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- New leadership energizes N.C. Democratic Party
For someone living in a rural county like Rutherford where the name of the Republican candidate is the only one on the ballot in most local races, it’s not news that the state Democratic Party has been largely missing in action during the past several election cycles. At the state level in 2022, Republicans were unopposed by a Democrat in one-fourth of House and Senate races. Even though it wasn’t news, it was gratifying to hear a Democratic Party official acknowledge it, as Vice Chair Jonah Garson did during a recent event at Henderson County Democratic Party headquarters. Thankfully, the party shows promising signs of coming to life again. Garson filled in for N.C. Democratic Party Chair Anderson Clayton, who stayed in Raleigh to participate in demonstrations associated with Gov. Roy Cooper’s veto of legislation that will ban nearly all abortions in North Carolina after 12 weeks. The New York Times recently profiled Clayton who, at 25, is the youngest state party chair in the U.S. After a friend invited me to the event, I looked forward to hearing her speak. But in her stead, Garson didn’t disappoint. An energetic, enthusiastic and engaging speaker, he told the gathering that a reform-minded board took over state party leadership a few months ago and plans to recruit and support candidates in every N.C. county. That’s good news. Voters deserve a choice when it comes to governing philosophy. But at the local level, where voters often have more direct knowledge of candidates, being able to choose the more capable one, no matter party affiliation, in terms of temperament, knowledge of the community and record of service should arguably carry even more weight. When there’s no competition, even the most incompetent or temperamentally unsuitable candidate can prevail. Garson, 36, is a civil litigation attorney who worked in the N.C. General Assembly for the late Rep. Paul Luebke, a Greensboro Democrat, before attending law school. He acknowledged that Democrats face an uphill battle. He quickly summarized how Republican strategic planning helped the party gain control of state legislatures, including North Carolina’s, through project REDMAP, by pumping huge amounts of money into swing state races aided by the Citizens United decision that allowed corporations and labor unions unlimited spending in support of candidates. Republicans outmaneuvered Democrats at a time when advances in computer software make it possible to surgically draw district lines to their advantage. Now that the Republican majority on the state Supreme Court has reversed precedent and declared it has no role in determining whether district boundaries disenfranchise voters, you can bet the Republican majorities in both chambers will draw maps that virtually guarantee noncompetitive districts. But Garson said N.C.’s new Democratic Party board has a six-year strategy to turn things around with four major goals. The first is to elect a Democratic governor in 2024. The second is to break the Republican’s supermajority in at least one General Assembly body, making it possible to sustain a gubernatorial veto. The third focuses on the courts, with a goal of replacing retiring Justice Michael Morgan, a Democrat, with another Democrat, and winning a full term for Judge Allison Riggs on the Court of Appeals. Gov. Roy Cooper appointed Riggs to the appeals court in 2023 to fill a vacancy left by Republican Richard Dietz, who was elected to the N.C. Supreme Court in November. The fourth goal is to win North Carolina for Joe Biden in 2024. In addition to putting resources into recruiting candidates and urging candidates and volunteers to go out into the community to talk to voters about their concerns, the party plans to employ 12 to 13 regional directors whose job it will be to support local candidates and to make sure the insights they gain from that voter interaction are integrated at the state level. “In so many of these communities that we need to win, the state Democratic Party has been like wall flowers at a middle school dance, dickering over the line that’s going to get the person we want to dance with us out on the floor and not saying anything at all,” Garson said. “I think that as Democrats we have great values and great policy. Policy is a terrible pick-up line. We really need to start just by talking to folks and having some variation of ‘Hey, we’re are fighting for freedom for you to retire with security, for having a town that your kids want to stay in, for the future of this place, for public education, for safe water, for you to do what you want when it comes to having a family.’” There is no motto or slogan that will move people, he said. Garson’s point is well taken. Until local Democrats develop a coherent and authentic response to Republican messaging, there can be no real debate about the role of government in solving the problems that confront us. And without that, there can be no consensus, no common-sense middle ground. We need civil debate about issues, not harangues that demonize those with a different point of view. Republicans have claimed the mantle of the party of freedom, but Garson talked about N.C. Democrats adopting Biden’s campaign theme that Democrats are in fact the party of freedom – freedom to decide what to do with your body, freedom to be safe in public spaces, freedom to vote. A vigorous debate about what exactly it means to be free seems a good place to start. North Carolina needs a vibrant, energetic Democratic Party, one that’s peeled off the wall, found its voice and walked onto the dance floor. Joy Franklin is a journalist and writer who served as editorial page editor of the Asheville Citizen-Times for 10 years. Prior to that she served as executive editor of the Times-News in Hendersonville, N.C. Franklin writes for Carolina Commentary.
