La equidad sanitaria se está convirtiendo en una prioridad en Carolina del Norte a medida que Medicaid experimenta cambios. Las personas en todo el estado están experimentando actualizaciones que significan que algunas personas transicionarán a la atención médica mientras que otras pueden perder su cobertura. Muchas personas también serán elegibles para Medicaid por primera vez. Todas estas actualizaciones son cosas que, según los defensores de salud, pueden empeorar las disparidades ya existentes.

Para abordar esto, Madison Allen senior de Kate B. Reynolds Charitable Trust explica que están colaborando con organizaciones locales para amplificar la retroalimentación y abordar los problemas.

"Algunos de los problemas que nos han comunicado los beneficiarios son las dificultades para inscribirse o darse de baja en los planes, los desafíos de los proveedores en la red, problemas de acceso al transporte y procesos de apelación confusos," explica Allen.

Además, afirma que los beneficiarios han encontrado casos en los que no se ha acomodado a personas con discapacidades. Allen subraya que los grupos e investigadores que apoyan están trabajando activamente como intermediarios entre la comunidad y los programas para garantizar que las personas reciban los beneficios que merecen.

Alrededor del 47% de los ciudadanos no estadounidenses carecen de seguro médico.
Hamutal Bernstein, del Urban Institute, explica que estos retos pueden ser aún más difíciles para las familias migrantes.

Un informe reciente titulado "Apoyando a las familias migrantes de Carolina del Norte" revela que existe un número creciente de residentes de habla hispana, swahili y hmong en el estado.

Bernstein explica que muchas de estas familias se enfrentan a barreras lingüísticas, aunado a problemas de migración y discriminación. Bernstein dice que, en algunos casos, se encuentran con largos procesos de inscripción y luchan por recibir ayuda con la documentación, lo que impide a algunos miembros de la familia que reúnen los requisitos a que accedan a programas esenciales de la red de seguridad.

"Así que hay familias en las que hay ciudadanos estadounidenses," explica Bernstein. "Hay ciudadanos nacidos en los Estados Unidos, hay ciudadanos nacionalizados, a veces hay miembros indocumentados y puede haber miembros de la familia elegibles para un programa y otros miembros de la familia que no son elegibles en lo absoluto, así que las familias tienen que resolver todo eso."

Según el informe, algunas agencias no están seguras de las necesidades lingüísticas de sus respectivos condados. Para solucionarlo, se ha creado una herramienta de datos que permite conocer las necesidades lingüísticas.

El informe también recomienda soluciones como contratar personal que represente a las comunidades migrantes, mejorar la accesibilidad al idioma más allá del español y utilizar modos de comunicación específicos para los distintos grupos de edad.




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United States Secretary of Health and Human Services Xavier Becerra and U.S. Rep. Yadira Caraveo - D-Thornton - recently paid a visit to Salud Family Health Centers' mobile clinic.

Each year, Salud serves up to two thousand migrant farmworkers who travel from other states and countries to plant and harvest leafy greens, corn, wheat, sugar beets, and other crops in North Central and Northeastern Colorado.

Director Deborah Salazar said her team always gets a very warm welcome.

"And it's usually the same guys that come to the same farms or greenhouses," said Salazar. "And so it's like seeing old friends. They know who we are, they know what we can do for them, and they trust us. There is trust because we have been doing this for a very long time."

In addition to its 12 brick and mortar health centers, and ten school sites, the mobile unit provides primary health services three to four evenings per week - primarily in rural areas.

They screen workers for diabetes, hypertension, cervical cancer, and anemia. Workers can also get lab tests, and flu and tetanus vaccines.

Salud is a federally qualified community health center that provides medical, dental, pharmacy, and behavioral health care services to all patients regardless of their ability to pay.

The first clinic on wheels was acquired in 1980, and Salazar said a brand new unit was rolled out in 2022.

She said her team works to build relationships with farm owners and supervisors to find the best time to plan a visit.

"If they need us to come out and start our visit on the mobile unit at 7 p.m, we can do that," said Salazar. "We are super flexible, because we don't want to interrupt their work day."

Salazar said the medical staff on the mobile unit might be the only people migrant workers see when they are not out planting and harvesting crops.

"These are the folks that put food on our table," said Salazar. "To give them quality, integrated health care - and go to them, so that they are taken care of - this is the least we can do."




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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.