About 790,000 Hoosiers are family caregivers for relatives in declining physical or mental health. But Indiana ranks fairly low in support for family caregivers on the latest AARP national scorecard
for Long-Term Care Services and Supports. It's 39th compared to other states.

As Indiana transitions away from reliance on nursing-home care into more home and community-based services, families play an even bigger role.

Marvell Adams Jr., CEO of the online resource 'CaregiverAction.org, said support is improving. He said 30 years ago, a caregiver's duties were not clearly defined, and support was nearly nonexistent.

"The organization really was started out of the notion that caregivers really did need to have a voice in order for their role not only to be more effective, but also they could be understood and respected as a vital part of an individual's treatment plan," Adams said.

Adams added family caregivers need to safeguard their own health in order to provide the most effective care. He also advises frequent communication with physicians and keeping medical and legal documents organized and easily accessible. According to AARP, family members in Indiana provide unpaid care worth more than $10 million a year.

For many families, caregiving doesn't even happen in the same household. The National Institute on Aging defines a long-distance caregiver as one who lives an hour or more away from the person being cared for, often by a local relative. Adams suggested coming up with strategies to pitch in remotely.

"Long-distance caregivers are going to want and need information; they're going to want and need insight. Being able to plan out visits in advance -- perhaps the caregiver
that is local can plan for that, whether it's for their own respite or for checking in with doctor's visits, but being able to set that up ahead of time," Adams said.

The NIA says long-distance caregivers can also help with preparing a living will or researching long-term care choices.

According to the site healthinaging.org,' of the 34 million Americans who care for older family members, roughly 15% do so long-distance.

Advocates for affordable health care are speaking out to remind people what is at stake if the Affordable Care Act is repealed in the wake of recent statements by former President Donald Trump.

Mr. Trump, who leads the polls for the 2024 Republican nomination, has recently said he is looking at alternatives to the Affordable Care Act, and criticized the GOP lawmakers who voted against his attempts to end the program in 2017.

Laura Packard, a Stage 4 cancer survivor, noted before the Affordable Care Act, insurance companies were allowed to deny coverage to people like her with pre-existing conditions.

"While I was on the couch, trying to survive, that's when Republicans in the U.S. House voted to repeal the Affordable Care Act that was keeping me alive," Packard recounted. "Then, they held a party to celebrate. We can't go back to that."

The Affordable Care Act created health exchanges -- like Covered California -- offering subsidized health insurance to millions of people. And it funded an expansion of MediCal, benefiting 5 million low-income Californians in the first six years after the law's passage.

Sen. Ron Wyden, D-Ore., who helped write the health care law, said the Affordable Care Act forces health insurance companies to cover basic services like maternity care, mental health services, cancer screenings and contraception. The idea of getting rid of the law has been largely unpopular, and Wyden knows why.

"It would mean higher premiums for families and health insurance," Wyden pointed out. "And it would also threaten Medicaid nursing home benefits, because Medicaid is paying much of the nursing home bill for this country."

The law also allows adult children to stay on their parents' health plans until age 26 and bans lifetime caps on coverage.


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Nurses who care for patients in their homes in the Willamette Valley are pushing to get their union contract negotiations across the finish line.

Home health and hospice care workers at PeaceHealth Sacred Heart in the Eugene area have been in a long struggle to complete negotiations. The nurses' contract expired in April.

Jo Turner, a hospice visiting nurse who has been leading negotiations for the Oregon Nurses Association, said they are holding an informational picket today in Eugene.

"The plan is to get the public involved," Turner explained. "Get them to understand the lack of respect that PeaceHealth is demonstrating to their home care nurses."

The home care nurses are looking to maintain pay parity with nurses in hospitals. Turner argued continuity of care between hospital and home is important. PeaceHealth did not respond to a request for comment.

PeaceHealth is closing the only hospital in Eugene at the end of the year. Turner noted there is concern it will mean more patients will need care at home.

"There's all these patients that are being discharged quickly and with no safety net," Turner pointed out. "They're just expecting Sacred Heart hospice and Sacred Heart home care to take these patients that are extremely heavy burdens that the rest of the home care companies will not take."

Turner added PeaceHealth cannot take the same approach to negotiations in Eugene as it does in other cities.

"You have to meet your community where it's at and you have to provide for your community, not like you would provide for Vancouver or Bellingham," Turner stressed. "We are our own special community, and who better to serve it than your nurses that live in the community?"

Starting Friday, North Carolinians will have greater access to health care as the long-awaited Medicaid expansion is launched.

Medicaid will provide coverage to individuals ages 19 to 64 with higher incomes, allowing eligibility for those earning up to 138% of the federal poverty rate.

Kody Kinsley, North Carolina's Secretary of Health and Human Services, said this expansion will bring essential care to thousands, improving their health and overall well-being.

"That's 600,000 people who will be able to have their medications covered by insurance and that's 600,000 people who -- when they face an emergency event and they have to go to the hospital -- will have the peace of mind to know that they're not going to get stuck with a medical bill that they can't afford," Kinsley said.

In addition to the increased income threshold, the Family Planning Medicaid program will offer reproductive health care at no cost to people with incomes up to 195% of the Federal Poverty Level. This means even a single person earning up to $2,400 per month will have access to essential care.

Kinsley added individuals already receiving family planning benefits and meeting the requirements for full Medicaid will be automatically enrolled on Friday. They should expect to receive notification via mail. He said this expansion not only ensures health care for many throughout the state but also supports hospitals and empowers working families to thrive in the workforce.

"Medicaid expansion helps working families; 80% of the individuals that will benefit from expansion are in working families. It will increase access to mental-health and substance-use treatment and will help build a healthier workforce," he explained.

To support the expansion's non-federal share cost, more than 100 hospitals will also receive about $3 billion through the Healthcare Access and Stabilization Program. North Carolina is now the 40th state to expand Medicaid under the Affordable Care Act.


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