Harum Helmy

With the Missouri legislative session ending on Friday and a Republican supermajority that still won't budge, the hope to expand Medicaid in Missouri is pretty much dead for FY 2014.

It's so dead that perhaps the only thing that could bring it back to life is, well, interfaith prayers for a miracle.

Health and Human Services Secretary Kathleen Sebelius today announced another round of funding to help Americans enroll in the Affordable Care Act's new online health insurance marketplace.

About $150 million is now available for community health centers nationwide to hire and train employees who would provide in-person help for the public about their insurance options in the marketplace, which is set to open for enrollment on Oct. 1. 

Many Missourians will likely need help navigating the Affordable Care Act's new health insurance marketplace that's set to go online by Oct. 1, but one analyst says there might not be enough time or federal funding to train those who can help.

This week on the show, we're hearing from Francine Robison and D.J. Fry, two out of the more than 20 cowboy poets and musicians who performed at the 15th Annual Missouri Cowboy Poetry and Music Festival. 

If you think all cowboys are of the rugged, silent and stoic Marlboro Man type – think again. Some cowboys write poetry.  

Every year since 1998, for a weekend in April, a group of cowboy poets Missouri and its surrounding states gather in Mountain View, Mo., near West Plains. They spend three days in town, usually from Friday to Wednesday, giving poetry performances, playing folk songs, telling classic cowboy stories. The gathering, also known as the Missouri Cowboy Poetry and Music Festival, is one of the largest of its kind in the Midwest. 

At only 17 cents per cigarette pack, Missouri has the lowest tax for tobacco in the U.S. In 2012, Missouri voters said no to increasing that tax to 90 cents per pack. Missouri is also one of 14 states that don't have some sort of a statewide ban on smoking in non-hospitality workplaces, and/or restaurants, and/or bars. All of this adds up to the Show-Me State's top spot as the freest state in the nation when it comes to tobacco. 

But since 2007, about two dozen municipalities in Missouri have enacted a comprehensive smoking ban in all workplaces, including restaurants and bars. This Monday, rural Washington, Mo., joins that list. The City Council voted to pass the ordinance to ban smoking back in January. 

Every Friday, KBIA's Health & Wealth Desk talks about the week's most interesting articles and reports on rural health, wealth and society issues. 

'Redneck reality' and rural portrayal in cable television

Entertainment newspaper The A.V. Club muses on A&E's popular reality show Duck Dynasty, saying the show is the 21st century incarnation of old rural-themed sitcoms that once dominated network television. Think Petticoat Junction, The Beverly Hillbillies, and Hee-Haw. It's an interesting read, but we were especially interested with the author's take on ways the television shows have to negotiate the rural-urban political disparities. 

While the rural-themed programming of days gone by tended to depict the small Southern town as a bucolic haven for good-hearted folk, redneck reality is more apt to acknowledge the social and economic ills of the subcultures it depicts. These shows are sanitized for the protection of viewers with blue-state sensibilities; when they occur at all, political discussions tend to center on generalized platitudes about freedom and family, rather than specifics that might turn off half the potential audience.

 

H/T: The Rural Blog. 

Did headlines about death rates at rural hospitals tell the wrong story?
The Daily Yonder is killing it with their opinion pieces this week. 

Case in point: A new report made headlines last week, saying death rates are rising at rural, geographically isolated hospitals. But an opinion writer for the Yonder says news reports are not telling the real story of these so-called critical access hospitals:

The patients in the small rural hospital with heart attack, heart failure or pneumonia have become a select population. A large proportion has decided that they are through paying all the human costs of the miracles of modern medicine. They have made the decision to stay in familiar surroundings near home and family. 

The researchers found that 13.3% of the patients at critical access hospitals with one of the three conditions died, compared to 11.4 % of the medical center patients. Given all the terrible tools that modern medical centers have to work with, I’m amazed they only manage a small difference in patient survival over the most basic, little country hospitals in America. 

In his proposed budget, President Barack Obama wants to delay cuts to federal payments to hospitals, keeping the payments intact for an extra year. That could affect the debate over expanding Medicaid in Missouri.

Through what’s called the disproportionate share hospital payments or DSH payments, the federal government gives money to hospitals that provide a lot of free care to patients who are uninsured and can’t afford services. The Affordable Care Act, though, includes significant cuts to DSH payments.

The uphill congressional battle to expand Medicaid in Missouri is making rural hospitals that serve areas with high poverty levels really, really nervous. KSMU's Jennifer Davidson has the story.

Friends and family gathered in Woodcrest Chapel on Friday to honor the life of Tom Clements, the Colorado Department of Corrections executive director who was killed March 19.

Clements lived in Columbia for 27 years before moving to Colorado in 2011. He and his family attended Woodcrest for 15 of those years. Clements worked at the Missouri Department of Corrections for about three decades, working his way up from probation officer to director of the Division of Adult Institutions.