COLUMBUS, Ohio — Researchers say national talk of turning Medicaid into a block grant program could threaten health-care coverage for vulnerable kids in Ohio.

States currently share the cost of Medicaid with the federal government. With a block grant, states would get a set amount of money and would need to cover any differences if the program exceeded costs. Supporters say it would make the program more efficient.

At the Center for Community Solutions, researcher Loren Anthes countered states could end up restricting who qualifies or reducing services in order to save money.

"You suddenly are putting state policy makers and the state department of Medicaid into a very difficult position where they're making toxic tradeoffs between who is and who is not deserving,” Anthes said. “The most likely victims of that budget consideration are going to be the people with the biggest needs."

Medicaid covers more than 1.1 million Ohio children, and about 60 percent of Medicaid beneficiaries nationally who are younger than age 19 have a disability. Anthes said because they have higher health-care costs, services for children with special needs would be the most susceptible to cuts.

He added the next target for cuts could be children - the second largest group for Medicaid expenditures.

Supporters contend block grants would give states flexibility with their Medicaid dollars, and perhaps the ability to address other enrollee needs, such as housing or food. Anthes said there are many drawbacks that should be considered.

"Before policymakers put forward something that may sound good, let's talk about this in terms of dollars, cents and in terms of your constituents, maybe your family members, and really try to outline what some of the impacts of these choices may be,” he said.

Anthes contended rather than experiment with access for children or others who rely on Medicaid as a way to control costs, it would be wiser to examine why prices are high in the first place.

"What are things that are happening that are costing us tens of millions of dollars that have nothing to do with people who rely on this coverage?” he offered. “So let's talk about price, let's not fiddle with things that could potentially compromise access to care for children."

President Donald Trump's budget proposal calls for cuts to Medicaid and block-grant funding, and the Centers for Medicare and Medicaid Services reportedly are drafting a plan to encourage states to apply for a waiver to implement their own block grants.

A new survey shows many young people are worried about losing access to birth control.

The survey from the nonprofit Power to Decide found that about seven in 10 young adults think the U.S. Supreme Court's decision to overturn Roe v. Wade, which protected the right to an abortion, will also limit access to birth control. Federal lawmakers have stepped in with the "Right to Contraception Act," which passed in the U.S. House but stalled in the Senate.

Tara Mancini, director of public policy for Power to Decide, said the fate of the bill rests in part with people demanding some action on it.

"If they're interested, they could also ask their senators to bring this to the floor and pass this bill," she said, "which I'm sure the president will sign if it comes to his desk."

In 2018, Tennessee approved the Comprehensive Contraception Act, to provide insurance coverage for birth-control drugs, devices and products approved by the Food and Drug Administration. Mancini added that more funding for the Title X program could help, so more clinics can offer family planning and STI testing services.

In the survey, about half of people ages 18 to 29 said they believe birth control is going to be harder to get in the future. Mancini pointed out that increased funding for Title X could also reduce the number of "contraception deserts," including in parts of Tennessee.

"We know that millions of people in the country already live in areas where there's not reasonable access to the full range of contraceptive birth control methods," she said, "including over 406,000 women in Tennessee."

Mancini added that there's still a stigma associated with birth control, including the myth that it's easy and inexpensive to access, or that one method is best for everyone. She said her group works to ensure that people have access to a wide range of options.

"Another myth is that birth control is just for preventing pregnancy," she said. "Obviously, that's the main reason that people use it, but people use it to help control different health conditions as well. So, that's important - that people also have access to it for whatever reason they need it."

Mancini said she feels hopeful about the future of birth control, since the survey found it is widely accepted across ethnicities and the political divide.

North Dakota has a new survey online seeking information on how to better address the needs of people with autism.

Right now, state officials admit there are knowledge gaps which may be hindering the care people on the autism spectrum are getting. Parents, educators, law enforcement agencies, service providers and people with autism are being encouraged to fill out the survey, to see if they know what services the state offers or think there should be others.

Katherine Barchenger, autism coordinator for the North Dakota Department of Human Services, said the biggest knowledge gap is between health care providers and schools.

"Another gap is our law enforcement and how to handle a child that has autism and how to approach them, how to keep them calm," Barchenger explained. "Families are searching. They are trying to find areas that can best help them keep their child at home, and keep their child successful."

She added the state will use the information to educate the public, including the very people they are soliciting responses from, to find and implement ways to be more supportive of people on the autism spectrum. The survey is online and open through the end of the month.

Barchenger pointed out the needs of parents of autistic children are often overlooked, because the focus is typically on the demands of the child. She noted one of the most important factors in addressing the gap is to help parents get the rest and support they need.

"Because that is a full-time task, for kids who are very smart or sometimes are runners, so they get out of the house a lot," Barchenger emphasized. "You have to be on top of them constantly, so parents need a break."

She added the Autism Spectrum Disorder Task Force will make recommendations to the North Dakota Legislature when lawmakers convene in January.

It's tough to find workers for Idaho's health clinics right now, but an apprenticeship program is hoping to address these woes.

Nearly three years of the pandemic have led to turnover and burnout in the medical field, and workers are hard to find with unemployment numbers so low.

To deal with the crunch, the Idaho Community Health Centers Association is collaborating with North Idaho College and the Idaho Department of Labor on a statewide apprenticeship program where students can earn while they learn.

Robin Donovan is the program manager of workforce development for the association.

"We know that there's a huge shortage for medical assistants and dental assistants, and those are a little bit more entry-level positions coming into a clinic," said Donovan. "It doesn't require a degree. And so we looked at ways to bring these apprenticeship programs across the state."

Donovan said the goal was to create a program that wouldn't be a burden for their organization or clinics to manage.

Since January, one student has graduated from the dental assistant program and six more expected to graduate this month.

The dental assistant apprenticeship is four and a half months and the medical assistant apprenticeship is eight and a half months.

Students not on North Idaho College's campus in Coeur d'Alene work with clinical preceptors, or experienced clinicians in their community.

Marty Matney - manager of health, occupations and careers for the North Idaho College workforce training center - said the pandemic has shown the school how it can be successful at a distance.

"We're very successful in our medical assistant apprenticeship because we've benefited form COVID, if you can believe that," said Matney, "in that we have learned how to take a program that is largely hands on and put it online."

Donovan noted that the apprenticeship program also can create career ladders for people, and says that program helps local communities.

"They're 80% more likely to stay in that clinic in that community and continue working," said Donovan. "So it's a great retention tool for the employer to offer those types of trainings."

Matney said higher education is adapting post-COVID.

"Higher ed is playing a role right now by being flexible and responding to the needs of the community," said Matney.

Support for this reporting was provided by Lumina Foundation.