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The Appalachia Initiative: A Bipartisan Approach for the 21st Century

We have immense pride in the Appalachian region. For years, it has been a key pillar of American industry, driven by the strength of the work ethic and culture of Appalachian communities.

This vast region that spans 13 states and comprises more than 25 million people has been disproportionately hurt by the waves of economic shifts that have swept the country in recent decades. Declines in industries such as coal and traditional manufacturing—once the backbone of the region—have caused millions of jobs to disappear and affected the broader health of many communities. Despite decades of effort, many communities in the Appalachian region are still being left behind. Determined to improve conditions, many individuals and organizations across the region have successfully directed resources, talents, and ingenuity to respond to these challenges. Progress has been gradual, and more can be done to generate lasting change.

We partnered with the Bipartisan Policy Center to convene regional and national stakeholders to capture innovative ideas for the region. We worked collectively to develop pragmatic policy solutions focused on improving job training, economic development, healthcare, and strengthening the infrastructure and energy sectors in the region.

Each senator led one of the four policy roundtables, and through these discussions we found areas of agreement on many, but not all, of the recommendations found in this report. Advancing the interests of the Appalachian region requires working across the aisle, both in areas where we agree and where we disagree. We look forward to working together on a bipartisan basis on
these recommendations.

We are grateful to the members of this task force for their partnership on this initiative and their tireless efforts on a daily basis to strengthen Appalachia. The solutions in this report will amplify their efforts, and ultimately make a real difference in the lives of families who call this region home. We will engage with our Appalachian constituents, Congress, and the administration to find common ground on many of the issues presented in the report.


The Appalachian region has long faced daunting challenges of poverty and geographic isolation. Today, despite state and federal anti-poverty efforts dating back to the Johnson and Kennedy administrations, many of the region’s residents continue to be vulnerable to the effects of persistent economic deprivation. In recent decades, declines in coal production and traditional manufacturing, once the region’s backbone industries, have contributed to stubbornly high levels of unemployment and poverty—with serious ripple effects on people’s health and well-being. Because a larger share of Appalachia’s population lives in rural communities—over 40 percent, compared to 20 percent for the nation as a whole—the region has been particularly hard hit by problems, from opioid abuse to low educational attainment and youth out-migration, that are affecting rural areas across the United States.

Appalachia confronts these challenges with unique strengths and resources. As coal production has declined and other traditional manufacturing jobs have left the region, natural gas development has grown, and major auto plants and other state-of-the-art manufacturing facilities have moved in. Community and family bonds are strong, as is the region’s tradition of hard work and self-reliance. And Appalachia abounds with examples of success as well as hardship: communities that are successfully re-inventing themselves and attracting new business investment; programs that are achieving promising results; and individual citizens and local leaders who, despite formidable obstacles and limited resources, are making a difference. Now as in the past, Appalachia commands attention as a region that is both disproportionately affected by the negative consequences of recent social and economic disruptions, and uniquely positioned to demonstrate how these consequences might be addressed more creatively and effectively going forward.

In May 2017, the Bipartisan Policy Center joined with Senators Mark Warner (D-VA), David Perdue (R-GA), Joe Manchin (D-WV), and Thom Tillis (R- NC) to form a task force dedicated to finding pragmatic, bipartisan solutions to Appalachia’s challenges.

The task force gathered leading regional and national experts to explore critical issues in four areas: education and workforce, entrepreneurship and job creation, energy and infrastructure, and rural health. In a series of four roundtable meetings—each focused on one of these topic areas—participants exchanged information about current challenges and opportunities in the Appalachian region and identified priorities for near-term action, including federal policy options. This report summarizes the key themes and insights that emerged from these discussions. It also builds on these themes and insights to offer a set of targeted recommendations that can command broad bipartisan support inside and outside the region, while achieving tangible progress on the issues of greatest concern to the people of Appalachia.

For 50 years, the Appalachian Regional Commission has supported economic development in the region. In this report, the task force offers additional regional recommendations that aim to build on the foundation of these ongoing efforts. Further, participants in the four task force roundtables emphasized that while the Appalachia region has success stories, additional information and support are needed to continue to assess the region’s needs and priorities.

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