DENVER – Mientras el Congreso sigue teniendo problemas con el fondeo del gobierno federal, los centros comunitarios de salud de los EE. UU. –centros que dependen de programas que los legisladores dejaron vencer en septiembre de 2017– se enfrentan a una disminución en el estado de ánimo de su personal y a un aumento en su esfuerzo para contratar personal.

Si el Congreso no encuentra la manera de poner un remedio al fondeo federal de estos centros comunitarios, sus sedes en todo Colorado sufrirán un duro golpe en sus recursos este marzo.

El Congreso dejó que varios programas de los que dependen los centros para financiar la atención de sus pacientes, incluyendo el Programa de Seguridad de Salud Infantil, vencieran en septiembre.

Polly Anderson, vice presidenta de estrategia y financiamiento en la “Colorado Community Health Network” (Red de Salud Comunitaria de Colorado), afirma que esos programas, que tradicionalmente han gozado del apoyo bipartidista, ahora están atrapados en un Congreso cada vez más polarizado.

“Se está enredando en el DACA, se está enredando en el gasto militar. Y realmente es cosa de armar un paquete de fondos en el que puedan estar de acuerdo el Congreso y el Senado, y los Demócratas y Republicanos de cada Cámara.”

Anderson dice que además de los co-pagos y reembolsos de seguros, los dólares federales son esenciales para los centros de salud que brindan atención primaria y preventiva a más de 740 mil coloradeños. Agrega que los nueve miembros de la delegación de Colorado en el Congreso afirmaron que apoyan la permanencia del fondeo.

Anderson destaca que la incertidumbre ha hecho que decaiga el ánimo del equipo, y dificulta el reclutamiento y la retención del personal que muchas veces trabaja en áreas lejanas del estado. Agrega que la inacción del Congreso ya también afectó la confianza de los pacientes.

“Muchos coloradeños y gente de esta tierra dependen de los centros comunitarios de salud para atenderse. Y la incertidumbre del fondeo mes-a-mes, hace muy difícil manejar una empresa –porque aunque no tiene fines de lucro, hay que pagar la nómina; hace falta dinero para tener la luz prendida.”

Advierte que sin centros de salud robustos, con acceso disponible incluso para la gente que no puede pagar seguros, los pacientes tienen que retrasar su atención y seguido acaban haciendo ingresos muy costosos a la sala de emergencia. Más del 90 por ciento de los pacientes de centros de salud comunitaria viven en un 200 por ciento del nivel federal de pobreza, o incluso más abajo.


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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.