SOUTH JORDAN, Utah – Getting some children to the dentist in Utah is a lot like pulling teeth.

The Pew Children's Dental Campaign says in a new report that across the country, more than half of low-income children didn't see a dentist at all in 2011. And in Utah, 10 to 15 percent of the population lives in areas with an overall shortage of dental care.

Dr. Steven Steed, dental director with the Utah Department of Health, says it isn't so much a supply problem as a distribution problem. Most of the dentists practice in the four urban counties.

"There really has not been a real shortage of dentists in Utah,” he says, “and now with two dental schools, we see even less of a problem with having enough dentists. It's just going to be those issues to be sure that we can entice those dentists to go to some of these rural areas where there are some underserved populations."

Steed says the state's two dental schools will accommodate about 100 students a year and are being encouraged to place them in areas of need. The state also has a mobile dental clinic.

However, only about half of the dentists in Utah see people on Medicaid, and Steed says only 12 percent have a "meaningful number" of Medicaid patients.

Jane Koppelman, senior officer for the Pew Children's Dental Campaign, says that's a frustration in many states, since Medicaid covers dental care.

"For many families, Medicaid is like a hunting license,” she says. “You have the opportunity to search for a dentist. You might find one and you might not – low reimbursement rates being central to that issue."

According to Steed, dentists lose money on Medicaid patients with a reimbursement rate of only 30 to 40 percent. As an alternative, he says, Utah dentists do a higher percentage of charitable work than the national average.

"Many dentists I've talked to have said just because some of the challenges in Medicaid, they would prefer to see a Medicaid patient for free than to go through the process of billing and the other issues that are attached to it," he says. "So, we do know that some of that is happening as well."

The Pew report says one solution to the lack of access to dental care may come as more states license a newer type of practitioner, known as a dental therapist. Utah isn't currently one of them, but Steed says the state will keep an eye on other states' experiences.



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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.