- A striking gap between deaths of Black and white babies plagues the South
Reprint from Carolina Public Press and KFF Health News BAMBERG, S.C. — Years before the Bamberg County Hospital closed in 2012, and the next-closest hospital in neighboring Barnwell shut its doors in 2016, those facilities had stopped delivering babies. These days, there’s not even an ultrasound machine in this rural county 60 miles south of Columbia, much less an obstetrician. Pregnant women here are left with few options for care. Federally qualified health centers offer prenatal services in nearby Fairfax and Barnwell, but only when a pregnancy is uncomplicated and only through about 34 weeks of gestation. During the final weeks of pregnancy, women must transfer their care to the nearest obstetrician, often in Orangeburg, which can be 20 miles away or more, depending on where they live in Bamberg County. Some women travel farther to hospitals in Aiken or Beaufort, where health outcomes are better. “Most of our women are driving an hour or more from their homes to an OB provider,” said Tracy Golden, a doula and senior program manager for the South Carolina Office of Rural Health. Although the regional hospital in the city of Orangeburg delivers babies, the birth outcomes in the county are awful by any standard. In 2021, nearly 3% of all Black infants in Orangeburg County died before their 1st birthday. Nationally, the average is about 1% for Black infants and less than 0.5% for white infants. Meanwhile, Orangeburg County’s infant mortality rate for babies of all races is the highest in South Carolina, according to the latest data published by the South Carolina Department of Health and Environmental Control. By 2030, the federal government wants infant mortality to fall to 5 or fewer deaths per 1,000 live births. According to annual data compiled by the Centers for Disease Control and Prevention, 16 states have already met or surpassed that goal, including Nevada, New York, and California. But none of those states are in the South, where infant mortality is by far the highest in the country, with Mississippi’s rate of 8.12 deaths per 1,000 live births ranking worst. Even in those few Southern states where infant mortality rates are inching closer to the national average, the gap between death rates of Black and white babies is vast. In Florida and North Carolina, for example, the Black infant mortality rate is more than twice as high as it is for white babies. A new study published in JAMA found that over two decades Black people in the U.S. experienced more than 1.6 million excess deaths and 80 million years of life lost because of increased mortality risk relative to white Americans. The study also found that infants and older Black Americans bear the brunt of excess deaths and years lost. That makes Black infant mortality in the South a complex regional crisis that should alarm everyone, not just future parents, said Georgina Dukes-Harris, senior director for social care at Unite Us, a national technology company focused on societal needs. Birth outcomes for mothers and infants are a leading indicator of population well-being and they run much deeper than health care: They reflect politics. They’re a direct product of generational poverty and racism. They reveal our priorities, Dukes-Harris said. Often, babies die under circumstances that states, communities, and parents can help control, like making sure infants don’t suffocate in beds or in unsafe cribs, or extending health coverage so that young women can afford to see a doctor before they become pregnant. In many of these respects, the South is failing. “This is something that has to change,” Dukes-Harris said. ‘An urgent problem’ with no easy solution Public health officials are still trying to parse the long-term impact of the covid-19 pandemic, but infant death rates in South Carolina were higher than the national average long before the health care landscape changed in 2020. And a report published by the South Carolina Department of Health and Environmental Control in April shows the rate for non-Hispanic Black babies — who died at a rate nearly 2½ times that of non-Hispanic white infants in South Carolina in 2021 — is growing worse. The death rate among infants born to Black mothers in the state increased by nearly 40% from 2017 to 2021. “That’s just not acceptable,” said Edward Simmer, director of the South Carolina health department. “It’s absolutely an urgent problem to me.” It’s a problem, though, without an apparent solution. Multimillion-dollar programs to improve South Carolina’s numbers over the past decade have failed to move the needle. To make things more complicated, separate state agencies have reached different conclusions about the leading cause of infant death. The state Department of Health and Human Services — which administers Medicaid, the health coverage program for low-income residents, and pays for more than half of all births in South Carolina — claims accidental deaths were the No. 1 reason babies covered by Medicaid died from 2016 to 2020, according to Medicaid spokesperson Jeff Leieritz. But the state health department, where all infant death data is housed, reported birth defects as the top cause for the past several years. Accidental deaths ranked fifth among all causes in 2021, according to the 2021 health department report. All but one of those accidental infant deaths were attributed to suffocation or strangulation in bed. Meanwhile, infant mortality is a topic that continues to get little, if any, attention, especially in the South. A group called the South Carolina Birth Outcomes Initiative meets regularly to talk strategy, but this consortium of the state’s top doctors, nurses, health insurers, and hospital leaders can’t solve fundamental problems, like teaching parents safe sleep habits or connecting all pregnant women to basic prenatal care. According to the Medicaid agency, nearly half of Medicaid-enrolled babies who died before their 1st birthday in 2021 were born to mothers who received no prenatal care. “There’s good work going on. It’s just in little patches. It’s just not spread out enough to change our overall numbers,” said Rick Foster, a retired physician and former chairman of one of the Birth Outcomes Initiative’s working groups. Expanding access to maternal care South Carolina and several other states recently extended postpartum Medicaid coverage for women who give birth, which means their coverage remains in place for one year after delivery. Historically, Medicaid coverage was cut off 60 days after having a baby. Some experts believe expanding Medicaid coverage to single, working adults who aren’t pregnant and don’t have children — something most Southern states have failed to do — would also help curtail infant deaths. A woman who is healthy when heading into pregnancy is more likely to give birth to a healthy baby because the health of the mother correlates to the health of the infant. But many women don’t qualify for Medicaid coverage until they become pregnant. Even when they become pregnant and are newly eligible for Medicaid, it isn’t unusual for women in South Carolina to put off seeing a doctor until the third trimester, physicians told KFF Health News. These women can’t afford to take time off work, can’t find child care, or don’t have a car, among other reasons. Telehealth could improve access if the state’s broadband network were better, said Simmer, the state health department director. The department could also invest in a fleet of mobile vans that provide prenatal care. Each costs just under $1 million, he said. Ultimately, South Carolina needs more doctors willing to practice in rural areas. Fourteen of its 46 counties lack a single OB-GYN, Simmer said. “We don’t have providers where we need them,” he said. To that end, he added, the state might consider using student loan forgiveness programs as an incentive for new medical school graduates to practice in rural areas of the state, where obstetricians are scarce. Meanwhile, two programs aimed at improving infant mortality in South Carolina, which were backed by millions of dollars in public and private funding over the past decade, were unsuccessful in hitting the goal. The Nurse-Family Partnership, for example, which pairs expectant South Carolina mothers with nurses for at-home visits, didn’t have a statistically significant effect on birth outcomes, according to an analysis of the multiyear project, published by the Harvard T.H. Chan School of Public Health. CenteringPregnancy, a separate program that offers small-group prenatal education to pregnant women, also failed to improve birth outcomes, said Amy Crockett, a maternal-fetal specialist in Greenville and one of the lead investigators for the state initiative. Crockett said she recently returned about $300,000 in grant funding to the Duke Endowment, a nonprofit that funds health, faith, and education initiatives in the Carolinas, because the evidence to support ongoing CenteringPregnancy projects simply wasn’t there. “It’s not the silver bullet we thought it would be,” Crockett said. “It’s time to move on.” Birth outcomes experts agreed that racism and poverty lie at the heart of this difficult problem, which disproportionately threatens Black infants and mothers in the rural South. Research shows that white doctors are often prejudiced against Black patients and minimize their concerns and pain. In South Carolina, the maternal mortality rate increased by nearly 10% from 2018 to 2019, according to the latest data, which found that the risk of pregnancy-related death for Black mothers was 67% higher than for white mothers. Upon review, the state health department determined 80% of those pregnancy-related deaths were preventable. Disparities related to both infant and maternal deaths deserve urgent attention from both the federal and state governments, said Scott Sullivan, division chief of maternal-fetal medicine at Inova Health System in Northern Virginia. Hospitals also bear a huge responsibility as doctors and health care providers must learn how to fairly and adequately take care of Black women and children. “The idea that we’re going to solve 400 years of racism in an hour’s worth of bias training is a cruel joke. Systems have to remodel their approach,” Sullivan said. “It’s going to take funding, and it’s going to take a sustained effort.” Have a question about this story? Do you see something we missed? Send an email to email@example.com. _____ KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF. This article first appeared on North Carolina Health News and is republished here under a Creative Commons license.
