A new report found more than three million Arkansans are among 100 million Americans facing barriers to accessing primary medical care.

The National Association of Community Health Centers said many in Arkansas live in areas without enough primary-care providers.

Lanita White, CEO of Community Health Centers of Arkansas, pointed out the state is mostly rural and people often have to travel many miles to get to the nearest primary-care provider. She added patients also experience issues with getting care due to the state's workforce shortage.

"And even in the larger areas, we have some disparities in those services, because we just don't have enough providers," White pointed out. "It makes it difficult in a lot of ways for patients to get to those services easily, or know where the services are, or even get into those services, especially in the case of behavioral health and mental health."

White noted Community Health Centers offer robust telehealth services, but not everyone has access to a good broadband connection, so they could use telehealth. In the latest annual survey on the website BroadbandNow.com Arkansas ranks 48th among states for internet coverage, speed and availability.

Joe Dunn, senior vice president for public policy and research at the National Association of Community Health Centers, said 90% of the patients treated at the clinics have incomes at or below 200% of the Federal Poverty Level, making them critical in treating vulnerable and often uninsured populations.

Dunn emphasized without the centers, 15 million people would be at risk of not having a regular source of primary care.

"Children represent almost a quarter of the medically disenfranchised population that we analyzed," Dunn reported. "Obviously, as we think of starting off children on a positive foot, you know, ideally, caring for them in a very comprehensive manner, to establish good habits and prevent later disease."

The report noted 65% of Community Health Center patients come from racial or ethnic minority backgrounds. Dunn said pandemic only underscored the importance of their work.

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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