OLYMPIA, Wash. — Washington state's bid to expand health care coverage to all is in its final stages of negotiations at the Capitol. Cascade Care is Gov. Jay Inslee's proposed plan to provide affordable insurance to all Washingtonians.

Bills have passed in both the House and Senate, but Ashley Sutton, health policy associate with the Economic Opportunity Institute, said she’s concerned a version currently moving through the Legislature has been stripped of the provisions that gave Cascade Care its teeth, including a cap on provider reimbursement rates at Medicare levels. She said studies have shown this measure would drive down premiums for everyone.

"When we cap the reimbursement rate at Medicare levels, we see what's called the spillover effect, where it actually creates cost reductions across the entire health insurance market,” Sutton said. “So, essentially, people on employer-sponsored insurance, private insurance, would also see the benefits."

Health industry groups have opposed the cap because they believe the rate is set too low.

Sutton said the bill as amended also weakens an original provision that created state-designed standard plans through the Washington Health Benefit Exchange by allowing non-standard plans to be offered after 2025. She said the standard plan provision was a key component for bringing down deductibles.

Suttons said Washington state's top ten health insurance executives earned nearly $80 million combined in 2018.

"This industry can afford to rein in cost without harming Washington families,” she said. “And so the Medicare reimbursement provision as well as the standard plan design are both components we need to have."

The legislative session is scheduled to end on April 28.


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Seven cases of H5N1 avian flu have been reported in Michigan since Dec. 16. The first case was discovered at a poultry facility in Ottawa County.

Avian flu circulates in wild birds and can infect poultry, causing illnesses classified as highly or low pathogenic. Michigan's first cases in 2022 introduced a highly pathogenic strain.

Dr. Kimberly Dodd, dean of the College of Veterinary Medicine at Michigan State University and an infectious disease expert, explained why the initial outbreak was unique.

"Generally, once it comes to wintertime the number of cases drop off and sometimes that's all we see at the outbreak, and it's resolved," Dodd noted. "In this case, the outbreak continued over the winter and spread across the entire country."

The recent outbreak has affected more than 340,000 birds. Early findings showed the virus also infecting wild mammals, especially young carnivores and scavengers, later spreading to marine mammals near infected waterfowl.

As of now, avian flu has been detected in 30 dairy cattle herds across Michigan. The initial case, reported in March 2024, marked the first instance of avian flu in dairy cattle in the U.S. Since then, the virus has spread to additional herds around the state. Dodd pointed out dozens of domestic and wild cats were also infected after the virus spread to dairy cattle.

"We think this is primarily due to the fact that these barn cats may have access to raw milk on the farm," Dodd emphasized. "We know that raw milk contains high levels of virus."

The Centers for Disease Control and Prevention has reported 67 confirmed human cases of avian flu in the United States, with one death reported in Louisiana. However, the CDC views the situation as a low health risk to the public.


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The Medicaid and CHIP programs are vital to rural Missouri, according to a report that says reliance on this safety-net health coverage is much higher in small towns than in cities - especially for children.

The Georgetown University report says proposed federal cuts threaten rural communities, where nearly 41% of children rely on Medicaid, compared to 38% in metro areas.

Dr. Shanon Luke, a pediatrician at a Federally Qualified Health Center in rural Missouri, said her clinic is essential to a community where the nearest hospital is 45 minutes away.

"The clinic being open is incredibly important to these kids receiving healthcare," said Luke. "Having Medicaid allows them to come in for their well-child checks, and for us to do some monitoring and treating of things before they get to scary points."

The report says to stay afloat, many rural hospitals have already been forced to close less profitable units. In 2022, 52% eliminated their maternity wards, compared to 36% of urban hospitals.

The report also reveals disparities, with about 40% of American Indian and Alaska Native people more likely to live in non-metro areas without access to adequate healthcare.

Joan Alker is the executive director and co-founder of the Center for Children and Families at Georgetown University. She said Medicaid helps recipients through much-needed preventive care.

"People wind up sicker and then, they're in the emergency room," said Alker, "and children can't get their asthma inhalers and they miss school."

Statistics show Medicaid helps prevent medical debt, covers most nursing home residents, and funds a significant portion of births and maternal care - issues Dr. Luke said her patients are familiar with, firsthand.

"For our families, both financially and medically, as well as mentally," said Luke, "it's really important to know that they have that coverage."

Just over 24% of Missouri's population lives in rural areas.

This month is National Blood Donor Month, and blood donor groups are making sure people know the importance of giving blood.

Blood can't be manufactured, so people need to donate blood at their local blood bank. Nearly 400 people a day donate blood to the American Red Cross in the DMV metro area.

Bethany Bray Patterson, communications director of the National Capital and Greater Chesapeake Region of the American Red Cross, said donor blood is used in a variety of medical situations.

"Donated blood," said Patterson, "goes to people who are heading into surgery, fighting cancer, newborn babies in the NICU and people who are living with sickle cell disease and other chronic illnesses."

Patterson added that someone in the U.S. needs a life-saving blood transfusion every two seconds.

However, only 3% of eligible donors donate each year. According to America's Blood Centers, if just 1% more of Americans donated, blood shortages would be alleviated.

Patterson said the blood supply in the country is stable, but organizations like the Red Cross are also on the look out for universal donors.

"There is an increased need right now for type O blood donation, and platelet donations," said Patterson. "Type O blood is always in demand. It's often going out to hospitals faster than it's coming in through blood donation, because it is the universal blood type. It's used the most by hospitals."

You can find blood donation locations and schedule an appointment at RedCrossblood.org.




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