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FL advocates worry about the EPA delaying an important decision on emissions; WV is a leading state in criminal justice reform thanks to national backing; CA groups are celebrating a judge rejecting a federal moratorium on offshore wind; U of MI child care workers are fighting for a livable wage; gray whales might not be bouncing back as fast as previously thought; and NY advocates are celebrating a federal ruling saying the Trump Administration's wind energy ban was illegal.

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The Senate fails to extend ACA subsidies all but ensuring higher premiums in January, Indiana lawmakers vote not to change their congressional map, and West Virginia clergy call for a moratorium on immigration detentions during the holidays.

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Farmers face skyrocketing healthcare costs if Congress fails to act this month, residents of communities without mental health resources are getting trained themselves and a flood-devasted Texas theater group vows, 'the show must go on.'

Unique government health plans try to find an audience

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Thursday, March 28, 2024   

Medicare and Medicaid are key sources of health coverage for many Americans and some people qualify for assistance under both programs. With lagging enrollment for the unique plans, outreach efforts are underway.

According to KFF Health News, only about three in 10 people who qualify for Dual-Eligible Special Needs Plans were enrolled in 2021. Experts said the option is designed for people who need additional help because of disabilities, certain health conditions or their age.

Dr. Gina Williams, associate medical director for UnitedHealthcare, said the plans try to take a dynamic approach to serving those eligible.

"Everything from managing your wellness to managing your behavioral health needs and then everyday needs," Williams outlined. "It's kind of a more comprehensive package for people who need a little bit more support."

Everyday needs include meal benefits and bathroom safety devices. The National Council on Aging said D-SNPs aim to provide a more streamlined coordination of care because there is assistance in arranging the services. Wisconsin's enrollment numbers are similar to the national rate, at 28%.

Christine Huberty, lead benefit specialist and northern region supervising attorney for the Greater Wisconsin Agency on Aging Resources, said a tricky component of the plans is navigating provider network restrictions. A rural resident might have to travel farther to see a doctor covered under the plan and she cautioned it warrants careful research when enrolling.

"I would say first and foremost, look at the provider network restrictions," Huberty advised. "Look at what's available in your area."

Meanwhile, Williams noted the push to get more eligible people to sign up coincides with more awareness around preventive care in a post-pandemic world.

"Everybody's kind of going into a phase where they're not only thinking about acute illness, but they're thinking about overall care," Williams observed. "What was the impact of the pandemic from a psychological standpoint? Do you need more support and then you also need more coordination of benefits?"

Disclosure: UnitedHealthcare contributes to our fund for reporting on Health Issues. If you would like to help support news in the public interest, click here.


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