LINCOLN, Neb. – After weeks of closed-door meetings, Senate Republicans released their legislation last week to repeal Obamacare. GOP leaders claim the plan will stabilize insurance markets, remove mandates and provide flexibility for states.

But Janele George, director of federal reproductive health with the National Women's Law Center, disagrees. She argues the plan drastically cuts Medicaid, defunds women's health centers and denies abortion coverage to those who get their insurance through the health exchanges, or who receive tax subsidies.

"By devastating the Medicaid program, taking away the ability of folks to access services at Planned Parenthood, making the essential health benefits optional, it would put affordable health care out of reach for many individuals and families," she says.

George adds that millions of Medicaid enrollees would not be able to access critical services, including birth control, cancer screenings, and testing and treatment for sexually-transmitted diseases.

Nebraska Republican Senators Ben Sasse and Deb Fischer have not commented on the legislation, which could be voted on this week.

Medicaid currently covers about half of all births and accounts for three-quarters of all public dollars spent on family planning.

Adam Sonfield, the senior policy manager with the Guttmacher Institute, says family-planning services are critical for long-term health by helping women plan for children and avoid unintended pregnancies.

"We know that's important from a health point of view because pregnancy spacing helps to avoid pre-term and low-birthweight births," he says. "It helps people to prepare for their pregnancies, so that they can become healthy before they get pregnant and get chronic conditions under control."

George notes she's also concerned because the bill allows what is known as "13-32 waivers," under which states could make changes to the essential health benefits insurers now must cover.

"Including maternity services and preventive services," George adds. "Not only is this bill stripping that away for folks who are covered under Medicaid expansion, but under the 1332 waivers, we could see other folks have their health care impacted as well."

On the private insurance side, Sonfield adds there would be massive cuts to subsidies that make coverage affordable for some people who have to buy insurance on their own rather than through an employer.

"In ways that will make it a lot harder for particularly low-income people to be able to afford to buy that coverage, and then to be able to afford to use that coverage, because they'll have plans that include really high deductibles and really high co-payments," Sonfield laments.


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A Chicago mom who lost her son to cancer in 2022 is using the occasion of Mother's Day to call on Illinois lawmakers to pass medical aid-in-dying legislation.

Suzy Flack's 34-year-old son Andrew was a special-education teacher and avid hockey player living in California when he learned his cancer was terminal. Rather than return to his home state, he stayed in California, where medical aid-in-dying is legal.

Now, with such legislation under consideration by Illinois lawmakers, Suzy Flack is using social media to urge its passage.

"Like I said in the video, I didn't realize how horrific cancer was," she said. "So, I would really like to stress that that comfort level that he had because he had the control over his death."

The legislation would allow mentally capable, terminally ill adults with six months or less to live the option to request a prescription for medication they could use to end their life.

According to a 2023 survey by the group Compassion & Choices, more than 70% of Illinois residents support such a law, while 17% would oppose it.

With no legal way to end his life in his home state, Flack said her son was unwilling to leave California because he wanted a peaceful death.

"That option of having the medication was strong enough to keep him there, despite missing his family," she said, "and certainly, it would have been easier for all of us if he had been back in Illinois."

In addition to California, medical aid-in-dying is authorized in ten other states and Washington, D.C., while two additional states - Wisconsin and Massachusetts - are considering legalization. The Chicago-based American Medical Association has not endorsed the legislation.

It's National Nurses Week, and educators and healthcare officials say there just aren't enough of them to go around. A combination of retiring baby boomers and nurses who chose to leave the field after the pandemic has left a projected shortfall of more than 5,400 nurses in Nebraska's hospitals, clinics and long-term care facilities.

Linda Hardy, Nebraska Nurses Association president, explained that the system is not training enough new nurses to fill the vacancies.

"I think across the country we have a nursing shortage," she intoned. "But the other thing we have a shortage of are nurse educators - and also, clinical sites for student nurses to be able to practice their clinical skills."

According to a Nebraska Health Care Workforce Collaborative report, 66 of the state's 93 counties have been declared medically underserved, and nine have no nurses. The report points to degraded "emotional health and well-being" as the main reason for staff shortages.

Hardy added healthcare providers and state officials are studying how to increase the investment in educational facilities and clinical sites to train new healthcare workers, and said one goal is to recruit them when they are young.

"There's a collaborative effort to try and get more healthcare workers, not just nurses but radiology techs, pharmacists, etcetera, into the pipeline from high school kids. So, that's a good thing," she insisted.

Carole Johnson, administrator of the Health Resources and Services Administration, said her mission during National Nurses Week is to highlight the vital role nurses play on the front lines, providing care, comfort and support to patients every day, but added the best way to honor them is to support them from training through retirement.

"You have to be investing in the nursing workforce. And so we're providing scholarships, loan repayment, stipends, upskilling - a whole host of training initiatives to really help ensure that we can recruit people into nursing and that when they're there, that they stay," she continued.


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Birth doulas assist new moms with the stress, uncertainty and anxiety of childbirth, while another type of doula offers similar support to those who are dying.

Death doulas, or end-of-life specialists, give spiritual and emotional support to people nearing death in a nonmedical setting. The word 'doula' comes from the Greek word 'doule,' meaning 'female helper.'

Kim Burgess, end-of-life doula and board certified adult geriatric nurse practitioner for Comforting Transitions, an elder care facility in O'Fallon, said fulfilling a dying person's wish to be in their desired setting is important.

"When I was in the home, primarily geriatric population, people wanted to stay in their home; the comfort of their home, their own surrounding, their own food, their own loved ones," Burgess explained. "I loved to being able to support people in that role."

Training to become an end-of-life doula happens in workshops, with required reading and work-study assignments. Since it is not a federally recognized field, insurance companies do not cover the services. The Illinois Department of Public Health said in 2022, Cook County alone saw nearly 46,000 deaths. Almost 20,000 were between ages 65 and 84.

Death, or what is sometimes called "the other side," can produce feelings of fear, or a sense of denial, especially if a terminal condition has been diagnosed. Burgess observed it is a 24-hour job for loved ones helping someone in their final days or weeks. She has encountered families who are unprepared for the caregiving needs.

"A lot of times, their family is saying, 'We're just overwhelmed, and we have hospice involved, but we still feel like we need some more support,'" Burgess recounted. "An end-of-life doula can be there, giving the family reassurance or making some slight suggestions on how to comfort their loved one."

Doulas can also help plan an advance directive, instructions a person can leave behind about their funeral service or cremation, what to do with a pet or help writing a loving message to family and friends.