LOUISVILLE, Ky. -- Three in four Kentuckians are worried about affording health care, according to a new statewide poll that also found dissatisfaction with the current health-care system on both sides of the political aisle. More than 90% of surveyed Kentuckians said they support expanding health-insurance options so that everyone can afford quality coverage.

Terri Bates, a single mother of two in Frankfort, said she had to file for bankruptcy because of medical debt after needing emergency surgery and not being covered.

"It was very stressful," she said. "I had credit agencies calling me all the time, hospitals saying they needed a payment or they were going to take me to court and sue me, and it was nonstop."

Bates said she's working on building her credit again and is no longer in debt, but the experience has made her wary of going to the doctor. Some 30% of survey respondents said they are delaying a doctor's visit. Six in 10 described themselves as "anxious or very worried" about affording treatment for severe COVID-19 illness.

For years, said Richard Seckel, director of the Kentucky Equal Justice Center, legal-aid offices across the Commonwealth have seen families crushed by debt to the point of bankruptcy. He said he believes the pandemic is highlighting long-standing weaknesses in the health-care system.

"We've made great progress on expanding coverage for folks in Kentucky and getting people signed up, but it's startling the degree to which people still feel insecure about health care," he said. "It's clear that we can't really have a thriving economy until we make health care something you can count on."

Lexington resident Allison Crawford had abdominal pain for more than a year before she could schedule the diagnostic surgery she needed. Working three jobs, she said, she made too much money to qualify for Medicaid but not enough to afford a high-quality insurance plan. Crawford delayed her procedure until she found a full-time job with benefits.

"I think people who don't want health insurance to be provided to everyone, whether or not you have a job -- health insurance not tied to a job -- I think those people just have never had an experience where it was life or death or facing a lower quality of life," she said.

So far, more than 233,000 Kentuckians have lost employer-sponsored health insurance after losing their job. More than a half-million state unemployment claims have been filed since the pandemic began.

The survey is available online at healthcarevaluehub.org.


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California is poised to become the first state in the nation to give health care to all income-eligible residents, regardless of their immigration status.

The Legislature is set to pass the final budget bills this week, which will be signed by Gov. Gavin Newsom shortly thereafter.

Cynthia Buiza, executive director of the California Immigrant Policy Center, said it is the fulfillment of an almost decadelong push by the Health4All campaign.

"This is very timely, but also long overdue," Buiza asserted. "Because for many, many years, many of our immigrant workers who have contributed tremendously to what makes California, California, have gone on without this very important safety net."

The budget deal represents a huge step toward universal health coverage and is expected to benefit about 700,000 people, starting in 2024. Opponents cite the cost: The budget includes $625 million to cover the first six months of 2024, and then allocates $2.1 billion per year.

Beatriz Hernandez, Central Valley organizer for the California Immigrant Policy Center, said it will make a huge difference in people's quality of life.

"This means that they will finally be able to get the health care that they need to care for the chronic illnesses that they've been suffering for many years," Hernandez pointed out. "And also be able to get the checkups that they need."

The deal marks the final push to expand Medi-Cal to all low-income Californians. In 2015, the state expanded Medi-Cal to include undocumented children. In 2020 the program grew to include young adults, up to 26 years old. And this year the program began to accept undocumented adults, age 50 and older.

The ruling on abortion by the U.S. Supreme Court has returned the issue to the states, fulfilling long-held goals of Republican lawmakers in Texas to ban and criminalize abortion.

With the 49-year-old Row v. Wade case overturned, a trigger law takes effect next month, banning abortions from the moment of fertilization - there is no exception for rape or incest.

Texas lawmakers were ahead of the high court, passing legislation last fall to prohibit abortions after six weeks. Aimee Arrambide, executive director of the Texas chapter of the abortion rights group Avow, said she expects half the states to follow Texas' lead.

"We've been ringing the alarm that what is happening in Texas, doesn't stay in Texas," said Arrambide. "And that the public health crisis Texans have been facing for nearly 10 months will be the reality in half the country. Our opponents are not going to stop until abortion is completely inaccessible in the country."

In his concurring opinion with the 6-3 vote, Supreme Court Justice Clarence Thomas said high court rulings that established a right to contraception, as well as gay rights should also be reconsidered.

Following the ruling, Texas GOP Gov. Greg Abbott said abolishing Roe v. Wade, "reinstated the right of states to protect innocent, unborn children."

New Mexico is now the closest state for many Texans seeking an abortion, but getting there may not be possible for low-income people who don't have the time, money or child care to travel out of state. Progress Texas Advocacy Director Diana Gomez said education is the next step.

"There are a lot of folks who don't know about the existence of abortion funds," said Gomez, "of infrastructures that are already in place to help people get abortions, and so we want to let people know about clinics in surrounding states."

In addition to Texas, 25 other states are expected to make abortion illegal, affecting the lives of 36 million people. University of Texas at Austin Associate Professor Kari White said entire regions of the country may soon be in the business of extreme criminalization.

"In a state like Texas," said White, "it's also going to criminalize a whole range of behaviors and practices for people who are trying to help someone get an abortion."

Prior to the court's ruling, a poll by Reuters showed about 71% of Americans - including majorities of Democrats and Republicans - believed pregnancy termination should be a patient-doctor decision.

Medical negligence cases in Washington and elsewhere have taken on a new shape during the pandemic, as hospital resources have been strained and the potential usefulness of certain treatments has ebbed and flowed.

Drugs like ivermectin, for instance, were touted online as a potential COVID-19 treatment but ultimately lacked scientific evidence to back up those claims.

Elizabeth Calora is a Tacoma lawyer who specializes in medical negligence cases. She said there are some legal requirements for determining if a health professional acted carelessly which have been affected by COVID.

"We need to figure out what a reasonably prudent provider should have been doing in that context," said Calora, "and it usually means talking to experts in the field and then determining if what the provider did in the moment or over the course of several visits violated that standard of care."

Calora said after that, the person has to prove that the breach is what caused the damages.

The Washington state Legislature modified evaluations of negligence cases in 2021 so that resources and staffing must be taken into account. For instance, hospitals have often lacked beds at the height of different COVID waves, a factor outside of doctors' or facilities' control.

Calora said the standard of care evolves over time. What was once an acceptable medical practice in the 1970s, for example, might not be anymore.

"But usually it happens in a much slower timeframe than what we experienced at the start of the pandemic," said Calora. "With COVID, you had physicians all over the world basically - it makes me think of throwing spaghetti on the wall to see what sticks. Everyone was trying everything they could."

Calora said the unforeseen nature of the pandemic has made it hard to bring medical negligence cases forward. However, she added that shouldn't discourage people from speaking with an attorney if they feel they or a loved one has been wronged.

"Even though things were bad," said Calora, "it doesn't give people license to practice beneath the standard of care."