- What if Medicaid is "welfare?"
North Carolina recently expanded Medicaid to more than 600,000 people. The state-federal partnership provides health insurance to the needy. The move will bring billions in federal dollars to the state because states cover only 10 percent of the expansion costs, and the federal government covers 90 percent. North Carolina is one of the last states, 40th, to expand Medicaid. The move is too-little-too-late for East Carolina University’s rural health system, which lost $46 million last year. The system recently closed five clinics— a women’s care clinic in Williamston, an urgent care in Wilson, and family medicine clinics in Jacksonville and Aurora plus a behavioral health center. (The behavioral-health beds will go to a new facility under development in Greenville.) Eleven rural hospitals have closed in North Carolina since 2005. Rural residents are 40% more likely to be uninsured, and eligible for Medicaid. Rural health clinics serve lots of workers who fall into coverage gaps, possibly needing two or more jobs to afford health care—for instance, child care, restaurant, and nursing home workers. Republican opponents to Medicaid in Congress view it as “welfare.” The program covers one in five Americans, and funds long-term care for most Americans. House Republicans have proposed a Medicaid work requirement, part of a deal for increasing the federal debt limit, but how much could that help? Two-thirds of Medicaid spending is concentrated on the elderly and disabled; most able-bodied Medicaid recipients already work. A Kaiser Family Foundation (KFF) poll finds broad public support for Medicaid. Two-thirds of U.S. adults say they’ve had some connection to Medicaid, including health insurance (59 percent); pregnancy, home health, or nursing home care (31 percent); coverage for a child (31 percent); or to help paying Medicare premiums (23 percent.) Seventy-nine percent of Democrats and 60 percent of independents view Medicaid as a “government program helping people pay for health insurance,” while 54 percent of Republicans, see it as welfare. Republicans with a connection to Medicaid—say, an elderly loved-one in a nursing home—are more likely to see it as a program that helps people afford health insurance. Another KFF study found that Medicaid expansion improves hospital and provider balance sheets, still challenged by lingering pandemic effects, declining federal relief, and pressure on wages. Recent studies show benefits from Medicaid expansion include lower overall mortality, reduced food insecurity, poverty, and home evictions, as well as self-reported improvements in health and healthy behaviors. As the insurance covers more and more poor people, hospitals’ uncompensated care costs decline; states also save on mental and behavioral health programs, and costs of covering the incarcerated. The 90 percent of Medicaid money provided by federal dollars represents, on average, 55.1 percent of state budgets. As that money circulates, the spending generates economic benefits. Health insurance needs aren’t going away. North Carolina is coping with an opioid epidemic—overdoses rose by 22 percent in 2021, according to the N.C. Department of Health and Human Services, the latest figures available. About 40 percent of overdose patients in emergency departments are uninsured, and they require follow-up care. Medicaid may be welfare—the health, happiness, prosperity, of a person, group, or organization—it’s cost effective, improves health outcomes, and lives. We’re all better off. Betty Joyce Nash reported for the Greensboro News & Record and the Hendersonville Times-News before moving to Virginia where she worked as an economics writer for the Federal Reserve Bank of Richmond. She co-edited Lock & Load: Armed Fiction, an anthology of literary short stories that probe Americans' complicated relationship to firearms. (University of New Mexico Press, 2017.)
- Edwards' debt ceiling survey deserves careful response
The current debate about the debt ceiling in Congress affects every household and business in Western North Carolina. It’s critical that our representatives in Congress understand that we want sound fiscal policy, not brinksmanship that threatens to damage our economy and undermine our financial stability. A recent survey sent to his Western North Carolina constituents by 11th District U.S. Rep. Chuck Edwards can be deceptive without careful reading. Before you respond, read the survey carefully. The survey itself requires a “No” answer to support raising the debt ceiling, even though the subject line of the email would require a “Yes” response if you are in favor of taking this critical step to prevent fiscal calamity. Our nation's debts come from past spending and tax bills. Responsibility for the current debt lies equally (50 percent each) with Democrat and Republican spending and tax policies. Both are equally responsible. Blaming each other is a distraction from responsible fiscal policy. Fiscal policy requires both responsible spending and responsible taxation. Continually cutting taxes on corporations and the wealthy is as irresponsible as pork barrel spending. The blame game and playing chicken with our nation's debt doesn’t solve this. Our current debt is not a threat to our economic viability. Stalling the debt ceiling approval is a threat. The important number to follow is our debt to GDP ratio. That tells us if we can service our debt. Banks use this for households when granting a loan. We need to use the same number. Most households, corporations, and businesses have debt greater than their revenues. Our nation's debt to GDP is currently falling and was 123.4% last quarter. It was 123.6% the previous quarter and was 132.4% in March 2021. The US is considered a responsible fiscal manager, so we can borrow at low interest rates. The Treasury interest rate is the risk-free rate because we are trusted to pay our bills. Threatening that trust in the United States will have big economic consequences nationally and globally. If you don’t pay your bills, it costs you more to borrow and you may not be able to borrow. The same can happen to a nation that fails to pay its bills. Not only will economic chaos result if Congress fails to raise the debt ceiling, the action will also undermine our security, as Defense Secretary Lloyd Austin has warned. "If the United States defaults, it would undermine the economic strength on which our national security rests," Austin said in a statement. "It would also seriously harm our service members and their families because, as secretary, I would have no authority or ability to ensure that our service members, civilians, or contractors would be paid in full or on time." Congress needs to raise the debt ceiling. Then it can negotiate responsible tax and spending policies. Susan Kask is a business and economic consultant and is retired from a 30-plus year career doing research and teaching economics.
