PORTLAND, Ore. – Researchers find that affordable housing is an integral part of keeping people healthy, and even compare it to a drug prescription plan.

New research published on the JAMA Network says investing in housing improves health outcomes for patients and lowers costs for the public.

In Oregon, groups are addressing this issue head-on. Last year, health care organizations, advocates for homeless populations and local government teamed up in Portland for the Housing Is Health initiative.

Rebecca Ramsay is executive director of Housecall Providers, part of CareOregon, one of the organizations partnering on this effort. She says the housing affordability crisis is hurting low-income people especially hard.

"They either have to spend so much on their housing that they have very little to nothing left for their other needs, including health care, or they end up with the inability to secure stable housing,” explains. “So they end up either couch surfing or moving between transitional housing, shelters, or in the worst case, they end up on the street."

Last week, Housing Is Health partners broke ground for a building in East Portland that will include a clinic, respite and palliative units, 90 transitional units and 34 permanent housing units.

The project's goal is 379 units total across three buildings. Other partners include Central City Concern, Adventist Health Portland, Kaiser Permanente Northwest, Legacy Health, OHSU and Providence Health and Services.

The research in JAMA cites studies connecting housing insecurity to a wide variety of health issues, including asthma, depression and the toxic effects of lead exposure.

It also finds that about half of health care costs are attributable to 5 percent of the population – the overwhelming majority of whom are poor or housing insecure.

Portland ran into this issue last year during a hard winter. Ramsay says emergency room visits and hospitalizations skyrocketed, especially among residents on Medicaid or Medicare.

She says investment in affordable housing is a way to save costs.

"It's a factor of 10 to 20 percent higher just for one hospitalization, and over the course of those three months, we saw people having multiple hospitalizations in a period of 30 days because they were not able to meet their health-care needs and they were out in the cold," she relates.

Ramsay adds that homelessness has always been an issue for metro areas, but it is becoming more urgent in Portland.

"All of us can see that the increase in this problem is staring us right in the face,” she stresses. “We need to do something about it. We need to do it because it's the right thing to do, because it's the ethical thing to do, but we also need to do it because it's unsustainable."




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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.