FRANKFORT, Ky. - A bill (HB173) that proposes a statewide smoke-free law in public places awaits a vote in the Kentucky House, and supporters are urging lawmakers to think about what it could do for children's health. For example, according to Dr. Bethany Hodge, a pediatrician, secondhand smoke is a common trigger of asthma attacks.

"It may not be the worst trigger that they have in their whole list of things that cause them problems, but there's no kid that is going to benefit at all from being around second-hand smoke, and all asthmatics do seem to be affected negatively by second-hand smoke," she said.

When the state's first local smoke-free ordinance went into effect in Lexington ten years ago, emergency room visits for asthma among children dropped by 18 percent, according to a study in the Journal of Occupational and Environmental Medicine.

Only about a third of Kentucky's 4 million-plus people are now protected by a hodgepodge of local smoke-free ordinances. Although Russellville doesn't have a smoking ban in public places, the owner of the Granny's Kitchen restaurant there, James Whittinghill, went smoke-free January 1. He called that a huge health benefit, both for his workers and customers.

"I read some information that the Health Department gave me that [said] if you were in a working environment of smoke, you know, where you had to breathe smoke eight hours a day, it was the same as smoking a pack of cigarettes yourself," he said.

Whittinghill said his lunch crowd has doubled since he banned smoking, and other restaurants in town have followed suit. The Kentucky Chamber of Commerce is pushing for a statewide smoke-free law because its member businesses support the idea.

Dr. Hodge, of the University of Louisville and Kosair Children's Hospital, said pediatricians and others who work with children see themselves as advocates for those who don't have their own voices in the political process. So, she's sending a simple message to Kentucky lawmakers about the smoke-free bill.

"We feel like if children had the ability to say what was important to them, that this would be on their list; that they would feel better and be healthier if they weren't in an environment with smoke."

She pointed out that smoke also affects unborn children, raising the risks of low birth-weight and of diseases later in life.

The smoke-free bill passed in the House Health and Welfare Committee Feb. 6. Since then, five potential amendments have been filed, including ones by the bill's sponsors to exempt cigar bars and private clubs, and two that would exempt so-called electronic cigarettes from the ban.

Link to HB173 at lrc.ky.gov.





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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.

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.