- The Debt Ceiling - Let's get serious
The current debate over the national debt and the potential for it to crash the economy right before summer starts is, frankly, funny. Not “tee-hee ha ha’’ funny but funny in that anyone believes the base arguments being put forth by some newly converted debt zealots in the U.S. House. Now, the debt is a serious issue. We’re spending around 8 percent of the budget just to service it every year. We’ve had the luxury of interest rates hovering around the non-existent mark for quite a while that kept debt service from rising higher. But those days are gone, maybe for good. So, yes, we need to pay down the debt. But the solutions being offered definitely leave defense spending off the table and likely leave Social Security and a lot of health care spending off as well (and no, those aren’t entitlements, we pay taxes for them). What’s left of the budget elephant is a couple of toenails and there isn’t any way trimming them is going to bring the debt down in any serious fashion. There’s another factor about the lack of seriousness among the latest round of budget hawks, and we’ll get to that in a bit. First, let’s look at how we got here, and how we’ve solved this problem in the past. The U.S. was in a little thing called World War II back in the 1940s, and winning that war meant building things like planes and tanks and aircraft carriers, and that cost money. And that meant debt. A booming post-war economy helped bring down the WWII debt without much effort. The sources of federal revenues were different back in those days. According to the Tax Foundation in FY 1954 the pie was 42.4 percent individual income taxes, 30.3 percent corporate taxes, 10.3 percent social insurance and retirement receipts, 14.3 percent excise taxes and 2.7 percent “other.’’ Fast-forward to 2019 and the numbers were 50 percent individual taxes, 7 percent corporate taxes, 36 percent payroll taxes and 8 percent excise, estate and other taxes. Now, the big picture is more complicated, as what is a defined as a corporation has changed a lot over the years. But what is an individual hasn’t, aside from Mitt Romney’s “corporations are people too.’’ And the top rate for individuals after WWII was more than 90 percent. LBJ knocked that down to around 70 percent and Ronald Reagan dropped it to 50 percent and then 28 percent by the time he left office. And in his time in office the debt ballooned, so maybe there’s a connection there. And as for the late '40s and '50s, despite the high top tax rate, there were still plenty of incredibly wealthy people, although we’ll concede they weren’t wealthy enough to be shooting themselves into space left and right. (Also, U.S. rockets had a tendency to blow up in that era, so there’s that). So now let’s get to the point of this article by jumping forward to the year 2000. Efforts to tighten the budget had paid off, and the country had a realistic chance of erasing the debt in a decade. So, what happened? The PEEPhole happened, that’s what. Deficit hawks, suddenly and probably unexpectedly confronted with a pile of surplus money, went the popular route: “That money belongs to THE PEEPhole! The PEEPhole know what’s best to do with their own money and we should give it back to the PEEPhole!” Politically popular? You betcha. The PEEPhole loved it. Remember those checks coming in the mailbox for $600 and $300? Those were swell. They were part of George Bush’s $1.35 trillion tax cut, a lot which of went to folks who would have been just fine without it. Those were swell. They were part of George Bush’s $1.35 trillion tax cut, a lot of went to folks who would have been just fine without it. The U.S. Treasury wound up having to borrow money to cover the tax rebate checks. And so, we come at last to today in the Year of Our Lord 2023. Deficit hawks are at it again, threatening default as they did in 2011 and 2013. Now, a lot of those hawks were just fine with President Donald Trump grabbing the debt tree and giving it a good hard shake for his round of tax cuts, so the new obsession with debt is … curious. But let’s say they get a deal that ends with a surplus – and that’s a big if – does anyone really think we won’t see these carnival barkers rear up on their hind legs and start braying about “the PEEPhole’’ and how they deserve their money back? And how that argument will logically turn to how the “PEEPhole’’ at the top, when they’re not in low-earth orbit, are paying the most and need to be refunded the most? It’s an old argument that sounds logical and is very appealing to the rest of us who are having trouble paying for a car or a dozen eggs and will get a little relief. In practice, well… let’s play around with the clock one last time, turning it back to 1932: “The money was all appropriated for the top in the hopes that it would trickle down to the needy. Mr. Hoover was an engineer. He knew that water trickles down. Put it uphill and let it go and it will reach the driest little spot. But he didn’t know that money trickled up. Give it to the people at the bottom and the people at the top will have it before night, anyhow. But it will at least have passed through the poor fellow’s hands.” Will Rogers was right 91 years ago about the yet-to-be-coined “trickle-down theory.” He was right about a lot of things when it comes to human nature. He’d get a hoot out of the current debt showdown and the players involved. And he’d wonder why the “PEEPhole’’ elected so many of those loons. Jim Buchanan is a longtime mountain journalist and author.
- A fair and balanced legislature is best for the people of North Carolina
In the United States, and in North Carolina, we learn at an early age the concept and practice of fairness, which is the quality or state of being fair. In our legal system, we allow adversaries to hear evidence, to question witnesses and encourage jurors to take the facts and render a fair and just verdict. The point is we consider our society to be a nation of justice and fairness. Yet the North Carolina House members have changed rules of fairness that have been in place for more than a decade. If you have not been keeping track, the N.C. House Republicans voted to remove the rule on veto-override votes. Previously, the House rules passed and approved stated that House members could not vote to override a gubernatorial veto “until the second legislative day following notice of its placement on the calendar. The new rule flies in the face of fairness, which is a dying concept in these days of political partisanship. The notion is fading that elected officials represent the people. Many representatives focus on supporting a political cultural and power agenda, fairness be damned. An example of one-sided government is the change of Feb. 15, when the NC House of Representatives passed a rule that allows votes to override Governor Cooper’s, and future governors’ vetoes, without notifying House legislators before a vote is taken. This is a significant change and one that lacks transparency and fairness for the people of North Carolina. The prior rule did not permit a vote to override a gubernatorial veto until the second legislative day, following notice of its placement on the calendar. This rule has been in place for many years and has worked for the legislators, the governor and, most importantly, the residents of North Carolina. With a Republican majority, the rule changes make it imperative that Democratic legislators be present if they hope to support a veto by the governor. Why is this? It’s because the Speaker has the power to change the order of business. Legislators now rely on the fairness and transparency of the Speaker’s actions. Is this possible, given the partisanship we have witnessed over the 12 years of Republican control of the Legislature and the Speakership? Who wins in this situation? You would think voters rely on legislators and the governor to work together for the betterment of the people, not their political agenda for gaining more and more power over government and the people who elected them to govern for the good of the people and the State. What can be done to address this inequity? Nothing at this time. The voters of the State ultimately are the decision-makers if they support this form of power-grab government. It is not enough for Republicans to suppress the vote across the country, including North Carolina, it is clear the Republicans are laser-focused on changing the outcomes of all elections in their favor. Their reward? To appoint officials who will claim ‘voter fraud’ in elections if their party’s candidates lose? Our nation is in peril as democracy continues to be attacked. Our enemies are watching for the chance to take advantage of our divisive political and social culture to use cyber and possibly military force to attack. Don’t take these power grabs as singular events. Ask yourself: Who can protect our democracy? It is not the politicians. It is the people and voters of North Carolina and the nation. Virgil L. Smith formerly served as president and publisher of the Asheville Citizen-Times and Vice President for Human Resources for the Gannett Company. He is the principal for the Smith Edwards Group and the author of "The Keys to Effective Leadership - Understanding Who You Are and Tips on Being a Successful Leader." He is the founder and writes for Carolina Commentary.
