AUGUSTA, Maine – The air is often dangerous to breathe for 44 percent of Americans, according to a new report – and for Mainers who live in what's known as the tailpipe of the nation, the Environmental Protection Agency's new Clean Power Plan should bring major improvements.
Michael Seilback, vice president of public policy for the American Lung Association of the Northeast, says the new 32 percent cap on carbon emissions from power plants is expected to mean shutdowns of some of the oldest and dirtiest plants in the Midwest.
And since that pollution migrates on air currents to Maine, he says the changes should mean improvements in local air quality.
"While air quality has been moving in the right direction, far too many communities in Maine still are breathing unhealthy air,” he points out. “Our State of the Air Report gave York County, for example, an 'F.'”
The American Lung Association compiles the annual State of the Air report and says nationwide, the Clean Power Plan is expected to have the greatest impact on economically disadvantaged communities that often are located near power plants. Only a handful of coal-fired plants remain in operation in New England.
But the Clean Power Plan is getting sharp criticism, including from the National Black Chamber of Commerce. It says the pollution standards will be "especially severe" for African Americans and Hispanics, destroying jobs and increasing the cost of electricity and natural gas.
Janice Nolen, the American Lung Association’s assistant vice president of national policy, counters that the Clean Power Plan was designed to address those very concerns.
"Under the plan as it's in place now, the requirements would be that we have to make sure that we're not harming lower-income neighborhoods, which means that for the first time, they may actually get more cleanup than they would otherwise," she points out.
Seilbeck adds low-income communities and vulnerable populations should benefit from reduced medical costs as the plan improves overall air quality in New England.
"The Clean Power Plan is going to reduce pollution from power plants by close to 90 percent, and that's going to mean – for the elderly, for youth, and certainly for people that have heart and lung issues – it's going to mean less trips to the hospital," he stresses.
The State of the Air report says at least 800,000 Maine residents should see improved health under the plan.
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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.
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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.
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