FRANKFORT, Ky. -- Tomorrow, the Supreme Court hears oral arguments in cases that could decide the fate of the Affordable Care Act. Health coverage for more than a half-million Kentuckians is at stake, as well as millions of dollars in rural hospital revenue.

More than a dozen states are asking the court to repeal the 2010 law that overhauled the private health insurance market and expanded Medicaid. Dustin Pugel, senior analyst at the Kentucky Center for Economic Policy, said before the ACA, Kentucky's uninsured rate was in the double digits. But Medicaid expansion opened coverage to hundreds of thousands - many for the first time.

"And they were able to get care for chronic conditions," Pugel said. "There was a lot of tobacco cessation counseling; there were cancer screenings. People were able to get old injuries looked at for the first time. And a lot of research showed that it saved lives."

ACA opponents believe the "individual mandate" - requiring people to have health insurance - is unconstitutional. They argue because a previous court struck down the mandate, the entire law should be repealed. The Supreme Court is expected to make its decision by next summer.

In addition to allowing coverage for people with pre-existing conditions, Pugel said the ACA has had positive ripple effects on local economies.

"[Between] 45,000 and 50,000 jobs could be lost just by pulling that $3 billion in federal dollars out of our economy - some of those in healthcare, but also in other industries, like finance and construction," he said.

Pugel said eliminating the ACA would be especially problematic during the pandemic, when many people are getting sick or may have coronavirus complications that require long-term care.

"Having less uncompensated care because a lot of your patients are covered by Medicaid, definitely helped keep their doors open, and you know, could be the tipping point in a hospital's decision on whether or not to stay open," he said.

A 2019 University of Kentucky study found the number of Kentuckians who received colon cancer screenings after Medicaid expansion jumped by 230%, compared to before the ACA.


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In the wake of the devastating overdose epidemic in North Carolina, the state's Department of Health and Human Services is stepping up to aid families and provide resources for youths battling substance abuse disorders.

State data show in 2021 alone, overdose deaths in North Carolina spiked by 22%, and nationwide, teen overdose deaths rose by 20%.

Kelly Crosby, director of developmental disability and substance use services for the North Carolina Division of Mental Health, said recognizing many adults with substance use disorders start using during their teenage and young adult years, it is crucial to educate and support young people in preventing substance abuse and overdoses.

"In North Carolina, among kids 12 to 17 years old, around 5% had a substance use disorder in the past year," Crosby reported. "That's more than 41,000 kids."

Crosby pointed out the COVID-19 pandemic exacerbated mental health challenges and substance use, with increased reports of anxiety, depression and substance misuse.

Sara Howe, CEO of Addiction Professionals of North Carolina, said to help address youth substance use challenges, a range of resources are available in the state. Some resources include education, harm reduction and treatment and mental health support.

Howe noted parents can get additional help at AlcoholDrugHelp.org.

"They can look, they have a list of what they provide, what insurance they take, do they take Medicaid, do they take commercial insurance, and do they have intensive outpatient, residential," Howe outlined. "This is a resource that we have right in our backyard that we can take advantage of today."

Research from the Centers for Disease Control and Prevention showed other protective factors to youth substance abuse disorder are family engagement, conversations around the disapproval of substance use, and mental health support.


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The prevalence of Type 2 diabetes is on the rise in Mississippi.

About one in seven Mississippians lives with diabetes.

Jernard A. Wells, cookbook author and host of New Soul Kitchen and New Soul Kitchen Remix on CLEO TV, said Black Americans are disproportionately affected by diabetes, but education and some lifestyle changes can help reduce the risk of diabetes and lead to improved overall physical and mental well-being.

"We should have more cardiovascular activity," Wells urged. "I try my best, even with my mother, walk, move, get out, grow a garden it doesn't even have to be big or anything like that. Grow it in your window seal. Those are things that are important to maintaining a great healthy lifestyle."

Every year, more than 17,000 people in the Magnolia State are diagnosed with diabetes, according to the American Diabetes Association. Wells suggested exploring alternative food options, such as fungi, which not only provide a great source of energy but also break down more efficiently in the body, reducing unwanted components like sugars.

Originally from Chicago, Wells grew up on his grandparents' 200-acre farm in Mississippi, where he developed a connection with the land, crops, and the art of harvesting food. He explained the experience galvanized his career as a chef and where he became an advocate for healthy eating and knowing the importance of having what he said is more "green on your plate."

"When we think about vegetation, we typically think about OK, my meal is not complete unless I have, as they call it in the south, meat and three vegetables," Wells outlined. "Meat is the side dish, the vegetation that's on your plate, that's where it's really at. It's about having those nutritional factors; those health benefits that come from it."

Wells recommended sustainable living and returns to his Mississippi roots and engages with students and families, stressing the importance of wholesome cooking and nutrition. Wells takes pride in instilling the values of environmental responsibility and healthy eating in his own children, dedicating every "Sustainable Sunday" to family education.


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When it comes to open enrollment and navigating the many health care options, experts say starting your research sooner rather than later is the best approach.

Understanding health insurance coverage benefits and comparing plans is critical so people get the coverage they need and can keep costs affordable for the coming year. The enrollment period starts Nov. 1 on the Health Insurance Marketplace. For employer-sponsored coverage, it's typically between September and December. And for people on Medicare, annual enrollment runs from Oct. 15 through Dec. 7.

Scott Darius, executive director of Florida Voices for Health, focused on increasing access to care.

"I would encourage people to go look at their options and really find out what's out there," Darius advised. "And to work with a navigator first of all, to really understand what those options are and what works best for them."

Darius recommended getting help through Covering Florida navigators, which he described as giving unbiased, in-person or virtual assistance at no cost. He suggested using a navigator or a certified application counselor who can search for options even though Florida has not expanded Medicaid. He also warned consumers to be wary of possible private "bad actors" who might be working on commission.

Dr. Rhonda Randall, chief medical officer of Employer and Individual for United Healthcare, said comparing plans and taking time to learn the basic insurance vocabulary -- like deductibles, copays, coinsurance, premiums and more -- are critical for understanding your benefits.

"We have a tool called 'Just Plain Clear,'" Randall explained. "It's a glossary you can find online - and for our Medicare Advantage members, a companion called 'Medicare Made Clear.'"

For people without employer-sponsored insurance, predicting income can be difficult for the year ahead. If you're a seasonal worker or an independent contractor, make an effort to estimate your income based on this year's invoices or pay stubs, and to use any help available to get you through the complicated process of choosing health coverage.