HARRISBURG, Pa. – A new report outlines severe consequences for hundreds of thousands of Pennsylvanians if the Affordable Care Act is repealed.

The Trump administration wants a federal appeals court to uphold a ruling that says the Obama administration's signature health-care law is unconstitutional. If the Fifth Circuit Court of Appeals agrees, the case is likely to go to the Supreme Court.

According to the report from the Pennsylvania Budget and Policy Center, repealing Obamacare would have a devastating impact on health, health-care costs and jobs in the Keystone State. Center director Marc Stier said repealing the ACA would return the number of people in the state with no health insurance to where it was 10 years ago.

"Full repeal of the ACA would leave about 1.5 million people without insurance, 14.4% of the state's population," he said. "That's an increase of 858,000 people."

Opponents of the law have said that eliminating the penalties for not having health insurance made the mandate that everyone must buy health insurance unconstitutional.

In Pennsylvania, Stier said, ACA repeal would lead to a 116.8% increase in demand for uncompensated care, costing hospitals $1.8 billion a year.

"They may find themselves losing a significant amount of money," he said, "and in rural areas, as well as some urban areas, where a large proportion of the population will now be uninsured, we may see hospitals go under."

Pennsylvania is among the top 20 states the report said would see the largest increases in demand for uncompensated care. Repeal also would result in the loss of about 137,000 jobs in Pennsylvania, increases in prescription drug costs for seniors, and a loss of insurance coverage for young adults. Stier said coverage for pre-existing conditions could be eliminated or become extraordinarily expensive.

"And that affects everyone who has health insurance," he said. "It doesn't matter whether you get it through one of the Affordable Care Act institutions or you get it through your employer, or you get it through an individual market."

The report said more than 426,000 Pennsylvanians get their health coverage through the insurance exchange, and most qualify for tax credits to help with the cost.

The report is online at krc-pbpc.org.

March is Sleep Awareness Month and health experts say Americans are not getting enough of it.

United Health Foundation data found more than 32% of those surveyed said they got fewer than seven hours of sleep, although the rate was slightly better in Oregon at about 28%.

Dr. Kimberly Hutchison, associate professor of neurology and sleep medicine at Oregon Health and Science University, said our culture devalues sleep, with the perception people who get the sleep they need are lazy or not working hard enough.

"Because we live in this accomplishment-driven culture, it results in people sacrificing sleep in order to get other things done," Hutchison explained.

Hutchison pointed out sleep is as important for our health as the food we eat or exercising. The recommended amount of sleep for adults is seven to nine hours in a 24-hour period. For teens and adolescents, it can be as much as 10 hours. For older adults, the number is closer to seven.

Dr. Ravi Johar, chief medical officer for UnitedHealthcare, said one of the best ways to ensure you are getting enough sleep is to have a regular schedule.

"That's something that's really important, just having a routine, whether it's brushing your teeth, changing into pajamas, doing some kind of activity before you go to sleep," Johar outlined. "Yoga, listening to music, reading, things of that sort, setting your alarm for the same time every day."

Johar added people should see a health professional for medical issues such as insomnia or sleep apnea.

"Sometimes there may be underlying medical problems that are making it difficult for you to sleep," Johar noted. "The other thing that's really important that people don't realize is how much stress and behavioral-health issues can factor into their sleep."

It's been 13 years since more than 156,000 West Virginians gained health insurance coverage through the Affordable Care Act.

As sweeping and sometimes controversial as the ACA has been, its longer-term effects are still being felt today at the state level.

Gary Zuckett, executive director of the West Virginia Citizen Action Group, pointed to a new West Virginia law capping insulin copays at $35 per month. The law goes into effect January 1.

"I think we now have the best insulin copay cap legislation in the country that we just helped get passed in a very 'red' legislature," Zuckett noted. "Which does show you that health care is not partisan."

Federal data shows since the launch of the federal health insurance exchange, enrollment in health insurance plans has doubled from 8 million to more than 16 million nationwide.

According to the West Virginia Center on Budget and Policy, the Medicaid expansion included in the ACA allowed more than 200,000 West Virginians to gain access to health coverage.

Zuckett cautioned when the "continuous coverage" rules enacted during the pandemic expire April 1, the state will begin re-evaluating people's eligibility, which could signal a setback in progress.

"A lot of people won't qualify or won't fill out the paperwork, and they'll lose their health insurance in West Virginia," Zuckett explained. "That could be as many as 50 or 100,000 people. So, that's going to be a step backwards."

According to America's Health Rankings, around 6% of West Virginians were uninsured in 2021, far fewer than the nearly 16% of the state's population who lacked coverage prior to the Affordable Care Act.

Beginning next year, more Kentuckians will have expanded access to biomarker testing - which helps doctors customize cancer treatment. Advocates of the new law say it will save lives and improve patients' quality of life.

Signed into law by Gov. Andy Beshear, House Bill 180 requires both private insurers and Medicaid to cover biomarker testing after a cancer diagnosis.

Doug Hogan - director of government relations for the American Cancer Society Cancer Action Network (ACS CAN) - explained that without biomarker testing, doctors typically try several rounds of chemotherapy or other treatments, without knowing which will work best for the patient.

He said biomarkers increase the odds of matching the right treatment to a specific cancer.

"We will be the fifth state in the country to adopt an enhanced access to biomarker testing law," said Hogan. "And so, we're on the cutting edge. This is the way that we can utilize technology to improve health outcomes."

The bill passed unanimously in both the House and Senate. According to the American Cancer Society, more than 30,000 Kentuckians will be diagnosed with cancer this year.

Hogan added that the new law will allow care teams to use the latest technology to make the best decisions for their patients.

"It is so important for these patients to get that right treatment at the right time," said Hogan. "It really will improve their health outcomes. It will save lives in many instances, and certainly will improve the quality of life."

Research shows biomarkers can in many cases reduce the cost of therapy, especially for lung cancer and colorectal cancer patients.

Cancer-care costs are expected to top more than $245 billion by 2030, according to the American Association for Cancer Research.





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