SANTA FE, N.M. -- For the third time in five years, New Mexico lawmakers are considering legislation to allow a terminally ill patient to seek prescription medication from a healthcare provider, which they could use if they decide to end their own life due to unbearable suffering.
After passing in the House, the Senate will consider the "Elizabeth Whitefield End-of-Life Options Act," modeled after similar laws in other states.
Dolores Huerta, American labor leader and civil-rights activist, has joined the cause to get House Bill 47 passed.
The 90-year-old Huerta said mentally capable, terminally ill adults should be allowed to obtain the medication to die peacefully.
"The fact that there is an alternative, and that people can make a choice that they want to end their life in a graceful and a peaceful manner, with their loved ones around them, I think that is something that's very important," Huerta explained.
The New Mexico bill is named for Elizabeth Whitefield, an Albuquerque family law judge and attorney, who advocated for a version of the bill before dying in 2018 following an 11-year battle with cancer.
For the third time, Rep. Deborah Armstrong, D-Albuquerque, is co-sponsoring the bill. Armstrong has a 39-year-old daughter she said has battled cancer for 20 years and is running out of treatment options.
Armstrong said if passed, the state law would be very specific about which patients are eligible.
"They have to be terminal; they have to be mentally competent; they have to be able to self-administer," Armstrong outlined. "Two providers have to affirm that they're eligible on all counts."
The bill also protects all healthcare providers from civil and criminal consequences, and they can opt out of writing such prescriptions.
Huerta believes since the start of the pandemic, many more Americans are contemplating healthcare planning and end-of-life decisions.
"People don't often think about making a plan for the end of life," Huerta observed. "I know that if my mother would have had that choice, even though she was a very devout Catholic, that she would have taken it. You might even say that it's a civil right that people have."
In neighboring Colorado, a report on that state's End-of-Life Options Act, passed by voters in 2016, shows an uptick in participation, both by physicians and terminally ill patients.
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During National Health Center Week, health-care advocates are highlighting the work Community Health Centers are doing to improve access to care throughout the state.
More than 600,000 Missourians turn to Community Health Services for primary care and preventive services - as well as dental, mental-health and substance-abuse services.
Steve Douglas - director of marketing and public relations with ACCESS Family Medical and Dental Clinics in Neosho - said their focus is underserved populations, including people without health insurance or gaps in coverage.
"We're able to get them a lot of care they can't get any other place," said Douglas. "And if we can take care of a debilitating health issue, or a toothache, whatever it may be, they can get back into the workforce and provide for their family and keep them off of other government assistance programs."
Nearly 75% of Missourians served by CHCs have incomes at or below 100% of the federal poverty level. About one-in-four lack health insurance, and nearly half have Medicaid.
Douglas said state and federal funding are critical to their work, especially in rural communities where medical care is more scarce. He pointed to programs such as the National Health Service Corps, which helps connect medical professionals to jobs in underserved areas.
"We need incentives to get the very best providers that we can possibly have," said Douglas. "The people that are in our region deserve the same quality of health care they might see in Los Angeles. So support grants that help us to recruit and train great talent are just vital."
During National Health Center Week, the Missouri Primary Care Association and Community Health Centers are celebrating a $150 million investment in the 2023 state budget that will help expand services.
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Health advocates are hailing the new Inflation Reduction Act, saying it would be the biggest health-care reform since the Affordable Care Act.
The House of Representatives is expected to vote tomorrow on the bill, which already has passed the Senate. Anthony Wright, executive director of the Health Access California, said it includes many proposals activists have pursued for years.
"It would allow the government to negotiate down prices for the most expensive drugs," said Wright. "It would cap Medicare costs for medications, and it would require rebates if prices rose greater than the rate of inflation. That would help millions of Californians."
The bill also would extend subsidies from the American Rescue Plan that help people afford health care. Without the extension, Wright said he predicts the average Covered California enrollee would see an 82% increase in premiums - a jump of about $1,000 per year.
Bianca Blomquist - California policy director and Northern California outreach director for Small Business Majority - said more than half of people enrolled in ACA-subsidized health plans work for or own a small business, or are self-employed.
"The provisions in this package are crucial for the equitable recovery of small businesses in California," said Blomquist. "And we urge Congress to advance a vote on this legislation quickly."
The American Rescue Plan capped CoveredCA premiums at 8.5% of income. That is set to expire at the end of the year unless the Inflation Reduction Act becomes law.
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Backers of a bill now in the U.S. Senate contended it will address rising health care costs and could provide Americans with some relief.
Part of the Inflation Reduction Act would allow Medicare to negotiate directly on prescription drug prices in 2023, and cap out-of-pocket drug costs for Medicare patients at $2,000 a year. It comes a month after Gov. Ned Lamont expanded the state's Covered Connecticut program to adults without children.
Jim Manley, board member of Consumers for Quality Care, noted rising out-of-pocket costs are a chief concern.
"The issue comes down to caps on copays, rising deductibles and prescription drug copays," Manley explained. "Caps on copays are largely absent from the current health care bill that the Senate is going to take up this week. And so, that's been driving out-of-pocket costs higher and higher for more and more Americans."
In the group's new survey, 45% of Americans said their out-of-pocket costs are far too high, and more than 70% feel health care costs are increasing "much more than other things they need." The Urban Institute said one in 10 people in Connecticut, and 13% of Americans overall, have past-due medical debt.
Manley feels while the issue is important, it will not be a dominant factor in the November midterm elections. However, he believes a change is needed. In the survey, 60% of people said they skipped or delayed medical treatment because it is so expensive.
"Health insurers have shifted costs onto patients through higher deductibles and out-of-pocket costs," Manley pointed out. "That's proven to be a real problem for the American consumer. It is leading them to either skip the care and/or go into medical debt. Medical debt is increasingly rampant throughout this country."
For now, the Affordable Care Act outlines out-of-pocket caps, but Manley believes they should be updated. His group also is backing a cap on the price of insulin, which according to a 2020 study is much higher in the U.S. than in most countries.
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