- N.C. Senate should approve House Medicaid expansion bill
North Carolina may finally be on the verge of finding its “compassion and common sense” in the words of Mary Scott Winstead, spokeswoman for Gov. Roy Cooper. Winstead’s remark, made in an email to the Associated Press, disparaged the fact that North Carolina is one of the last states that haven’t extended Medicaid coverage to hundreds of thousands of people eligible under a federal program that would pay 90 percent of the cost. That may be about to change. A bill to expand Medicaid coverage easily gained approval in the state House earlier this week. But the bill could still falter in the Senate over a disagreement among Republican lawmakers about whether to saddle it with other changes to the health care system that are opposed by hospitals and doctors. Rep. Donny Lambeth, R-Forsyth, a retired Health care executive, filed House Bill 76, Access to Health Care Options Feb. 9. The Department of Health and Human Services estimates it would extend health care coverage to as many as 600,000 low-income uninsured North Carolinians. A similar bill, passed in the Senate last year, failed in the House because it contained provisions that would repeal North Carolina’s certificate-of-need rules and would allow nurses with advanced training to perform more medical procedures without a doctor’s supervision. Opposition from lobbies for doctors and hospitals killed that bill. Lambeth’s bill doesn’t contain those provisions but they could be added in the Senate, where Senate leader Phil Berger has made his support for Medicaid expansion contingent on them in the past. Those changes to the health care system are separate issues that should be decided on their merits, just as Medicaid expansion should be decided on its merit. And if lawmakers ever encountered an incontrovertible choice, expanding Medicaid is it. The federal government will pay 90 percent of the cost. A section of Lambeth’s bill would implement the Healthcare Access and Stabilization Program, which would increase the amount hospitals ar e paid to care for Medicaid patients to an amount closer to the actual cost. In return, hospitals and health care plans would cover the remaining 10 percent. According to Lambeth, about 70 percent of those who would qualify for coverage if Medicaid is expanded already work, including many nursing home, home health, childcare, restaurant, hotel and grocery employees. Instead of establishing a work requirement, something the courts have struck down in other states, Lambeth’s bill creates a comprehensive workforce development program called NC Health Works that would match recipients with training and job opportunities. This section is modeled on a similar program in Montana where 78 percent of unemployed participants found employment after completing the program, according to a report prepared for the Montana Healthcare Foundation. The economic benefit of reduced sick time and increased productivity resulting from a healthier workforce can’t be easily measured, but job growth can be. A report in Michigan found that new economic activity associated with expanded Medicaid spending resulted in the creation of 30,000 new jobs. “Our analysis suggests that for individual states … there are economic benefits to the state and state government that far outweigh the cost of … Medicaid expansion,” Dr. John Ayanian, said in a 2017 interview with New England Journal of Medicine Managing Editor Stephen Morrissey. Ayanian, director of the University of Michigan Institute for Health Care Policy and Innovation, said about one-third of the new jobs were in the health care industry. The remainder were created in other sectors as health care spending flowed through the economy and caused a multiplier effect. The additional spending netted the Michigan government an additional $150 million in sales tax and income revenue. Medicaid was signed into law in 1965 along with the law that created Medicare. All states have Medicaid health coverage for some low-income people. The federal government pays about 70 percent and requires states to make it available to certain groups. States have considerable discretion at setting income eligibility levels. To qualify in North Carolina you must be a caregiver for a child 18 years of age or younger or a disabled family member and make less than 40 percent of the federal poverty level. Or you must be blind, have a disability, or be older than age 65 and have an income of less than 100 percent of the federal poverty level. Non-disabled, childless adults ages 19-64 are not eligible for Medicaid coverage. Beginning in 2014, the Affordable Care Act offered states the option to expand eligibility for Medicaid to all persons with an annual income of less than 138 percent of the federal poverty level. For 2023, the income threshold to qualify for a single person would be $20,120. The COVID-19 relief bill passed in March 2021 included financial enticements for North Carolina and the other holdout states to expand Medicaid. If it does so, North Carolina could get $1.5 billion or more as a signing bonus. Some lawmakers are talking about using $1 billion of that to shore up the state’s pitifully inadequate mental health system. But the bonus comes with the condition that states agree not to put stipulations on enrollees. A workforce amendment added to the bill creates a contingency that requires the state to develop a work requirement plan if the federal government should authorize it. That may disqualify North Carolina from getting the bonus. That would be an outrageous case of politics trumping good judgment. North Carolina taxpayers paid their share of the federal money being used to fund Medicaid expansion and they deserve to have their share of those tax dollars returned to benefit our state. North Carolina can increase federal funding for health care by $8 billion annually and potentially an additional $1.5 billion one-time signing bonus by expanding Medicaid and implementing the Hospital Access and Stabilization Program. There can be no justification for burdening a bill that so obviously benefits so many people in North Carolina, at virtually no cost to the general fund, with controversial amendments that have already scuttled it once. North Carolina is one of 11 states that have not adopted Medicaid expansion. It’s long past time for North Carolina lawmakers to choose “compassion and common sense.” Joy Franklin is a journalist and writer who served as editorial page editor of the Asheville Citizen-Times for 10 years. Prior to that she served as executive editor of the Times-News in Hendersonville, N.C. Franklin writes for Carolina Commentary.
- A pandemic tax policy cut poverty to a record low. It expired.
