Maine requires its hospitals to provide medically necessary care to its residents at no charge as a condition of receiving tax-exempt status, but not all eligible patients apply.

Mainers with income up to 150% of the federal poverty level can apply for charity-care funds, but documentation requirements can be tricky for non-English speakers, gig workers and those without reliable internet access.

Kate Ende, policy director at Consumers for Affordable Healthcare, said the funds exist so Mainers can get the health care they need.

"These programs are available to people who are uninsured as well as people who maybe have private insurance but have a really high deductible, or other out-of-pocket costs that are expensive," Ende explained.

Accessing the charity funds can help people avoid the heavy burden of medical debt, Ende pointed out, adding many people would be surprised to learn they qualify, if they would simply apply.

Four in 10 Americans carry medical debt while one in seven adults say they have delayed hospital services due to cost. Yet, charity funds remain underutilized.

A recent Kaiser Family Foundation study shows half of U.S. hospitals reported the cost of providing charity care made up just 1.4% of their operating expenses.

Ende argued people deserve quality health care, and it is OK to ask for help.

"People are avoiding care, cutting pills in half, or not filling a prescription their doctor has prescribed," Ende observed. "We know Mainers are going without the care and medications they need because of costs."

Maine hospitals are required to notify patients of charity-care policies prior to collecting payment, and Ende noted some health care workers, such as anesthesiologists, practice care at hospitals but are not employees and would not be covered under any assistance funds.

Patients can find more information at mainecahc.org or by calling the Consumers for Affordable Healthcare hotline at 1-800-965-7476.

Consumer advocates in Maine said the availability of enhanced subsidies have helped record numbers of people get the health care coverage they need.

Nearly 65,000 Mainers enrolled in health plans this year through the state's online marketplace.

Rachel Collamore, consumer assistance program manager at Augusta-based Consumers for Affordable Health Care, said more people are catching problems early and avoiding trips to the emergency room.

"It means that people who might otherwise kind of roll the dice don't have to anymore," Collamore emphasized. "They can get that security by having a health plan that is more likely to meet their budget and more likely to meet their health care needs."

Enhanced subsidies have cut some premiums, on average, by more than 40%.

Collamore noted open enrollment is closed until November but people can still get coverage if they experience certain "qualifying life events" like getting married or losing an employer-based plan.

The enhanced subsidies will expire at the end of the year unless Congress votes to extend them or make them permanent. Without action, the vast majority of marketplace premium payments will increase, and low-income enrollees will face the biggest premium hikes.

Collamore argued it should concern everyone because "healthy neighbors make good neighbors."

"We know that having access to medications that help you manage chronic conditions," Collamore pointed out. "Even just having access to affordable prenatal care; that those are really, really important and that kind of coverage is really out of reach for some many people if they don't have those tax credits."

Collamore added there are a lot of unknowns, but the Consumers for Affordable Health Care hotline is available for Mainers with questions about their coverage. She encouraged people to contact their elected officials to let them know the importance of keeping the enhanced subsidies in place.

February is American Heart Month and some Minnesota families are sharing their experiences with a sometimes overlooked disease among newborns: congenital heart defects.

Studies show congenital heart defects are the most common birth defect in the U.S., affecting nearly 40,000 babies each year. The American Heart Association said thanks to progress in the world of research and treatments, outcomes have improved. But families still find themselves in delicate situations.

Stephanie Johnson is a Minnesota mother whose son Henry was born with a syndrome restricting oxygen supplies to the body. Henry endured several surgeries and now lives a mostly normal life like kids his age but the worry is not over.

"We also know that the honeymoon period doesn't last forever," Johnson acknowledged. "At some point his heart's gonna get tired and he'll be looking at likely a heart transplant at that point."

Johnson hopes for additional medical breakthroughs but she and health experts noted congenital heart defect research is grossly underfunded. Another complication is government spending cuts sought by the Trump administration and the potential impact on agencies such as the National Institutes of Health. Policy experts say the research arm has already been dealing with flat funding levels.

In the absence of government support, current research heavily relies on awareness campaigns involving families navigating health scares. Johnson is among those trying to get the issue on the public's radar.

"We need to move science forward," Johnson urged. "Creating awareness for this is just incredibly important because awareness leads to funding, and funding leads to hope, and we're hoping for a cure."

Studies indicate congenital heart defects are underdiagnosed because milder symptoms are not always caught at birth. It means the disease is detected later in childhood or when the person becomes an adult.

Minnesota's Mayo Clinic and its HeartWorks program, as well as the Heart Association, are part of a network of health entities pushing for research advancements.

For Pennsylvanians with disabilities, there may be unexpected side effects to ending so-called Diversity, Equity, Inclusion, and Accessibility policies.

President Donald Trump has opted to eliminate DEIA initiatives in federal agencies and federally funded programs.

His executive order signed in January characterizes DEIA policies as "discriminatory."

But in Pennsylvania, Mallory Hudson - the director of the disability justice program at the Keystone Progress Education Fund - said a memo went out ordering the Justice Department's Civil Rights Division to not file any new complaints, motions to intervene, agreed upon remands, amicus briefs, or statements of interest.

"That means that the Department of Justice Civil Rights Division has been instructed not to file any new civil rights cases, right?" said Hudson. "And that includes ADA complaints. So, those are - that is one of the few ways that disabled people can even protect their civil rights."

She adds the Americans with Disabilities Act was first passed in 1990 under President George H.W. Bush, and its legal precedent was based on the Civil Rights Act of 1964.

Hudson said another potential concern is the future of the Inflation Reduction Act under the new administration.

She noted that the IRA has allowed the Centers for Medicare and Medicaid Services to negotiate drug prices - and many are benefiting from its progress, like a $35 co-pay for insulin.

"Older adults and some folks with disabilities have been able to do that $35 copay, and for folks on disability, that's still a pretty big chunk of change," said Hudson. "But it was better than before - and then, that meant taxpayers were paying the difference."

Lower prices have been negotiated for 10 medications so far, cutting costs for patients and saving taxpayers billions.

It's estimated that if the IRA had been enacted in 2023, it would have slashed prescription drug spending by 22% - or roughly $6 billion.