The existence of health care inequities in the United States based on race or ethnicity has been widely covered, especially since the COVID pandemic.

A Kansas City group is actively working to identify and change systems contributing to such disparities. The Kansas City Health Equity Learning and Action Network is a coalition of 15 interdisciplinary teams who have committed to 18 months of learning and action, both as a group and independently.

Ninon Lewis, vice president of the Institute for Healthcare Improvement, which facilitates the network along with Health Forward and the Kansas City Health Collaborative.

Lewis said they do it through face-to-face meetings and "action periods."

"In between those face-to-face meetings, they're actually going out and driving an improvement project around an improvement area that they've identified -- through data -- is an area around advancing equity and anti-racism that they want to effect in their system," Lewis explained.

During the "action periods," the organizations receive dedicated coaching from Health Forward and the Institute for Healthcare Improvement on anti-racism, quality improvement and systems improvement. And they are tracking each group's progress on its projects and its use of practices such as partnering with people with "lived experience," coalition building, and using data in new ways.

Paul Howard, senior director for the Institute for Healthcare Improvement, has worked with Lewis on health care projects around the world. He said they were impressed from the start with the commitment to anti-racism they observed in Kansas City.

"Often, we have to sort of wade into equity -- we know where we want to go -- but I'll say that Kansas City, in many ways, was pushing us forward even faster than what we're used to," Howard noted. "I think that's something that speaks strongly of Kansas City."

Eusebio Díaz, vice president of strategy, learning and communication for Health Forward, said in addition to their work with the network, they are exploring ways to strengthen diversity in the health care arena.

"The research shows that greater diversity in the health sciences arena results in better health outcomes for Black and Latino folks," Díaz pointed out. "And certainly, that applies to Black and Latino folks, but it also applies to rural communities."

Diaz added providing support for credentialing and licensing is one of the ways Health Forward is trying to promote diversity, since it can create barriers for some people entering the health care field.

After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.