COLUMBUS, Ohio – From healthier air to job creation, some experts from Ohio spoke with legislators in Washington last week about why the Clean Power Plan is good for the Buckeye State.
The group represented the public health, science, labor, business and environmental sectors, and included Mark Shanahan, principal at New Morning Energy, who served as former Gov. Ted Strickland's energy adviser.
Shanahan says while producing electricity is critical to the economy, he maintains reliance on fossil fuels is leaving a legacy of environmental ruin.
"Ohio is one of the largest electricity users in the country and we get a vast majority of it coming from coal,” he points out. “There are other ways we can do it that are much cleaner, that generate jobs and do not do the environmental damage that fossil fuels do."
The group met with U.S. Sen. Sherrod Brown of Ohio and other leaders as congressional hearings on the rule began.
The Clean Power Plan calls for Ohio to reduce carbon emissions 28 percent by 2030. The EPA recently finalized the plan and it will be published soon.
Ohio is among more than a dozen states fighting back against the Clean Power Plan, with some utilities arguing the rules are too strict.
Claire Boettler, president of the Ohio Public Health Association, who also was in Washington, says Ohioans need clean air to be healthy, especially the hundreds of thousands of children and adults in the state suffering from asthma.
"You know, any time we change from an older paradigm to a newer paradigm and people aren't as aware, it’s hard,” she states. “But the health implications are huge and we really do have to act now because climate change isn't something happening in the future. It's here. It's happening now."
At a hearing Friday, the director of the Ohio EPA, Craig Butler, voiced concerns about the impact of the Clean Power Plan on the state's manufacturing base.
But Shanahan contends there's no need to fight between a healthy economy and a healthy environment. He says industry in Ohio has enormous potential to make the parts, components and technology needed to generate clean power.
"And that certainly can range from all kinds of solar arrays to wind turbines, and it's important that we capture these jobs rather than letting them go to other states,” he says. “That way we get both clean air and good jobs."
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A recent report examined how some rural Tennessee hospitals have managed to stay afloat despite financial challenges.
The report includes interviews from staff at five different rural hospitals, which range in size from 25 to 125 beds.
Judy Roitman, executive director of the Tennessee Health Care Campaign, said some of the hospitals are drowning in uncompensated care. She explained as part of their research, they did an interview with a CEO from a rural hospital in Kentucky who expressed the importance of Medicaid expansion.
"Kentucky has expanded its Medicaid program and Tennessee has not," Roitman pointed out. "He said that's the key to our stability is actually having the funds coming in to treat these patients. And the CEOs and others in Tennessee hospitals said it would make a huge difference to have that federal funding."
Roitman added the federal government is offering Tennessee a nine-to-one match. If Tennessee were to expand Medicaid, at least 330,000 people would gain access to coverage.
Roitman pointed out the report suggested further steps hospitals could take, including examining how they are reimbursed for services provided. She noted private insurance plans tend to provide the highest reimbursement rates, and said more funding is needed to support TennCare, which does not cover enough of the cost.
"TennCare is all managed by managed-care organizations," Roitman explained. "They negotiate with every hospital about how they're going to reimburse and the big hospitals have some leverage to demand better payment and the smaller hospitals are just, they're just not getting paid."
Roitman added the report credited strong community engagement and effective hospital leadership as key factors in staff retention. Robust management and maintaining an engaged workforce significantly affect a hospital's viability, according to the report.
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Medicare and Medicaid are key sources of health coverage for many Americans and some people qualify for assistance under both programs. With lagging enrollment for the unique plans, outreach efforts are underway.
According to KFF Health News, only about three in 10 people who qualify for Dual-Eligible Special Needs Plans were enrolled in 2021. Experts said the option is designed for people who need additional help because of disabilities, certain health conditions or their age.
Dr. Gina Williams, associate medical director for UnitedHealthcare, said the plans try to take a dynamic approach to serving those eligible.
"Everything from managing your wellness to managing your behavioral health needs and then everyday needs," Williams outlined. "It's kind of a more comprehensive package for people who need a little bit more support."
Everyday needs include meal benefits and bathroom safety devices. The National Council on Aging said D-SNPs aim to provide a more streamlined coordination of care because there is assistance in arranging the services. Wisconsin's enrollment numbers are similar to the national rate, at 28%.
Christine Huberty, lead benefit specialist and northern region supervising attorney for the Greater Wisconsin Agency on Aging Resources, said a tricky component of the plans is navigating provider network restrictions. A rural resident might have to travel farther to see a doctor covered under the plan and she cautioned it warrants careful research when enrolling.
"I would say first and foremost, look at the provider network restrictions," Huberty advised. "Look at what's available in your area."
Meanwhile, Williams noted the push to get more eligible people to sign up coincides with more awareness around preventive care in a post-pandemic world.
"Everybody's kind of going into a phase where they're not only thinking about acute illness, but they're thinking about overall care," Williams observed. "What was the impact of the pandemic from a psychological standpoint? Do you need more support and then you also need more coordination of benefits?"
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In Mississippi and across the country, Community Health Centers are getting a funding increase, thanks to Congress passing a bipartisan spending package.
Community Health Centers in Mississippi serve patients without regard to their insurance status or ability to pay. More than 20 locations in the state provide medical care to more than more than 380,000 people.
Joe Dunn, senior vice president of public policy and advocacy for the National Association of Community Health Centers, said roughly one in 11 Americans gets their care from this type of clinic.
"Community Health Centers are the largest primary care network in the nation, providing care for 31 million Americans," Dunn pointed out. "This network is critically important, because they provide primary care, behavioral health, dental; just an array of services that are so critically needed."
Dunn emphasized more can be done. Research shows more than 100 million Americans need better access to primary care. Community Health Centers in Mississippi also support more than 4,000 jobs and about $678 million dollars in economic activity in the communities where they're located.
Dunn noted the increased funding from Congress will help the clinics provide more comprehensive care and reach more underserved patients, especially in rural communities, which ends up saving the state money.
"By incentivizing people to go get primary care, you alleviate more downstream costs," Dunn emphasized. "There's fewer hospitalizations and complications from chronic conditions, based on preventive screening and care at the outset."
The Congressional Budget Office reports the increase in funding for Community Health Centers just through the end of this year will reduce federal spending on public health insurance programs by more than $700 million.
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