In Arkansas, thousands of people have lost Medicaid coverage since April, as states recheck everyone's eligibility, a process known as "unwinding."

The federal policy prohibiting states from removing people from Medicaid during the pandemic has ended. In April, 72,000 people were disenrolled from Medicaid in Arkansas, and another 68,000 in May.

Gavin Lesnick, chief of Communications for the Arkansas Department of Human Services, said they have been preparing for this process for more than a year, and sending notices to Medicaid enrollees requesting current information to determine their eligibility.

"Then we take that into our system and we confirm eligibility and for those who are still eligible, they will keep their coverage," Lesnick explained. "And for those who are no longer eligible for Medicaid, we do offer them information about other ways to get health care coverage, such as through an employer-sponsored plan or through the federal health insurance marketplace."

Lesnick pointed out they began the outreach process last spring, urging people to make sure Medicaid had their updated information. He added the department confirmed or updated addresses for more than 170,000 Medicaid enrollees.

Arkansas' Medicaid rolls increased by more than 230,000 people during the pandemic. Lesnick acknowledged the importance of the program, whether people have chronic health conditions or do not make enough money to afford private health insurance. He urged people to visit www.ar.gov/renew, which he called the state's "one-stop shop" for information about the redetermination process.

"There's different ways that you qualify, and there's many different programs under the Medicaid umbrella," Lesnick noted. "But certainly, it is an important service that our beneficiaries rely on. And that's why it's so important that we go through this process, to make sure that the Medicaid resources that are out there are available for the folks who truly need them."

Marcus Robinson, president of individual and family plan markets at UnitedHealthcare, agreed people need to have continuing coverage and to maintain a relationship with their physician, to stay on track for preventive care and critical screenings, for themselves and their family.

"Maintaining coverage is important to prevent against missed opportunities of managing chronic conditions," Robinson emphasized. "Maybe there is an emerging illness or emerging condition that you can catch early on, and really get on a path to better health."

Robinson added some might have options for coverage through a circumstance considered a "qualifying life event," which makes someone eligible for a coverage change outside a yearly defined-enrollment period. Such events might be a sudden loss of employment, change in marital status or having a baby.

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.