The Child Tax Credit for the year 2021 expanded from $2,000 per eligible child age 6 to 17 to $3,600 per child under age 6 and $3,000 for children age 6 through 17. The American Rescue Plan also included 17-year-olds for the first time. The Census Bureau’s 2021 poverty statistics show the child tax credit expansion nearly halved child poverty. (In North Carolina, 20 percent of children live in poverty.) Half the credit came in advance monthly payments even to those with low or no earnings. (Under the previous law, they’d received partial or no credit.) Remember that families with low or no income are ineligible for the tax benefits higher income families receive. Nineteen million children receive less than full credit, or no credit, because family incomes are too low. This includes 45 percent of Black children and up to 39 percent of Latino children because of ongoing disparities in income due to structural and historical racism. Extended eligibility for 17-year-olds, the increased benefits, and the advance payments reached 61 million children in more than 36 million households, according to the Center on Poverty and Social Policy at Columbia University. Families got the second half of their credit, a lump-sum payment worth the remaining six months’ value, at tax time in 2022. We can’t afford not to address child poverty. The costs of children growing up poor are associated with low incomes, poor health outcomes, and mental health disorders later in life. And incarceration. Consider the long-term costs of children growing up in crowded, noisy conditions, with inadequate food and nutrition, but enough worry and stress to change brain structure. Cornell University researcher Gary Evans has followed children who grew up at or below the poverty line for the past 20 years. He and his colleagues found differences in brain structure between participants in their twenties who grew up poor and those who grew up in middle-class households. Cut childhood poverty. Save a child’s adult life. Early investments in the household security and education of children pay dividends that benefit all of us. This temporary credit expansion cut poverty. The Columbia University study states: “The weight of the evidence is clear: while in place, the expanded Child Tax Credit reached the vast majority of families with low, moderate, and middle incomes; shored up family finances amidst the continuing COVID-19 and economic crisis; helped reduce child poverty to the lowest level on record; decreased food insufficiency; increased families’ ability to meet their basic needs; and had no discernable negative effects on parental employment.” But the credit expired and was not renewed in 2022. Gains have been lost. Households once again face food shortages. Financial distress is mounting. Factor inflation into the mix, and poor families are hurting. Again. January 2022 statistics showed 3.7 million more children in poverty than in December 2021. Except for a slight dip around tax time, monthly child poverty rates stayed higher in 2022. Elected leaders could have renewed the child care tax expansion. They opted not to. Last ditch Congressional efforts in December 2022 failed to extend the expansion. Let’s get it right. Low-income children will wind up in the bottom fifth of incomes as adults. Childhood poverty influences everything from health care to voter turnout to how we shape our society. There’s a simplistic misconception that poverty causes crime. That relationship is complicated. It is clear, though, that policy changes have criminalized offenses associated with poverty: homelessness, mental illness, and drug and alcohol problems. One more avoidable human cost if we invest in poor children. Betty Joyce Nash reported for the Greensboro News & Record and the Hendersonville Times-News before moving to Virginia where she worked as an economics writer for the Federal Reserve Bank of Richmond. She co-edited Lock & Load: Armed Fiction, an anthology of literary short stories that probe Americans' complicated relationship to firearms. (University of New Mexico Press, 2017.)
- Democracy Wins ... for Now
Surprise, the Democrats held the Senate and did not lose as many seats in the House of Representatives as projected. Most election followers listening to news reports were expecting a “red wave” of Republican victories in the House and Senate. That did not happen. The country can no longer count on polling as a predicator of election results. That’s a key takeaway from the 2022 midterms. The polls have proven again, as they did in 2020, that they are not reliable predictors of election outcomes. That’s true for a variety of reasons, including that they rely on people to answer their spam-ridden cell phones and to engage with a pollster. But is prediction really the point? Or should we be placing more focus on the most important issues and demanding that candidates address them? Given our interminably long campaign cycles, a lot of valuable time and space in the media gets squandered on hand-wringing and polling analysis instead of examining the candidates and the issues and following executive, judicial and legislative action day by day. Whatever the predictions, here’s hoping voters continue turning out in record numbers to exercise their constitutional privilege of voting for their candidate of choice, despite voter suppression strategies by the Republicans. Here’s another takeaway from the midterm elections. In North Carolina, residents need to pay close attention to the Supreme Court, as Republicans picked up two seats. This is a game-changer for conservative policies. We should expect to see more action on voter ID and other issues related to voting and elections. The Republican majority in the General Assembly has already signaled that it plans to redraw congressional district lines in 2023 and based on past performance, it’s reasonable to expect the new maps will be gerrymandered to favor Republicans. A Republican majority on the court makes it much more likely that those new maps will stick for longer than one election cycle. Not surprising in Eastern North Carolina, five African American incumbent legislators lost their elections due to lower turnout and gerrymandering, despite having large African American populations. A cause for concern is NC voter turnout was lower than midterm 2018. According to the N.C. State Board of Elections, roughly 53% — 3,755,778 — of eligible voters went to the polls during the 2018 General Election. This year, that percentage was about 51%, or 3,745, 547 North Carolina voters. Consider this, Americans care about democracy and want to protect it. Yes, we have high inflation, the President has low approval ratings, housing prices have skyrocketed, women lost the right to choose, kids have lost ground with their education, the Nasdaq stock market has lost almost a third of its value. Despite Republican voter suppression, in North Carolina and other states voters found ways to vote with early voting, voting by mail and simply going to the polls on election day. They did so as we recover from the pandemic that took over a million American lives. Let me repeat that. Covid killed more than a million Americans! Yet Americans turned out and voted. Voters gave Democrats continued control of the Senate with a majority 50 to 49 as this is written. The Senate election in Georgia is still undecided, with a runoff scheduled for Dec. 6 between Democratic incumbent Raphael Warnock and Republican challenger Herschel Walker. A win for the Dems is important because it would diminish the power of any single Democrat to hijack the President’s priorities. Even so, with the Republicans poised to win the House of Representatives, Americans are faced with the potential for more gridlock, unless President Biden can use his influence and gain nonpartisan approval of his Build Back Better for America agenda. North Carolina can benefit from the President’s agenda. It would address the cost of prescription drugs, lower housing costs, and increase funding for Medicaid, delivering health care coverage through Affordable Care Act premium tax credits to up to 4 million uninsured people in states, including North Carolina, that have locked them out of Medicaid. The N.C. General Assembly rejected federal Medicaid dollars, choosing GOP politics over the health of North Carolina residents. In the often uncivil and sometimes alarming political climate leading up to the 2022 midterms, it hasn’t always been easy to fathom, but maybe the biggest takeaway of the election is that Americans are looking for politicians to work together and get things done, despite their differing views. At the end of the day, notwithstanding the less than noble tactics many use to get elected, the job of the politicians we choose to become lawmakers is to protect democracy and improve the lives of Americans. It’s up to the media to keep tabs on them and make sure we the people know how well they’re doing that job. Just in, Trump announces his run for President. Buckle Up! Virgil L. Smith formerly served as president and publisher of the Asheville Citizen-Times and Vice President for Human Resources for the Gannett Company. He is the principal for the Smith Edwards Group and writes for Carolina Commentary.
