FRANKFORT, Ky. - More than nine out of 10 Kentuckians now have health insurance, but supporters of health-care reform in the Bluegrass State fear a murky future as Republican Matt Bevin prepares to take office as governor on Dec. 8.

Bevin has said he wants to shut down the state's health-benefits exchange, kynect, and transition to the federal exchange. He also wants to roll back Medicaid expansion, which has added more than 400,000 low-income Kentuckians to that program.

To Sheila Schuster with the Action Advocacy Network, rolling back Medicaid "makes absolutely no sense."

"What do you say to people, 'You're not worth getting healthy, you're not worth taking care of?' We had such a good deal, but we're going to say no to it? It makes absolutely no sense," she said, "financially, economically, in terms of business, in terms of the growth of our state, in terms of the health of our state."

Bevin said his intent is not to cut people off but to customize Medicaid to Kentucky through a waiver - known as a "1115 Medicaid demonstration waiver" - of federal rules on eligibility and coverage.

Bevin has pointed to Indiana's model as an example of the direction he wants Kentucky to head. Medicaid recipients there pay either premiums or co-pays, sometimes both. Ashley Spalding, research and policy associate for the Kentucky Center for Economic Policy, said that would tamp down access to health care.

"Research shows that even when premiums and co-payments are seemingly modest," she said, "low-income people are less likely to enroll, and they're less likely to seek needed care."

Gov.-elect Bevin said he isn't looking to make draconian moves. However, Spalding noted that tens of thousands of Kentuckians have received cholesterol screenings, mammograms and other types of preventive care since obtaining insurance through Medicaid expansion. She warned that rolling back expansion could slow down that trend.

"We could see fewer people accessing these preventive-care services," she said, "which, in the long term, we expect to increase not only the health of individuals but to increase the health of our state."


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With Black History Month underway, Wisconsin researchers and support groups are highlighting the disparities in cases of Alzheimer's disease.

The Centers for Disease Control and Prevention said older Black Americans are about two times more likely than whites to have Alzheimer's and other dementias.

As drugs designed to treat conditions accelerate toward the market, the University of Wisconsin School of Medicine and Public Health noted Black adults are less likely to be included in the research. The school has made it a priority to focus on the Black population in an ongoing study.

Diane Beckley Milner, director of diversity, equity and inclusion for the Alzheimer's Association Wisconsin Chapter, said participation is important.

"Without us being involved in those clinical trials as Black Americans, then the research, it's not going to lend itself to giving accurate information," Milner pointed out.

The university acknowledged Black individuals can be reluctant to participate in studies, citing historical trauma from events such as the Tuskegee experiment. Officials say when it comes to the UW study, Black volunteers account for 27% of the people enrolled, which is much higher than the state's Black population, suggesting it provides hope in boosting research inclusivity.

Milner emphasized partnerships her group has with organizations such as the African Methodist Episcopal Church can help ease fears and create more awareness within the Black community.

"Having that partnership has proved to be very, very important and critical to making sure that people get information that they can trust," Milner explained.

She added a common challenge her group has found in outreach is many Black Americans view cognitive decline as simply a sign of aging, and not a disease. The association also works with nursing organizations in hopes of educating more people within the Black population.

Preventing maternal and infant mortality in Georgia is a top priority for health care providers in the state.

Georgia already has the nation's highest maternal mortality rate, with more than 46 deaths per 100,000 live births, and ranks 16th for infant mortality.

In Lawrenceville, Obria Medical Clinics has what it calls a Supportive Pregnancy Care program, where people meet monthly in two-hour group sessions during pregnancy.

Robin Mauck, executive director of Obria, said they ask questions, learn how to take their own vital signs, and also meet with their providers for checkups.

"And then, March of Dimes has provided a curriculum that our facilitator goes through that has been proven to reduce maternal mortality," Mauck explained. "The great thing we see in this program is, it creates community for these girls. A lot of them don't have support in the community, they don't have family close by."

Mauck pointed out the group discussions help the participants build confidence, and the clinic also offers resources to help ensure new parents can take the best care of themselves and their babies.

Shelmekia Hodo, maternal and infant health director for the March of Dimes, said her organization is also focused on reducing health inequities in Georgia, with programs to address postpartum care and preterm birth, plus maternal and infant mortality.

One is a Neonatal Intensive Care Unit Family Support program, to help improve the experience for new parents. Hodo noted the program has been around for more than 20 years, with more than 70 sites across the country.

"March of Dimes provides an in-house coordinator that is on-site in the NICU, that does patient education with the actual moms, as well as staff education," Hodo outlined. "We know that so many moms are facing so many challenges and barriers having to be away from their babies, with their babies being in the NICU."

She added Georgia took a big step last year to address the maternal mortality rate, by extending Medicaid coverage to low-income mothers to a full year after giving birth, instead of only six months.

With the increasing use of digital devices and computers in daily life, we're all exposed to more and more blue light. They may be convenient and help us stay connected, but prolonged exposure could pose real health risks.

One of those risks is interfering with the body's circadian rhythm, the "internal clock" which regulates a person's sleep cycle. Throwing it off can cause insomnia, headaches and eye strain.

Dr. Joseph Nezgoda, president of the Florida Society of Ophthalmology, said it does not mean a person should completely block out blue light, because a broad spectrum of light is needed throughout the day. But it is important to manage exposure.

"Individuals are just usually on their devices much longer and later than usual," Nezgoda pointed out. "Potentially during those times, it may be good to limit the exposure. Again, there's been convincing data in animal models, but in humans, the jury's still out."

One tip is scheduling an eye exam, others include taking breaks around every 20 minutes from digital screens, by looking at something else at least 20 feet away for 20 seconds. And of course, limit screen times before bed.

Dr. Scott Edmonds, chief eye care officer for UnitedHealthcare Vision, said eye specialists became concerned during the pandemic about blue-light exposure as more people started using digital devices for longer time periods at home. He worries soon, some of the same concerns will surface about blue light that happened with ultraviolet light.

"The photo receptors can certainly process blue light, but it puts a lot of strain on them," Edmonds noted. "We're concerned that over time, the retina will become damaged, and we'll start to see age-related macular degeneration from this, like we did with UV light."

In addition to taking screen breaks, eye-care professionals recommend making sure your computer screens are clear and clean, as researchers continue to study potential dangers.