe black lung. For men of Aundra Brock’s generation, just a few years can be enough. Nationwide, one in 10 working miners is now estimated to have black lung. In the heart of the central Appalachian coal fields, it’s one in five. Often, their disease is more severe, the progression faster. Doctors are seeing larger masses and more scarring in the lungs. Transplants, disability claims and deaths are all on the rise.

* * *  

In an old industry, the reasons are modern. Centuries of extraction have altered the landscape, making the mountains more dangerous to mine, researchers say, and the men beneath them vulnerable not just to black lung, but to another lung disease called silicosis.

* * * 

Silicosis is caused by inhaling a mineral called crystalline silica that is typically found in sand, stone and concrete. It is a building block of the Appalachians. But in the air, it is dangerous, able to create much worse scarring in the lungs than coal dust alone. Breathing the coal and silica dust together can create a kind of hybrid disease that quickly leads to progressive massive fibrosis.

Scientists and miners alike have long understood the dangers of the rock dust. “You can tell there’s silica when you see the flicker in it,” said Charles Thacker, a 69-year-old former miner from Norton, Va., who now has black lung. “It looks like bits of glass flashing in the light. It’s almost pretty. But that’s what gets in your lungs and cuts you up.”

Don't miss the rest of the story, which is chock full of human interest context.   Also, I want to mention that the ravages of silica on miners was a topic of discussion at this event at West Virginia University College of Law this spring.  (See the panel at 11:00 am).

Another rural hospital at risk, this one in northern California

Ana Ibarra reports for Cal Matters from Willows, in Glenn County. home of a small hospital, the Glenn Medical Center, which is under threat of closure.   The reason for the new threat:  a new interpretation of a provision on distance in relation to a regulation that requires facilities with the "critical access" designation to be at least 35 miles from the nearest medical center.  Here's an excerpt: 

Glenn Medical Center, a 25-bed hospital in the rural agricultural town of Willows, north of Sacramento, is about to lose its “critical access” title. Without it, administrators say the hospital couldn’t afford to stay open because it would lose its increased Medicare reimbursements and regulatory flexibilities.

Glenn Medical Center received a letter in April from the U.S. Centers for Medicare and Medicaid Services notifying the hospital that it was no longer in compliance with the distance requirement to qualify as “critical access.” That requirement states that hospitals must be more than a 35-mile drive on primary roads — or a 15-mile drive on mountainous or secondary roads — from the next nearest hospital.

The next closest hospital is Colusa Medical Center, which the federal Medicare and Medicaid agency places at 32 miles south of Glenn Medical Center. That makes Glenn County’s hospital three miles short of the qualifying distance for the critical access title. But local health officials and the Willows Fire Department say ambulances and most patients take the “more reliable” route of I-5 and Highway 20, which makes the distance between the hospitals 35.7 miles — far enough to qualify.

About 40% of Glenn County’s 30,000 residents rely on public health insurance programs — Medicaid and Medicare — and 12% live under the poverty line.

“We treat and see and care for a lot of people who are unseen in the community. A lot of behavioral health crises, a lot of justice-involved folks, a lot of elderly, a lot of people without transportation. And we are truly a lifeline for those folks,” said Lauren Still, chief administrative officer at Glenn Medical Center.

About 40% of Glenn County’s 30,000 residents rely on public health insurance programs — Medicaid and Medicare — and 12% live under the poverty line.

“We treat and see and care for a lot of people who are unseen in the community. A lot of behavioral health crises, a lot of justice-involved folks, a lot of elderly, a lot of people without transportation. And we are truly a lifeline for those folks,” said Lauren Still, chief administrative officer at Glenn Medical Center.

Closing the only hospital in this Sacramento Valley county would mean residents would have to travel farther for emergency care and ambulances would take longer responding to 911 calls.

Dr. Jared Garrison, Glenn County’s health officer, said losing the hospital would be a devastating blow to the community. Garrison worries about the elderly who may be afraid to drive at night and people who don’t have transportation to make it out of the county. Heart attacks, strokes, traumatic injuries and overdoses can become more deadly when hospital treatment is delayed.

“If Glenn Medical Center closes, it’s not just a health crisis — it’s an economic and social crisis,” Garrison said. “We’ll see longer emergency response times, job losses, declining local businesses, and worsening health outcomes for our most vulnerable neighbors.” 

