FRANKFORT, Ky. - Two million more children nationwide covered under Medicaid and the Children's Health Insurance Program (CHIP). It's a victory many in Kentucky are celebrating on the two-year anniversary of the Children's Health Insurance Program Reauthorization Act. The federal program has allowed the state to continue to provide health coverage for low-income children, thereby lessening the number of uninsured kids.
Anne Joseph, director of Covering Kentucky Kids and Families, says state leaders have made it easier to get and keep kids enrolled in the state program, K-CHIP. The investment, she says, is paying off.
"It's a win-win for the Commonwealth. It's a win-win for the kids. It will cost less if kids have care up front. It is a building block for education in the state. It's got everything positive going for it."
Kentucky Gov. Steve Beshear eased the process for families to enroll in K-CHIP in 2008. Since then, more than 51,000 children have been enrolled in K-CHIP or Medicaid. Kids up to age 19, with family incomes up to 200 percent of the federal poverty level, are eligible for K-CHIP. (That equates to annual earnings of $44,000 for a family of four.)
The governor also removed the $20 monthly premium families were required to pay into K-CHIP. Advocacy groups claimed it was a financial barrier for many families and added little revenue to state coffers.
Lacey McNary, deputy director of Kentucky Youth Advocates, urges the state to focus now on online enrollment, allowing continuous eligibility, and matching application information with existing systems in order to get and keep more families in the program.
"For instance, the social security system already has a lot of information about people. Can we somehow data-match to that when people sign up, to make it even easier for them to stay enrolled in the program?"
The executive director of Kentucky Voices for Health, Jodi Mitchell, notes it's more important than ever to families who rely on K-CHIP and Medicaid that those programs run efficiently.
"Families are really busy trying to make ends meet. Jumping through any extra hurdles to get health care coverage is very difficult at these challenging times. We recognize that and want to help secure affordable coverage for kids. We'd like to see all of Kentucky's kids covered."
The federal Children's Health Insurance Program is authorized until 2019, but only funded until 2015. According to federal health officials, CHIP and Medicaid together have served more than 42 million children who would have otherwise lacked access to regular medical care.
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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.
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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.
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