CARSON CITY, Nev. — The Affordable Care Act is in danger again as the Trump administration is back in federal court in New Orleans today fighting to overturn it.

A judge on the 5th Circuit Court of Appeals will hear oral arguments in the case that pits the Justice Department and 18 conservative-led states who want he healthcare plan thrown out against Nevada and 15 other states, and the House of Representatives, who are defending the program. Caroline Mello Roberson, state director of the National Abortion and Reproductive Rights Action League in Nevada, said if the ACA is overturned, many people would suffer.

"My thoughts are primarily with the hundreds of thousands of Nevadans who have health insurance thanks to the ACA and have access to things like no co-pay birth control,” Roberson said.

About 20 million Americans gained health care when some states expanded Medicaid with money from the Affordable Care Act. The act also established important protections for people with pre-existing conditions and imposed lifetime caps on the amount patients would have to pay. It also allowed young people up to age 26 to stay on their parents' insurance.

Opponents have said the ACA amounts to an unconstitutional mandate to buy insurance.

Chip Evans, co-founder of Indivisible Northern Nevada, said there would be chaos if the Affordable Care Act is dismantled with nothing to replace it.

"It creates more problems than it fixes,” Evans said. “Every piece that you take out of the ACA, you take it out of people's economic security."

The Supreme Court upheld the law after a prior challenge, and could well see it again, depending on the outcome of this case.


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Small-business owners in North Carolina are reaching out to legislators for help, citing hospital mergers as one reason their health-care costs are soaring.

The fusion of former hospital competitors has left employers in the state with fewer options for services, as well as higher expenses for both companies and workers, which could ultimately hinder business expansion.

State Treasurer Dale Folwell revealed that even at the top levels, they're grappling with challenges such as cost transparency.

"The fact," he said, "is that this is the only product in your life that you don't know the value and the price of it, even after you have consumed it."

In a recent national poll, 45% of entrepreneurs said soaring health-insurance costs have forced them to hit the brakes on expanding their businesses. The majority of companies in North Carolina are small businesses, but together they employ more than 1.7 million people. So, Folwell said, the higher rates could signal lasting economic impact.

Greater NC Black Chamber of Commerce regional president Valerie Benton Smith stressed the urgent need for affordable, quality health care for businesses to stay competitive. She emphasized that without regulations on hospital consolidation and pricing, small companies in particular will keep facing obstacles.

"Small-business owners struggling with the expense of providing health-care benefits to their employees face a stark choice when costs rise," she said, "drop or cut health-care benefits, making it hard to attract quality candidates or divert funds to health care."

She said addressing the growing burden of escalating health-insurance costs is essential to ensure the growth and stability of small businesses. In the survey by the group Small Business for America's Future, 86% of business owners said they believe federal and state governments should actively intervene in health-system consolidations.

Doctors in Iowa are studying the brains of babies to learn more about sleep patterns in adults and teens.

The United Health Foundation reports one-third of Americans don't get enough sleep, and about 30% of Iowans fall into that category, which can lead to poor health and affect decision-making abilities. Cognitive processing, mood, blood sugar levels and immune response all are regulated by sleep.

Dr. Ravi Johar, chief medical officer at UnitedHealthcare, said one of the best things someone can do for their health is to prioritize getting enough rest.

"Adults from about 18 to 60 need between seven and nine hours of sleep per night," he said. "Adults 61 to 64 are maybe a little bit less, seven to eight; and adults 65 and over usually need about seven hours of sleep a night."

Johar said insufficient sleep is a risk factor for many chronic diseases, including cancer, depression, diabetes, hypertension and obesity. March has been Sleep Awareness Month.

While sleep research often focuses on teens and older adults, doctors at the University of Iowa are studying neonatal sleep patterns to learn what they can apply to the rest of the population. They have a deep pool of research candidates, because babies sleep so much.

Sleep researcher Mark Blumberg, a professor of psychological and brain sciences at the University of Iowa, said babies also get more of what's known as "REM" sleep than most adults, giving doctors even more to study.

"When you see that there is specific activity, and a lot of activity that is specifically occurring during sleep - even more in some cases than we see during wake - that occurs in early life," he said. "And then, you have to couple that with the fact that we sleep most when we're young. So, you know, when we're born, we spend 16 hours of each day asleep."

Blumberg said the university is now ramping up research on babies who were born prematurely and those less than six months of age, and he's looking for parents of children who fit those guidelines to advance his work.

Two Atlanta facilities are the latest hospital closures in Georgia, reflecting a trend for more than a decade that's left tens of thousands of people without access to hospital care, both in rural and urban areas. The New Georgia Project's "My Hospital, My Community campaign" is fighting to reopen the WellStar Health System facilities.

At the most recent Level One trauma center that closed, said Kierra Stanford, the campaign's lead organizer, more than half the local population is Black. She noted that Atlanta Medical Center blames the closures on Medicaid not being expanded in Georgia. Policymakers and community leaders have asked federal officials to investigate the shutdowns.

"Fulton County Chair Commissioner and the IRS have filed federal complaints with WellStar Health System," Stanford said. "These federal complaints basically call WellStar out for closing these hospitals under the guise of they didn't have the funds, they were losing profits."

Stanford said local residents have told her they've either missed out on their regular checkups or have to get to other hospitals, where they report longer wait times. A statement from WellSstar's CEO said they had been seeking partnerships to stay open, but were unable to secure them because of AMC's infrastructure and finances.

Stanford explained that the lack of access to quality health care is a growing disparity for communities of color. The New Georgia Project's campaign has also expanded into several rural counties including Calhoun, Randolph and Stewart - where, in some cases, people have to travel many miles to another county or state for primary care.

"And they tell me that they have to drive 40 minutes or an hour into Alabama to go to a hospital," she said. "They tell me that they call the ambulance and it takes two hours for an ambulance to come. And I asked them, 'So, what do you guys do?' And they say, 'People die.'"

In an Associated Press article, Atlanta Mayor Andre Dickens said the WellStar Health System didn't give the city a chance to assist or the advance notice that could have helped prevent closing the hospitals.