* * * 

Both hospitals, Colusa and Glenn, have been at the same location since their construction decades ago. In 2001, Glenn Medical Center was first approved to participate in the federal Critical Access Hospital Program under the same distance rule. Hospital and county health officials say geographically nothing has changed.

“We tried to send some emails back and forth and say, ‘Hey, this is not the road people would take. This is not the road the ambulance takes. This is just not accurate,’” Garrison said. The “shorter” route, he explained, actually takes longer because it includes a county road that often floods and is primarily used by farm equipment.

The hospital’s appeals to the federal agency have been unsuccessful. Still said she is clinging to one last hope that U.S. Rep. Doug LaMalfa, a Richvale Republican, can make the hospital’s case.

Mark Spannagel, chief of staff at LaMalfa’s office, told CalMatters that no resolution has been reached yet, but that conversations with the federal agency continue and that the hospital’s situation is under “heightened review.”

The federal Medicare and Medicaid agency is supposed to review critical access hospitals’ eligibility periodically. This review started last year and the issue seems to be a reclassification of roads, Spannagel said.

From Congresswoman Gluesenkamp Perez on public media

I've written often on this blog of Congresswoman Gluesenkamp Perez's campaigns and stances; she represents WA-03 in the southwest corner of Washington, a district with a great deal of rural area.  I was struck by fundraising email I got from her today (I get a lot of them!) because it stands up for public broadcasting while invoking the rurality of her district.  Here's what the email says:  

Last week, I voted against a hyperpartisan package that guts federal funding for nonpartisan, independent public broadcasting, a critical resource that rural communities like ours rely on every day.

The House Majority’s plan will force public radio and television stations across the country to close, including 14 here in Washington. We depend on public broadcasting for so much: quality local journalism, educational children’s programming, and even lifesaving emergency alerts.

Lisa, I’m all for tackling waste and making sure our tax dollars are used efficiently, but that doesn’t mean compromising our safety, health, or general well-being.

I’ll continue calling out D.C.’s misplaced priorities and getting things done for Southwest Washington – but to keep this work going, I need your help defending this seat.

I'm glad that the Congresswoman sees public broadcasting as a critical resource for rural communities.  I do, too.  I am guessing many of her constituents see public media as hyper-partisan, and not in ways favorable to their interests. 

In fact, NPR does a great deal of fine reporting--nuanced reporting--on a wide range of rural issues.  I trust NPR to deliver the facts, and I listen to it everyday.  That said, there are times when I think NPR has been  unhelpfully woke in ways I suspect alienate rural voters and those with less formal education.  

CLE on recruiting and retaining rural lawyers sponsored by Virginia Bar Association

See the announcement here for the program on June 26 at 12:00 pm/noon Eastern.  I'm cutting and pasting core details below.   

Recruiting and Retaining Rural Lawyers: Challenges and Incentives

Join the VSB for its new virtual Lunch & Learn series—monthly CLEs and webinars featuring topics of interest to VSB members. Tune in from your office to learn more about the programs and initiates of the VSB and earn free CLE credits (when applicable).

Recruiting and Retaining Rural Lawyers: Challenges and Incentives

Thursday, June 26, 12–1 pm

Join us for a Lunch and Learn webinar sponsored by the Virginia State Bar’s Entry, Growth & Distribution of Virginia Attorneys Study Committee(EGAD VA), on June 26 at noon. Rural legal practice is vital to ensuring access to justice, yet many underserved communities continue to face a shortage of attorneys due to geographic, economic, and professional barriers. Professor Hannah Haksgaard will examine the landscape of rural legal practice and share research-based strategies for recruiting and retaining lawyers in these areas, including insights on effective incentive programs.

Trump administration flip flops again on immigration enforcement in the agriculture sector

I wrote late last week about Trump's moratorium on immigration enforcement in the agriculture and hospitality sectors, and he has already reversed that position.  The Washington Post reports:  

Officials from Immigration and Customs Enforcement, including its Homeland Security Investigations division, told agency leaders in a call Monday that agents must continue conducting immigration raids at agricultural businesses, hotels and restaurants, according to two people familiar with the call. The new instructions were shared in an 11 a.m. call to representatives from 30 field offices across the country.