- Be informed and vote on issues that matter
When early voting ended Saturday in North Carolina, more than 2.1 million voters had cast their ballots. That’s almost 28 percent of the state’s more than 7.4 million registered voters. For some perspective, it’s helpful to know that by the end of the 2018 midterm election, a total of 52 percent of voters had cast a ballot. Of those, 21.8 percent of eligible voters voted early. Given the stakes, it’s not surprising that interest in this midterm election runs high. Worries about voter intimidation don’t seem to be deterring North Carolina voters from exercising their right to vote, even though the state was one of ten viewed by the Brennan Center for as being at high risk for intimidation to disrupt the process. The center released a guideproviding an overview of federal and state laws, including those in North Carolina, that protect against intimidation. Despite concerns raised by the false claims of Republican candidates influenced by former President Donald Trump’s “Big Lie’’ that the 2020 election was stolen from him, the Brennan Center’s director of voting rights, Sean Morales-Doyle, told “The Pulse,” an N.C. Policy Watch blog, that voters should go to the polls with confidence. “Yes, there’s reason to be more concerned in some ways this year than in previous years,” he said. “But I want to temper that concern and say that most voters are not going to face intimidation . if they do run into some trouble, they’ve got election protection and election officials and many, many advocates who are watching developments closely, who they can rely upon to ensure that there won’t be any major disruption to our elections.” Based on early voting turnout, the biggest challenge voters are likely to face Tuesday will be lines. Polling places will be open from 6:30 a.m. to 7:30 p.m. and any voter in line at 7:30 p.m. at their assigned polling place will be allowed to vote. Every election is important because we the people are choosing those leaders who will make the laws that govern our lives. In every election cycle there are candidates who distort the truth and try to make the election about emotionally charged issues that incite unfounded fears and bring out our basest feelings. Candidates do that because fear works. A meta-analysis conducted by Dolores Albarracin, PhD, professor of psychology, business, and medicine at the University of Illinois at Urbana-Champaign and her colleagues found that messages with fear are nearly twice as effective as messages without fear. The study was published in Psychological Bulletin in November 2015. As a result, we often end up casting ballots based on non-issues – concerns that have little effect on the matters that determine the quality of our lives. To find out where candidates stand on the issues that do shape our lives – laws that affect the economy, education, the environment, our rights and freedoms – requires research and comparison that many voters don’t have much time to do. That makes us vulnerable to scare tactics. It also makes it harder to vote with a focus on the principles that we believe in. President Dwight D. Eisenhower said, “We must be willing, individually and as a Nation, to accept whatever sacrifices may be required of us. A people that values its privileges above its principles soon loses both.” In North Carolina this election cycle, voters will choose a new U.S. Senator, 14 U.S. representatives, state legislators, numerous judges and local officials. All of these elected leaders will have the power to affect our lives. It’s critical that all of us do our research before we go to the polls in order to choose candidates that truly care about serving their constituents. Most candidates have websites where their positions on issues can be researched. The North Carolina League of Women Voters has a highly informative nonpartisan voters’ guide. Don’t waste your vote on non-issues. Become informed before you go to the polls and vote based on your interests and the principles that guide you. Joy Franklin is a journalist and writer who served as editorial page editor of the Asheville Citizen-Times for 10 years. Prior to that she served as executive editor of the Times-News in Hendersonville, N.C. Franklin writes for Carolina Commentary.
- Project reassures voters N.C. elections are secure
It ironic that at a time when elections, at least in North Carolina, are undoubtedly the safest, most secure and most accurate they’ve ever been, fears of election fraud and tampering are rampant. Election fears result primarily from the rantings of ousted former President Donald Trump who gracelessly refused to accept defeat and made outlandish accusations of election fraud while he himself attempted to “find” votes and rig the system. As hundreds of Republican candidates around the nation echo Trump’s false claims, fears are growing of election disruptions in 2022 and 2024. In response to that concern, the North Carolina Network for Fair, Safe and Secure Elections, a bi-partisan grassroots group of individuals and organizations, are holding town hall meetings around North Carolina to provide information about the electoral process and to rebuild trust in our voting system. Henderson County Information Technology Director Mark Seelenbacher vouched for the system recently at a town hall held at Asheville-Buncombe Technical Community College. Lots of things keep him up at night, he said, but, ““I’ve got to be honest with you. Election security in North Carolina…isn’t one…. I’ve been in local government and in IT for over 20 years. I’ve worked elections for most of those years, supporting on the IT side. We’ve got a fantastic process.” The town hall at A-B Tech was one of 14 being held in each of the state’s congressional districts. A 15th was held virtually. Former Republican N.C. Supreme Court Justice Robert Orr and former Democratic Charlotte Mayor and Mecklenburg County Commission Chair Jennifer Roberts are leading the project with support from the North Carolina League of Women Voters and the U.S. Veterans Hall of Fame. At each town hall, panels of local cybersecurity experts, election officials and election law attorneys explain how voting machines and election procedures work and encourage voter questions. North Carolina and three other states, Arizona, Georgia and part of Florida, are also participating. The project was initiated by The Carter Center with a goal of expanding nationwide before the 2024 election. The A-B Tech panel included Buncombe County’s Board of Elections Chair Jake Quinn and Election Services Director Corinne Duncan and Henderson County’s Board of Elections Chair Charles Medd and Director of Elections Karen Hebb. They described a transparent, redundant system of checks and balances governed by state laws and regulations. The system is designed to make sure every eligible voter has an opportunity to vote while preventing voter fraud, they said. From Boards of Elections to poll workers, election activities are carried out by bipartisan teams, preventing hyper-partisan actors from gaming the system. Voting machines are backed up by paper ballots. They are not connected to the internet. There is no opportunity for foreign actors or anyone else to tamper with vote counts. “They’re not connected to anything but a power source and if the power goes off, the batteries kick in,” Medd said. Voter registration rolls are kept updated and are available online at the State Board of Elections website. Anyone can check to see if they or anyone else is registered to vote and review their voting history. “Election fraud is very rare,” Quinn said. “One of the reasons it’s so rare in this state is because the checks and balances are so strong. If anyone actually tries to vote multiple times or vote fraudulently, they’ve got to have a pretty good idea that they are going to get caught, that they are going to get prosecuted.” The state board of elections has an investigative division, Hebb said. Anyone who suspects voter fraud should report it to their local board or directly to the state. If there’s enough evidence, a