Florida leads the nation in the number of individuals, nearly 6 million, who are living in Dental Health Professional Shortage Areas.

Sixty-six of Florida's 67 counties lack the amount of professionals needed to provide care, according to U.S. Health Resources and Services Administration data. Advocates say the shortage is of crisis proportions leading to significant impacts on general health as they say poor oral health is linked to impaired school learning, heart disease and even death.

Dr. Frank Catalanotto, founder of Floridians for Dental Access, said part of the problem is the significant cost of dental care. He noted in Florida and nationally, thousands of people with toothaches take their problems to an emergency room.

"The physicians in the emergency rooms aren't prepared to deal with this, so the patient gets antibiotics and pain medication and then told to see a dentist tomorrow," Catalanotto pointed out. "Well, if they couldn't afford a dentist today, they are not going to afford one tomorrow."

Catalanotto reported of the 150,000 who went to the emergency room in 2019, 4,000 of them were admitted to the hospital because the dental infections were life-threatening. As of 2020 and 2021, there were 12,264 dentists in Florida, according to the state Department of Health, and not all of them take Medicaid, which provides coverage for low-income individuals.

Most dentists in Florida are concentrated in large urban counties, with very few dentists in many rural counties. Three counties -- Dixie, Glades and Lafayette -- have no dentists. State health data show three other counties -- Union, Gilchrist and Franklin -- each had just one.

Catalanotto noted more research is connecting the dots on how this disparity is impacting the health of school children and adults.

"If you're not learning, you're not going to get an education," Catalanotto emphasized. "And for adults it's way more serious because there is now very good strong scientific literature about the relationship, for example, between gum disease, periodontal disease and diabetes."

At last count in Florida, Catalanotto said fewer than one in five dentists, just 18%, participated in Medicaid in 2016. He added the scary part of the crisis to him is how little the public knows about how oral health impacts their everyday health so, his group's focus is to spread awareness and eventually land on concrete solutions which get to the root of the problems.

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.