Here are some quotes from a story in the Wall Street Journal yesterday re: what's a stake with raids on food producers and related sectors.   The headline is "Trump Struggles to Press Deportations Without Damaging the Economy," and some excerpts related to the agricultural sector follow.  The first is what Secretary of Agriculture Brooke Rollins wrote on X (formerly Twitter) on Sunday:  

Severe disruptions to our food supply would harm Americans.  It took us decades to get into this mess and we are prioritizing deportations in a way that will get us out.

The journalists use the illustration of a Sackets Harbor, New York farmer whose diversified farm operation (which includes agri-tourism) was raided in March: 

Ron Robbins, who runs a family farm in Sackets Harbor, N.Y., has been short-handed since March, when he says around 45 immigration agents showed up.

ICE agents searched the 8,000-acre operation that milks 1,500 cows and grows corn, soybeans and some produce, then arrested eight people they said were in the country illegally. One of the detainees was a Guatemalan man who worked as the top assistant to the farm’s tourist business, Robbins said.

Since the raid on his property, Robbins, a 4th-generation farmer, said family members are working 18-hour days to keep the operation going, except for the strawberry patch. “We don’t have enough people to do this work,” he said. “It’s a no-win situation.”

Meanwhile, the WSJ reports that an Omaha meatpacker that was raided a few weeks ago is functioning at just 20% of capacity following the raid.  

Here's some helpful data from the WSJ on the extent to which our workforce is staffed by undocumented immigrants: 

Immigrants living in the U.S. illegally account for about 4.4% of the U.S. workforce, according to a Goldman Sachs analysis of 2023 census data. But their share of the workforce in some industries is much higher, the analysis found: 19% in landscaping services, 17% in crop production, 16% in animal slaughtering and processing and 13% in construction.

Roughly 12 million people immigrated to the U.S. from 2021 to 2024, according to the Congressional Budget Office, many of them either illegally or through an emergency process set up by the Biden administration. Many now have some kind of temporary permission to stay in the country and work, though they could ultimately face removal. Others sneaked into the country or overstayed visas.

The newcomers provided the economy with an infusion of working-age people eager for jobs. Immigration boosted economic growth in recent years and helped cool a job market that was in danger of overheating by “rebalancing the tightest parts of the labor market, where wage and price pressures were most extreme,” Goldman Sachs economists wrote in a note last year.

Trump has recently been given the nickname TACO--"Trump always chickens out"--in relation to trade negotiations.  I can't help think the same applies to his recent quick change of mind on immigration enforcement priorities.  

Postscript.  Politico Magazine published this on the topic yesterday, but I just became aware of it.  A few key excerpts follow:  

For now, Trump appears to be siding with the farmers. He responded last week with a vague Truth Social post acknowledging that his immigration policy was hurting farmers and vowed that “change was coming.” He followed with another post late Sunday, directing immigration officials to “FOCUS on our crime ridden and deadly Inner Cities, and those places where Sanctuary Cities play such a big role. You don’t hear about Sanctuary Cities in our Heartland!”

* * *

For months, farmers and ranchers across the United States operated with a cautious understanding that Trump’s deportation spree would not touch their workforce, with some lawmakers saying the White House had promised to spare the industry from aggressive enforcement — until last week.

House Agriculture Chair G.T. Thompson (R-Pa.) said the raids on agriculture producers were “just wrong” and suggested the president agrees — but it “must be somebody a little lower in the food chain that’s making those mistakes.”  

“They need to knock it off,” Thompson told reporters Thursday. “Let’s go after the criminals and give us time to put processes in place so we don’t disrupt the food supply chain.”

Rep. Dan Newhouse (R-Wash.) said he was told “straight to my face” that the Trump administration was “not going after agriculture.”

White House spokesperson Anna Kelly said Trump has “always stood up for our farmers” and will continue to “strengthen the agricultural industry and boost exports” while also enforcing the country’s immigration laws and removing undocumented immigrants.

Trump’s statements on protecting the farm workforce came as a relief to the ag sector. Zippy Duvall, president of the American Farm Bureau, said in a statement he looks “forward to working with the President on solutions that ensure continuity in the food supply in the short term.” On Saturday, Michael Marsh, president of the National Council of Agriculture Employers, sent a letter expressing his willingness to collaborate with the Trump administration on a solution that “enhances national security and simultaneously recognizes that America’s ability to feed itself is integral to our national security.”

Postscript 2:   NPR's Politics podcast on June 17 is about this issue.   And WSJ has just published a brief story about Chobani Yogurt CEO's statement that the U.S. food system cannot function under current immigration enforcement strategies.