DENVER — Colorado health-care advocates celebrated wins after the close of the 2019 legislative session, and now are working to ensure programs are implemented. Bills headed to Gov. Jared Polis' desk include the addition of a public insurance option, a measure allowing the state to buy medicine from Canada, and the creation of a reinsurance program designed to lower premiums.

The passage of House Bill 1174 should result in an end to surprise out-of-network medical bills. Adam Fox, director of strategic engagement at the Colorado Consumer Health Initiative, said bipartisan support for these protections has grown over the past several sessions.

"I think it's reached a threshold now with so many consumers being hit by these surprise bills, and so many legislators hearing about it - and some of them being hit by those bills themselves - that it really pushed this issue to the forefront,” Fox said.

HB 1174 protects people with state-regulated health plans. Fox said the measure also should act as a strong deterrent, but added the issue needs to be resolved federally to protect all consumers.

Some health measures did not advance. A proposal to increase drug-price transparency died over industry concerns about proprietary information. And a move to boost tobacco taxes to prevent addiction and fund education and health reinsurance was criticized as an unnecessary tax increase.

Fox noted while there were disagreements on some policies and on how others should be implemented, he saw bipartisan agreement on the need to address the underlying causes of rising health costs.

"There was less contention this session on health care in general,” he said. “There was a very high level of bipartisan agreement that health care was something they wanted to work on and could find some agreement."

Some measures need federal approval before moving forward, including the addition of a public health insurance option under the Affordable Care Act. Fox argued with premiums increasing every year, especially in western and rural areas with just one or two carriers, there aren't enough options for Coloradans to choose the health care they want.

"By creating a public option at the state level, we can sort of spur that innovation and competition and try to make the private insurance market a little bit more robust and competitive,” Fox said.

As part of World AIDS Day, a report finds through treatment, patients are able to suppress HIV - the virus that causes AIDS.

According to data from the Ryan White HIV/AIDS Program, in New York, almost 89% of people receiving medical care are virally suppressed.

While this is a little lower than the national average of 89.7%, it's an improvement since the disease reached its peak.

Dr. Laura Cheever - associate administrator of the HIV/AIDS Bureau at the federal Health Resources and Services Administration - described what makes viral suppression so important in fighting HIV/AIDS.

"We do not have a cure for HIV or a vaccine, but we have all the tools we need to end the HIV epidemic in the United States," said Cheever. "For someone who gets tested and started on medication and takes them every day, they can achieve what we call viral suppression - which means they're not cured, but we can't measure the virus in their body."

With viral suppression, a person with HIV can live a near-normal life and cannot transmit the disease sexually.

Cheever said one of the most important points about the disease is that anyone can get it - so anyone who is sexually active should be tested for HIV regularly.

And despite the major developments made in treating HIV/AIDS, there's still plenty of work to be done.

Cheever said she finds some of that work is getting people who test positive for HIV started on medical treatment - which means getting more people tested is a top priority.

"The work that's really in front of us is, first, getting people tested," said Cheever. "As I've said, one in eight people with HIV in this country don't know they have it, because they haven't been tested. For people that are tested and do not have HIV infections but are at high risk for acquiring it, they can be started on PrEP, pre-exposure prophylaxis."

She added that stigmas about HIV and AIDS persist, one of which is homophobia.

But with new treatment options available, people with HIV can live long and healthy lives.

Not everybody gets a holiday break, especially caregivers, but advocates of paid family medical leave in Maine say momentum is building for a plan to pass in the upcoming legislative session.

With Democrats in charge at the Statehouse and a ballot initiative which has already gained nearly 70,000 signatures, Mainers could get up to 16 weeks of paid medical leave a year.

Bridget Quinn, associate state director of advocacy and outreach for AARP Maine, said the pandemic exposed the difficulties many Americans face when a medical emergency strikes.

"Caring for a loved one shouldn't mean losing pay and risking your financial security, or even your job," Quinn asserted. "You should be able to do both and care for a loved one, while being able to remain in the workforce."

Maine has the oldest overall population of any state in the U.S. Quinn said by supporting caregivers, more Mainers can age in place and reduce reliance on taxpayer-funded long-term care facilities.

Studies show working women continue to do the majority of caretaking, whether for a new baby, a sick child or elderly parents, providing 20 hours of unpaid care a week, on average. Three-quarters of working mothers with low incomes report losing pay when they miss work to care for family.

Quinn pointed out the lack of a statewide paid leave plan can create greater financial hardships for women down the road, or cause them to simply leave the workforce.

"That can be time that you're not contributing to programs like Social Security, or benefiting from a retirement savings plan that maybe your employer could have," Quinn noted.

If approved, Maine would join 11 states and the District of Columbia offering paid family and medical leave, funded through a combination of employer and employee payroll taxes.

Maine lawmakers approved a bill last year creating a commission to study the issue, which is expected to release its recommendations next month.

Oregon nurses are urging state lawmakers to make hospitals better and safer places to work.

With the 2023 legislative session just around the corner, the Oregon Nurses Association is calling for changes to ensure minimum staffing standards based on patient numbers and accountability for hospitals so there are enough nurses on the floor.

Matt Calzia, director of nursing practice and professional development for the Oregon Nurses Association, said the lack of staffing has real implications for patients. For instance, if a nurse goes on break for lunch, another nurse assumes care of their patients, doubling the other nurse's workload during that time.

"So when you've just had knee surgery and if that period of time falls when you need your next pain medication dose, it may be delayed because right now your nurse actually has eight patients instead of four," Calzia explained.

Calzia pointed out turnover is higher now than during the Delta wave of the pandemic because nurses are burned out. According to the union, turnover was 2% in 2021.

Sean Kolmer, senior vice president of policy and strategy for the Oregon Association of Hospitals and Health Systems, countered under the union's proposal, "community hospitals will have no choice but to reduce access to services if they are unable to hire enough staff" and argued there is a staffing shortage in the state.

Paige Spence, director of government relations for the Oregon Nurses Association, said along with minimum safe staffing requirements, the union proposal would ensure Oregon's current staffing law is enforceable and provide accountability when nurses make complaints. In addition, Spence emphasized an annual review of the staffing plan would include the number of missed meal and rest breaks over the past year.

"To ensure that the staffing levels going forward are robust enough to accommodate nurses' abilities to take the rest break which they need for sanity and physical well-being, and also are entitled to by law," Spence stated.

Calzia refuted claims the state has a shortage of nurses.

"It's not a pipeline issue; it's a turnover issue," Calzia stressed. "You have more nurses leaving the bedside than you can get in, and then you're just burning through them."