DES MOINES, Iowa – Since Iowa expanded its Medicaid program in 2013, more low-income rural residents are covered by health insurance.

A new report from Georgetown University shows that coverage gaps in states where Medicaid was expanded are much smaller than in states that did not expand.

Anne Discher, executive director of the Child and Family Policy Center with the Iowa Department of Human Services, says only 15 percent of Iowa's low-income rural residents were uninsured in 2016.

That's compared with a nationwide high of 47 percent in neighboring South Dakota, which chose not to expand.

"I think that Iowa's decision to expand Medicaid to low-income adults has really paid off and it's paid off across the state, really, including folks who live in small towns and rural areas in every part of the state," Discher states.

In 2016, Iowa moved its Medicaid program away from federal and state management and hired private companies to run Medicaid programs and administer benefits paid for by the state.

Medicaid serves 685,000 low-income or disabled Iowans.

Study co-author Joan Alker, executive director of the Georgetown University Center for Children and Families, says the uninsured rate for low-income adults has dropped much faster in states that expanded Medicaid.

She notes that unlike some states where the gap between metro-area uninsured residents and rural residents is significant, Iowa is nearly equal.

"And rural areas are struggling for a lot of reasons,” she states. “They already have a higher poverty rate. Oftentimes they have higher unemployment rates. And so being uninsured is just adding another woe to these struggling communities."

Discher says Iowa is a healthier state because more residents have insurance.

"Health insurance is the key that opens the door to the health care system,” she points out. “Without insurance, you just can't get the kind of regular care that you need to be healthy, to be a productive parent and worker."

Parents make up about half of rural low-income uninsured adults, many of whom are relied on by children as parents, child care providers, teachers or other caregivers.


get more stories like this via email

CARSON CITY, Nev. -- Eye exams can help determine your risk of dying from COVID, according to experts, because optometrists are often the first medical professionals to notice symptoms of diabetes.

A 2020 study in the Journal of Diabetes Science and Technology found people with diabetes are more than four times more likely to succumb to COVID than non-diabetics.

Dr. Scott Edmonds, optometrist and chief eye care officer at UnitedHealthcare, said getting treatment for diabetes will improve the odds against COVID.

"A well-controlled diabetic will fare better in the face of COVID infection than someone who is an uncontrolled diabetic," Edmonds explained. "And often that difference between controlled and uncontrolled is seen in the eye exam, as opposed to other tests."

Optometrists will suspect diabetes if a person is obese, or has a family history of diabetes, and if a younger person's prescription changes suddenly, if the patient starts to develop cataracts before age 60, or if small hemorrhages are visible under a microscope.

Edmonds noted if a patient is diagnosed as diabetic or pre-diabetic, the optometrist can recommend they take preventive measures against COVID.

"Then we can have that person take more precautions," Edmonds advised. "Being more careful with their masks, maybe talk them into getting a vaccine if they weren't otherwise inclined because now they're at higher risk."

He added so-called "long-haul" COVID can cause neurological changes that result in double vision, blur and eye strain, especially when someone is sitting in front of a computer screen.

FRANKFORT, Ky. -- In a few weeks, Kentucky lawmakers will convene the General Assembly, and health advocates are calling for new policies to address systemic inequities linked to poor health outcomes.

Vivian Lasley-Bibbs, board chair of the Foundation for a Healthy Kentucky, said the Commonwealth is at the top of the list for cancer-related deaths, smoking rates and depression, and trailing behind on rates of exercise, eating fruits and vegetables, and getting enough sleep.

She pointed out broader factors such as poverty and education are directly tied to residents' health.

"And some of the areas we're looking at include health-care coverage and accessibility, sufficient and equitable school funding, and we're looking at access to quality pre-Kindergarten and child care," Lasley-Bibbs outlined. "Those things are really those predictors of long-term health outcomes."

Lasley-Bibbs pointed to the pandemic as a glaring example of how racial inequities burdened Black and Brown populations with higher rates of COVID-19 exposure, hospitalizations and deaths. She added before the pandemic, Hispanic Kentuckians, who face greater obstacles accessing health care, were at higher risk for diabetes and pre-diabetes.

Lasley-Bibbs emphasized she hopes next year state lawmakers will consider how factors such as genderism, sexism and racism are impacting Kentucky families' long-term health outcomes.

"Those are the true issues that are driving the disparity gap," Lasley-Bibbs asserted. "We need to start thinking about those, instead of just thinking about those risk factors for chronic disease."

She added the state continues to make strides reducing the use of tobacco among residents; a habit linked to heart disease, cancer and premature death.

"We still feel like that's the number one area where I think we've made the greatest improvement so far," Lasley-Bibbs observed. "We know that Kentucky is number one in lung cancer deaths, so that's still one of our priorities."

Data show packs of cigarettes sold in the state are on the decline, more Kentuckians now report they are considering quitting smoking, and about half of Kentucky adults say they believe e-cigarettes are just as harmful as traditional cigarettes.

TUCSON, Ariz. -- With the holiday season beginning and family gatherings planned, Arizona public-health officials have some tips for staying safe.

The rates of new COVID-19 cases and hospitalizations have grown dramatically in Arizona in the past few weeks, but with a few basic precautions, most families can enjoy a get-together at grandma's house.

Paula Mandel, deputy director of the Pima County Health Department in Tucson, said adults who have received their first or second dose of a COVID vaccine should consider getting a booster. And for adults or kids who are unvaccinated, she said there is still time to get a shot.

"When you do this, you're not only protecting yourself," Mandel explained. "You're helping to protect those that you don't know what their vaccination status is and may be high-risk, like young children or our elderly population."

According to data compiled by the New York Times, new cases of COVID-19 in Arizona are up 31%, and hospitalizations up 25%. Statewide, only 54% of Arizonans are fully vaccinated.

Mandel advised bringing any questions you may have about vaccination to your doctor or pharmacist.

Mandel also recommended if you do not know the vaccination status of everyone at a gathering, it is a good idea to wear a mask, wash hands regularly and make sure the house is well-ventilated. She said you might consider taking advantage of Arizona's great fall weather.

"If you're coming together with individuals and they're not people that you see on a routine basis, they don't live in your home or they don't visit your home frequently, maybe consider -- because of our lovely weather that we've had recently -- maybe have your gathering outside," Mandel suggested.

While people are looking forward to seeing friends and family, in some cases for the first time in months, Mandel pointed out using common sense will make for a better holiday gathering. She added the COVID vaccination is not the only one to consider.

"We are heading into flu season," Mandel stressed. "All of those things that we talk about are the same. If you haven't, it's not too late to think about getting vaccinated."

For a comprehensive list of locations providing no-cost vaccines, check with your county health department.