felony conviction can result. “I don’t know of anybody who thinks one vote is worth going to prison or having a felony on your record,” she said. “Is there fraud? Probably, but at a very, very small level…. If you commit voter fraud, you are opening yourself up to going to jail.” In addition to voter fraud, the panel fielded questions about provisionary ballots, absentee ballots and even the possibility of hand-counting ballots. Provisionary ballots are a failsafe form of voting, Duncan said, offered anytime there is an issue at a location that a poll worker can’t resolve. Elections staff members heavily research those ballots to determine voter eligibility and present them to the local board of elections, which decides whether the ballot is counted. Absentee ballots must be requested by the voter and returned by the voter with the signatures of two witnesses or a notary, panelists said. All absentee ballots are reviewed by the local elections board before being accepted and, once accepted, the voter rolls are updated to reflect that voter has voted so that he or she cannot attempt to vote again on election day. Elections board meetings where provisionary and absentee ballots are reviewed are open to the public. As for returning to hand-counting ballots, Quinn said, “There were 5.5 million ballots cast in the state of North Carolina in the 2020 election. Does anyone have any idea how long it would take to count 5.5 million ballots by hand, understanding that on each ballot you are looking at multiple races? There’s the time factor. Now let’s get to the human factor. I love people, but they are not nearly as adept and accurate at tabulating vast quantities of data as machines that were designed for that task. So, if you want it done accurately and you want it done quickly, we don’t have any alternative that I can see.” Town halls sponsored by the Network for Fair, Safe and Secure Elections will be held through Oct. 6. A list of locations can be found at nctrustedelections.com or the virtual town hall can be viewed on Reimagining America Project’s YouTube channel. The state board of elections website has a section that contains great information about election security. The one good thing election deniers have done is shine a light on election integrity. We should all remain vigilant, but these resources provide voters with assurance that our precious right to choose those who lead us is securely and fairly administered in North Carolina. Joy Franklin is a journalist and writer who served as editorial page editor of the Asheville Citizen-Times for 10 years. Prior to that she served as executive editor of the Times-News in Hendersonville, N.C. Franklin writes for Carolina Commentary.
- Attacks on reproductive rights harm women’s health and rob their Constitutional rights
The Supreme Court's June overrule of Roe v. Wade denies women the right to control their bodies. Those privacy rights are constitutionally guaranteed—to women and men—by the 14th Amendment, the same amendment that underpinned the Court’s original decision affirming women’s right to abortion. “When states coerce and force women, girls, and people with the capacity for pregnancy to remain pregnant against their will, they create human chattel and incubators of them,” says Dr. Michele Goodwin, professor of law at the University of California, Irvine. “By doing so, state lawmakers force their bodies into the service of state interests.” Women of color, especially black women, will suffer most. Republicans need win only two more seats in the N.C. Senate and three in the House to attain a supermajority that could override Democratic Gov. Roy Cooper’s vetoes of anti-abortion legislation; two contested N.C. Supreme Court seats could change that court’s current composition of four Democrats and three Republicans. Polling reveals that most N.C. voters support abortion rights; anti-abortion Republican candidates are now backtracking from abortion-ban positions, but don’t be fooled by these softened stances. The barbaric restrictions on this fundamental freedom not only hurts women, but also democracy, already plagued by voter suppression and gerrymandered districts by the same minority of political extremists attacking women’s right to control their bodies. Stakes are high. In North Carolina, it’s not easy to get an abortion. The abortion ban at 20 weeks was reinstated by U.S. District Judge William Osteen Jr. Fetal viability typically falls between 24 and 26 weeks of pregnancy.Patients are forced to wait 72 hours after counseling (though not required in-person); state Medicaid coverage of abortion care is restricted to very limited circumstances; the state bans the use of telehealth or mail for medication abortion; parental consent or notice is required for a minor's abortion; only physicians, and no other qualified healthcare professionals, may perform abortions. As abortion bans in states take effect, chaos and confusion prevail, whether intended or unintended. Legislators know little about healthcare; their laws reflect ignorance or deliberate obfuscation or both, and only lead to more questions: As many as 30 percent of pregnancies end in miscarriage, the spontaneous loss of a fetus; while some resolve naturally, risks such as infection or excess bleeding may require treatment with the same drugs used in abortion. Similar confusion has arisen around ectopic pregnancies, which cannot produce viable embryos under any circumstance; such pregnancies occur when a fertilized egg implants and grows outside the uterus, often in fallopian tubes. The embryo does not develop into a baby. Delaying or denying treatment for such common complications risks women’s lives. Providers have no time to consult lawyers before treating a patient’s emergency. Anti-abortion activists are resorting to civil lawsuits. In Arizona, an ex-husband sued a clinic and doctors, claiming wrongful death, for prescribing an abortion pill four years ago. Allowing an ex-partner to pursue a woman after the fact, using the court system, is tantamount to abuse. Legal experts say such civil suits may become more common: The National Right to Life Committee has released model legislation, a playbook for state lawmakers. Those most vulnerable in restrictive states are women of color, poor women, young women, rural women, and women in abusive relationships. Carolina Commentary has already detailed economic consequences not only for these women but also society. Maternal mortality rates will climb; more children will be born into single-parent households, and fewer will graduate from high school and college. The economy will suffer as fewer women of any color are able to plan families, successfully enter the workforce, and stay employed. Abortion foes sow fear through vague and ignorant language combined with false narratives; this creates a chilling effect for the women who need medical care the most. Women are scared to talk about medical needs, pregnancies, and medical histories; they fear using period-trackers; they fear medical records may incriminate them. Any criminalization of pregnancy, or even the threat of it, is a national shame. The U.S. already ranks highest among developed nations in maternal mortality—death from any cause related to or aggravated by conditions related to pregnancy. States with the strictest anti-abortion laws have the highest maternal mortality rates. Think Mississippi. The loss of privacy rights can be deadly for girls and women of reproductive age; black women are 3.5 times more likely to die from pregnancy-or-birth-related causes than white women. That’s a shame, but there’s no time to cry. Even women’s right to prevent pregnancy is coming next: the right to use contraception. Betty Joyce Nash reported for the Greensboro News & Record and the Hendersonville Times-News before moving to Virginia where she worked as an economics writer for the Federal Reserve Bank of Richmond. She co-edited Lock & Load: Armed Fiction, an anthology of literary short stories that probe Americans' complicated relationship to firearms. (University of New Mexico Press, 2017.)