COLUMBUS, Ohio — Researchers say national talk of turning Medicaid into a block grant program could threaten health-care coverage for vulnerable kids in Ohio.

States currently share the cost of Medicaid with the federal government. With a block grant, states would get a set amount of money and would need to cover any differences if the program exceeded costs. Supporters say it would make the program more efficient.

At the Center for Community Solutions, researcher Loren Anthes countered states could end up restricting who qualifies or reducing services in order to save money.

"You suddenly are putting state policy makers and the state department of Medicaid into a very difficult position where they're making toxic tradeoffs between who is and who is not deserving,” Anthes said. “The most likely victims of that budget consideration are going to be the people with the biggest needs."

Medicaid covers more than 1.1 million Ohio children, and about 60 percent of Medicaid beneficiaries nationally who are younger than age 19 have a disability. Anthes said because they have higher health-care costs, services for children with special needs would be the most susceptible to cuts.

He added the next target for cuts could be children - the second largest group for Medicaid expenditures.

Supporters contend block grants would give states flexibility with their Medicaid dollars, and perhaps the ability to address other enrollee needs, such as housing or food. Anthes said there are many drawbacks that should be considered.

"Before policymakers put forward something that may sound good, let's talk about this in terms of dollars, cents and in terms of your constituents, maybe your family members, and really try to outline what some of the impacts of these choices may be,” he said.

Anthes contended rather than experiment with access for children or others who rely on Medicaid as a way to control costs, it would be wiser to examine why prices are high in the first place.

"What are things that are happening that are costing us tens of millions of dollars that have nothing to do with people who rely on this coverage?” he offered. “So let's talk about price, let's not fiddle with things that could potentially compromise access to care for children."

President Donald Trump's budget proposal calls for cuts to Medicaid and block-grant funding, and the Centers for Medicare and Medicaid Services reportedly are drafting a plan to encourage states to apply for a waiver to implement their own block grants.

Community Health Centers are stepping up to meet a critical need for dental care across Tennessee.

Dental visits at these clinics have increased by 19% and patient numbers have risen by nearly 16%, underscoring the importance of these services.

Libby Thurman, CEO of the Tennessee Primary Care Association, said the demand has grown, especially as more people have gained dental coverage through TennCare, the state's Medicaid program. Thurman explains TennCare did not cover dental services for adults until recently, although it did cover children.

"In 2023, the state expanded access to dental services under TennCare for adults," Thurman noted. "We have had some challenges keeping up with that demand, and that really stems from just making sure we have enough dentists to serve all of those patients."

In 2023, Community Health Centers in the state provided more than 79,000 dental visits to more than 35,000 patients. Across the state, 24 of the 30 health centers now offer dental health services.

Thurman stressed the importance of having access to dental care, since it is so closely tied to a person's overall health. She added the clinics integrate dental services into their broader mission of providing whole-person care.

"Dental care, aside from just oral health, actually has a lot of links to systemic health," Thurman explained. "It's linked to a lot of chronic disease management - so, if your oral health care is unmanaged, likely your chronic disease could be worsened."

Thurman emphasized Community Health Centers provide care to all, regardless of a person's insurance or income status. They also have a sliding-fee scale, so patients are often able to get dental care at a lower cost than they might find elsewhere.

Groups across the state are working to reduce overdose deaths among minority populations.

According to state data, overdose deaths are on the decline but among Black residents, there were around 68 deaths per 100,000 people last year; more than 51% greater than the overall rate of deaths.

Matt Johnson, board member of the nonprofit CARES Coalition in Franklin County, said the county is struggling with a lack of emergency shelter and medical services for undocumented individuals. The coalition's Community Connectors Project aims to go door-to-door in neighborhoods to help residents access the services they need.

"People who don't necessarily have a visa or a green card, or even health insurance," Johnson outlined. "We need them to be able to go and receive services; for kids to be able to see dentists, especially within our minority population has been a challenge."

The coalition is one of 10 organizations awarded $50,000 grants from the Foundation for a Healthy Kentucky's Funding for Recovery Equity and Expansion program, a partnership with the Cabinet for Health and Family Services' Kentucky Overdose Response Effort.

In Western Kentucky, the Four Rivers Foundation has expanded mental health and health care services in underserved schools.

Dr. Alex Wright, CEO of Wright Medical who works with the foundation, said gaps in access often result in students either not receiving or experiencing long delays in care. He noted so far, more than 3,000 students have been served in the classroom.

"In some of our districts, we estimated up to 50% of children were lacking any continuity of health care," Wright reported. "Many of these children haven't had a pediatrician or primary care provider, usually since they were an infant or a toddler."

Research points to increased stigma surrounding substance use disorder and mental health in communities of color. According to the Yale School of Medicine, treatment inequities persist. Nationwide in 2018, the majority of Black and Hispanic people diagnosed with the substance use disorder did not receive treatment.


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By Cat Sandoval for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

Respiratory syncytial virus (RSV) is on the rise in Indiana, according to the Centers for Disease Control and Prevention, and it's forcing some hospitals to implement visitor restrictions.

Dr. Christopher Doehring, of Franciscan Health in Indianapolis, spoke with News 8 about why this respiratory virus increases during winter months and what hospitals are doing to prevent its spread.

"Like most of the respiratory viruses, as the weather turns cooler and people spend more time inside and around each other, its a just a highly contagious respiratory virus," Doehring said. "Like all respiratory viruses, we tend to see an increase in cases this time of year."

Holiday get-togethers can help spread the virus.

"You start to see around Thanksgiving time, you start having families coming together," Doehring said. "They're spending times in doors and it's multiple generations together. It's a natural epidemiologic phenomenon."

According to medical experts, RSV causes infections in the lungs. In healthy adults and older children, symptoms are mild, similar to the common cold.

RSV can be prevented by using good hygiene, such as washing hands and avoiding touching one's face.

Doehring said babies, premature babies, and immunocompromised elderly adults can experience severe cough, shortness of breath, and pneumonia, or even death. Doehring recommends getting vaccinated.

"Once you have the symptoms or are under the weather, take the time to recover, heal, and minimize exposing others as best as you can," Doehring said.

At Franciscan Health Hospital, masks and hand sanitizers stations are readily available to prevent the spread. Those under the age of 18 because younger visitors are more likely to spread respiratory viruses. Other hospitals in Marion County are doing the same.

Doehring says he has seen an increase of RSV cases, which is typical this time of year, but it's not alarming.

"Certainly in our hospitals and around other hospitals in central Indiana, we're not at a point where we're overrun or overcrowded in our ICUs or emergency department," Doehring said.


Cat Sandoval wrote this article for WISH-TV.


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