CHARLESTON, W.Va. - West Virginia pregnancy-care providers want lawmakers to "pass the buck" by raising the state cigarette tax by $1 a pack.

With a big hole in the state budget, the $150 million more a year in tobacco revenue looks appealing. But doctors here also hope to reduce the rate of smoking by pregnant women here, which now is the highest in the country.

Amy Tolliver, director of the West Virginia Perinatal Partnership, said the sticker shock from a big tax hike would help, and as a result reduce problems such as low birth-weight babies.

"Smoking in pregnancy drives our pre-term birth rate, it causes an impact in the fetal brain development, and it's costing us as a state," she said.

Critics oppose raising any taxes, and have argued that this one would fall hardest on the poor. Supporters have said the state spends more than $1 billion a year on smoking-related health-care costs, but only brings in 17 percent of that through tobacco taxes.

According to projections from the Campaign for Tobacco-Free Kids, the tax hike would mean 2,700 fewer West Virginia pregnancies affected by smoking over five years, resulting in $6.5 million in health-care savings. Moreover, Tolliver said those premature and low birth-weight babies have lifelong health problems. From day one, they're more likely to end up in intensive care, which is expensive.

"If we could impact that and reduce the number of pre-term births and those babies that need additional high-level care in our neonatal intensive care units," she said, "we could impact the Medicaid budget."

Critics of the tax hike have also pointed out that smokers will resent it. However, Tolliver said most smokers want to quit long before they do, and research has proved that higher tobacco prices help them quit. She said that's especially true for pregnant women.

"Women are driven to try to quit smoking. They want to do the best thing for their baby," she said. "Pregnancy is a time when we can have the biggest impact on helping those women quit."

More information is online at wvperinatal.org and tobaccofreekids.org.


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Some New York health care facilities are getting a funding boost to help train the next generation of doctors and dentists.

The U.S. Department of Health and Human Services is awarding $155 million to Teaching Health Centers nationwide, operating primary-care medical and dental residency programs. More than $12 million will go to centers in New York State.

Carole Johnson, administrator of the Health Resources and Services Administration, said she is excited to see the centers doing the legwork to develop training programs.

"You have to be able to demonstrate that you have the staff to do the training," Johnson asserted. "That you have the predecessors, that you have all those critical parts in place so that we're getting good, skilled clinicians through these programs."

In addition to medical and dental programs, a special emphasis has been placed on psychiatry residencies, with the hope of providing underserved communities with greater access to mental-health services. The funding comes at a time when health care workers are facing burnout in large numbers as a result of the COVID-19 pandemic.

The hope for the programs is medical residents will then stay to set up their practices in the communities where they are trained.

According to Johnson, health-center leaders believe this program will create a conduit to the health care workforce. But she feels it will also allow young health care professionals to understand what it is like to work in different environments.

"We want them to know what it's like to work with clients who have challenges getting child care, or getting transportation to the clinic to make their health care appointment," Johnson noted. "To really experience how to provide care to individuals who lead complicated lives and have other challenges in accessing health care services."

The bulk of the funding for these awards comes from the American Rescue Plan, approved by Congress in March 2021.

California is poised to become the first state in the nation to give health care to all income-eligible residents, regardless of their immigration status.

The Legislature is set to pass the final budget bills this week, which will be signed by Gov. Gavin Newsom shortly thereafter.

Cynthia Buiza, executive director of the California Immigrant Policy Center, said it is the fulfillment of an almost decadelong push by the Health4All campaign.

"This is very timely, but also long overdue," Buiza asserted. "Because for many, many years, many of our immigrant workers who have contributed tremendously to what makes California, California, have gone on without this very important safety net."

The budget deal represents a huge step toward universal health coverage and is expected to benefit about 700,000 people, starting in 2024. Opponents cite the cost: The budget includes $625 million to cover the first six months of 2024, and then allocates $2.1 billion per year.

Beatriz Hernandez, Central Valley organizer for the California Immigrant Policy Center, said it will make a huge difference in people's quality of life.

"This means that they will finally be able to get the health care that they need to care for the chronic illnesses that they've been suffering for many years," Hernandez pointed out. "And also be able to get the checkups that they need."

The deal marks the final push to expand Medi-Cal to all low-income Californians. In 2015, the state expanded Medi-Cal to include undocumented children. In 2020 the program grew to include young adults, up to 26 years old. And this year the program began to accept undocumented adults, age 50 and older.

The ruling on abortion by the U.S. Supreme Court has returned the issue to the states, fulfilling long-held goals of Republican lawmakers in Texas to ban and criminalize abortion.

With the 49-year-old Row v. Wade case overturned, a trigger law takes effect next month, banning abortions from the moment of fertilization - there is no exception for rape or incest.

Texas lawmakers were ahead of the high court, passing legislation last fall to prohibit abortions after six weeks. Aimee Arrambide, executive director of the Texas chapter of the abortion rights group Avow, said she expects half the states to follow Texas' lead.

"We've been ringing the alarm that what is happening in Texas, doesn't stay in Texas," said Arrambide. "And that the public health crisis Texans have been facing for nearly 10 months will be the reality in half the country. Our opponents are not going to stop until abortion is completely inaccessible in the country."

In his concurring opinion with the 6-3 vote, Supreme Court Justice Clarence Thomas said high court rulings that established a right to contraception, as well as gay rights should also be reconsidered.

Following the ruling, Texas GOP Gov. Greg Abbott said abolishing Roe v. Wade, "reinstated the right of states to protect innocent, unborn children."

New Mexico is now the closest state for many Texans seeking an abortion, but getting there may not be possible for low-income people who don't have the time, money or child care to travel out of state. Progress Texas Advocacy Director Diana Gomez said education is the next step.

"There are a lot of folks who don't know about the existence of abortion funds," said Gomez, "of infrastructures that are already in place to help people get abortions, and so we want to let people know about clinics in surrounding states."

In addition to Texas, 25 other states are expected to make abortion illegal, affecting the lives of 36 million people. University of Texas at Austin Associate Professor Kari White said entire regions of the country may soon be in the business of extreme criminalization.

"In a state like Texas," said White, "it's also going to criminalize a whole range of behaviors and practices for people who are trying to help someone get an abortion."

Prior to the court's ruling, a poll by Reuters showed about 71% of Americans - including majorities of Democrats and Republicans - believed pregnancy termination should be a patient-doctor decision.