LARAMIE, Wyo. -- As more Wyoming workers lose their job-related health insurance because of downturns in the coal, oil and gas industries during the COVID-19 health emergency, state lawmakers are reconsidering the option of expanding Medicaid health insurance under the Affordable Care Act.

Jen Simon, senior policy advisor at the Equality State Policy Center, says this "perfect storm" has put newly unemployed residents in such states as Wyoming, that have not yet expanded coverage, at greater risk than neighboring states.

"Forty percent of the population in non-expansion states will become uninsured," Simon reports. "For states that have expanded the Medicaid health insurance program, far fewer people will lose health insurance coverage."

She points to a University of Wyoming poll showing that a majority of Wyomingites support expanding Medicaid to cover more residents, as far back as 2014.

Opponents of expansion have argued that Wyoming doesn't need help from the federal government to take care of its residents. They also warn that the state could be on the hook for additional costs if the Affordable Care Act implodes.

Simon counters that Wyoming would not be on the hook, because the state could reverse expansion if the federal contribution to Medicaid fell below 90%.

She adds that during the economic downturn, leaving hundreds of millions of dollars on the table as the state faces budget shortfalls is fiscally irresponsible, and goes against the state's values of taking care of its own.

"To turn down hundreds of millions of dollars that Wyoming citizens have already paid in federal income tax, that would be returned to our state to help our friends and neighbors and provide health insurance coverage," she states.

Simon also describes loss of health coverage as devastating for individuals and families -- and for entire economies, especially in rural parts of the state where hospitals, which are economic engines and primary employers, face the prospects of bankruptcy.

Hospitals and other care facilities are expected to see a spike in uncompensated care as people without coverage can't pay their bills.



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ALBUQUERQUE, N.M. -- A veterinary drug doctors call unsafe for treating COVID-19 has caused the deaths of two people in New Mexico, according to the state's Department of Health.

"Ivermectin toxicity" is being blamed for the deaths, with doctors reminding those desperate for a cure that drugs to treat animals are not approved for use in humans.

Elaine Blythe, New Mexico veterinary pharmacist and member of the American Pharmacists Association, said despite warnings, people have gone to the hospital after feeling ill from taking the drug.

"What we're seeing now is that when people do make that choice, physicians are saying, 'I don't know how to treat this patient who took a veterinary medication. We don't have any data on that. I don't know,'" Blythe observed.

Ivermectin is an antiparasitic drug which has been around for years and is used in both humans and animals. There are clinical trials still under way to determine if it has any benefits against COVID. Until then, experts said people should consult their doctor, and not listen to local politicians or television hosts who have touted it as a cure for the virus.

Poison-control experts say, depending on the dose, the use of veterinary medicines in humans can cause seizures and hallucinations, and even lead to a coma. Blythe noted a mistrust of COVID-19 vaccines or doctors, or even the easy access to veterinary medicines, has prompted a small number of people to experiment with ivermectin.

"People won't listen to the scientists, the epidemiologists, the virologists, the pharmacists, the physicians, the veterinarians," Blythe lamented. "But yet if they choose to do that, the first place they go is to the hospital, and they do expect the physicians and the pharmacists to treat them."

The acting director of the New Mexico Department of Health said the two people who died, ages 38 and 79, were trying to treat coronavirus with ivermectin, which led to kidney failure in one patient. He added the two were among 14 people in the state recently hospitalized after being poisoned by the drug.

ST. JOSEPH, Mo. - Missourians have a little more than a month until open enrollment for health-care coverage at healthcare.gov, and medical experts say it's important to understand your options to get the best plan for your needs.

More than 215,000 Missouri residents are enrolled in coverage.

But Michelle Davis Reed, eligibility and enrollment coordinator with Northwest Health Services based in St. Joseph, said many folks who previously had marketplace plans or no coverage at all will now be eligible for Medicaid - after the courts upheld voter-approved Medicaid expansion over the summer.

"Everybody who has put off their health care, couldn't find coverage," said Davis Reed, "we can put them on sliding fee scales all day. But that doesn't cover pharmacy, that doesn't cover if they need to go to the hospital. And with Medicaid expansion, everything is going to be covered."

Roughly 250,000 people who make up to 138% of the poverty level are newly eligible.

Davis Reed noted that prior to expansion, a family of three could not make more than $381 a month and still qualify. Now, they can make a little more than $2,500 and still be eligible.

For those without Medicaid, open enrollment starts November 1 and runs through December 15.

Dr. Rhonda Randall - chief medical officer for employer and individual plans at UnitedHealthcare - said it's important to anticipate what your health needs may be, and compare the differences between plan designs if you expect any upcoming health events.

"We have seen an increased interest in mental-health needs lately," said Randall. "That's another important thing to check on. Does your employer have an employee assistance program, and does the medical-plan benefits that they're offering have the mental-health coverage that you're looking for?"

Randall added that in addition to in-person care, many insurers have expanded their virtual health network of therapists and psychiatrists. She said some health insurers, including UnitedHealthcare, also offer advocacy services to help individuals find the right therapist and type of care.

HOUSTON - Door-to-door and "ZIP-code-by-ZIP-code" is how some COVID-19 health workers in Texas are reaching the vaccine-hesitant.

The "Your Shot Texas" campaign has invested more than a million dollars to help increase vaccine access and help communities hit hardest.

Beaumont, in southeast Texas, is one of those. Mary Scott is a nurse and vaccine coordinator with the Southeast Texas Faith and Community Leaders Coalition and said they've been working with the National Guard to set up clinics at events where people plan to congregate.

"I try to tell them from a health perspective," said Scott, "you have received vaccines your entire life. And if you have children - your children have been vaccinated so it's nothing new."

Only 32% of residents in Jefferson County - home to Beaumont - were vaccinated as of last week.

The Episcopal Health Foundation is part of a philanthropic collective awarding grants to speed the vaccination effort.

Brian Sasser - chief communications officer with the foundation - said the first round of grant money helped reach 100,000 people who were vaccine-hesitant and 2,500 of those received at least one shot.

Some people say they plan to get the vaccine, according to Sasser, but admit to procrastinating. Others have job-related concerns.

"It's just some practical, convenience matters," said Sasser. "'OK, if I get the vaccine, and I have side-effects, I can't take off my hourly job and still get paid.'"

By going door to door, Scott said she's learned that trusted people or organizations already embedded in communities are the most effective in reaching the hesitant, and encourages those still uncertain to seek advice.

"Talk to a trusted person, pharmacist, doctor, nurse, church member," said Scott, "somebody who's been vaccinated and just have a heart-to-heart because it's going to take face to face at this point."

Since June, 'Your Shot Texas' has awarded grants to 34 community organizations that are using innovative projects to reach the unvaccinated.