AUGUSTA, Maine – Friday is the last day of open enrollment for health insurance through the Affordable Care Act for 2018, a deadline even those with insurance should heed.

The open enrollment window was cut in half this year and the federal budget for advertising it was slashed by 90 percent.

But Scott Mulhauser, a board member with the Consumers for Quality Care, points out that despite efforts to repeal the program, it's still working, and it's important for everyone who needs insurance and those already in the marketplace to look at what's available.

"Even if you plan to keep the same policy, if you're looking for a new one, plans and policies are constantly changing, and this is the crucial moment to take note of what best serves your needs," he states.

To enroll or change your plan you can go to www.healthcare.gov.

With all the negative comments in the news about skyrocketing premium costs, some people may believe marketplace insurance is now simply unaffordable.

Mulhauser acknowledges that costs have gone up.

"But subsidies are going up in a lot of states, too,” he stresses. “And so what that means is you may still be able to find a good deal, but you can only take a look in these final days."

Navigators are available to help consumers pick the right plan.

Mulhauser adds that some policies may change their prescription plans, their co-pay or co-insurance requirements.

So getting that help can be critical because the changes can be confusing.

"It leads to coverage denials,” he points out. “It leads to increased costs. So for Americans shopping on healthcare.gov or in state marketplaces, they are open for business, but it's a shorter enrollment this year. And so it's important to shop around and pick the plan for you."





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Farmworkers in South Carolina and across the U.S. face scorching heat with little protection at the federal and state level. However, the Farm Labor Organizing Committee is taking steps to enhance worker safety.

The group is ramping up heat protection guidelines for migrant workers in the South through an existing rule. Originally negotiated in 2006 with the North Carolina Growers Association, the rule aimed to address heat-related incidents. Now, it is being strengthened to improve conditions for more than 9,000 farmworkers.

Baldemar Velasquez, president of the committee, believes the efforts are key in safeguarding workers where legal measures do not.

"The problem with legislation, whether it's the federal or state, it takes forever," Velasquez asserted. "Enforcement is always an issue because we're not talking about big factories with a lot of workers. We're talking very remote labor camps, isolated, and so it's important that workers know how to take action on their own."

He noted under the new guidelines, workers who are a part of their union take heat safety into their own hands. The rules say if it is getting close to 85 degrees and workers have symptoms such as dizziness or nausea, they should take a break in the shade and drink water, no matter what the boss said. When it hits 95 degrees or more, breaks are supposed to happen every couple of hours.

According to the Centers for Disease Control and Prevention, 67 people died from heat-related deaths from 2016 through 2020 in South Carolina.

Mario Vargas, lead organizing development coordinator at the Campaign for Migrant Worker Justice, shared his 15 years of firsthand experience. He vividly depicted the challenges faced by workers, such as tall crops blocking the wind and constant pressure from employers.

Recognizing the urgent need for change, Vargas and his organization are teaming up with the committee to go beyond guidelines. They are prioritizing education.

"Because if you say, 'Oh, we got another 100 feet to go so we can finish the row,' you might not make it to the end of the row," Vargas pointed out. "You need to stop and find some shade and drink some water. We let them know their rights, that they have a right."

The group will be teaching farmworkers about the new guidelines, signs of heat stress, how to stay hydrated and when to seek medical help. Vargas added they will also have support channels to report issues or pushback to ensure their well-being is not compromised.

Last week, Walmart became the latest major retailer to retreat from providing direct health-care service by announcing closures of all its health clinics and virtual health-care operations.

However, Florida's health centers say they are ready to fill the gap.

Florida is home to most of the soon-to-be-shuttered health centers - 23 of the 51 centers are now winding down operations in the Sunshine State, where they offer various services, including medical, dental, and behavioral health care.

Benjamin Browning - vice president and COO of the Florida Association of Community Health Centers - said many have tried to figure out the complexities of delivering health-care services, which doesn't always work.

He said the current concern is ensuring displaced patients, often in rural underserved areas, can still access care.

"Fortunately," said Browning, "the community health centers are positioned throughout the state to be able to welcome those patients, to encourage those patients to come and visit and receive their primary-care services."

In a statement, Walmart cited the challenging health-care reimbursement landscape and rising operating costs as reasons for the closures.

Additionally, Walgreens is closing 160 VillageMD clinics, Amazon is cutting jobs at One Medical and Amazon Pharmacy, and CVS Health plans to shutter dozens of pharmacies in Target stores.

Browning said their model of providing care is embedded in their name - building community.

When a patient enters their facility, they might also be connected to additional services. He said the model is financially challenging, but they've been working to perfect it.

"There is a level of streamlining," said Browning. "There is a level of efficiency that is maximized to the extent possible, within the health centers to provide for those patients that can and cannot afford to pay the full bill."

Walmart expects the closures to occur within three months and will now focus its health business on its nearly 4,600 pharmacies and more than 3,000 vision centers across the United States.

Community Health Centers are in all of Florida's 67 counties, serving patients in more than 800 locations - including dozens of mobile units and school-based sites statewide.

Michigan farmers are responding to the new Avian Flu "Extraordinary Emergency" order from MDARD, Michigan's Department of Agriculture and Rural Development.

New safety guidelines must be in place by this Wednesday that affect all dairy and poultry operations in the state.

The guidelines include the designation of a biosecurity manager, establishing a perimeter that limits access to livestock, and implementing cleaning and disinfection procedures at those access points.

Chief Medical Executive for the state of Michigan, Dr. Natasha Bagdasarian, said the most severe cases of the Bird Flu seem to be in poultry.

"Poultry don't recover well from this virus," said Bagdasarian. "This is a highly pathogenic virus in poultry and the dairy cows do tend to recover, even though their milk production is slowed down."

M-DARD first detected Avian Flu in Michigan dairy cattle on March 29 of this year. The disease has since been detected in more dairy herds and commercial poultry flocks in 7 counties.

The emergency guidelines also include farms maintaining a record of vehicles and people who cross access points.

Regarding the health risks for humans, Bagdasarian said there is some positive news amidst the crisis.

"We had a number of workers who had been exposed, but very few have been symptomatic," said Bagdasarian. "And no one who has been symptomatic and tested for the virus, had tested positive. So, that's really good news. "

The Food and Drug Administation continues to advise against drinking raw milk and recommends that the dairy industry does not manufacture or sell raw milk or raw milk products.



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