SACRAMENTO, Calif. - Consumer and business groups are speaking out in favor of California legislation to create an agency dedicated to cutting health-care costs.

Assembly Bill 1130 from Assemblymember Jim Wood - D-Santa Rosa - would establish a State Office of Health Care Affordability. The agency would have the power to set cost targets for health plans, hospitals and more - and to enforce them.

Bill Barcellona, executive vice president of government affairs for America's Physician Groups, said experts are needed to ferret out where, how and why the marketplace is failing patients.

"You have to have someone at the top of the system looking at the data, finding the gaps and driving innovation," said Barcellona. "And on the negative side, driving compliance."

Opponents object to what they see as more government intervention in the health-care marketplace.

According to the California Health Care Foundation, costs for California families who get health care through their jobs have jumped 142% in recent years - far outpacing the growth of median household income.

Rhonda Smith, executive director of the California Black Health Network, said the U.S. health-care system is broken.

"We spend the most on health-care costs and we have the worst outcomes," said Smith. "We spend more on hospitalizations than any other developed nation, and we have the worst life expectancy at birth than any other developed nation."

The new agency would look at moving to a new system of payments that rewards providers when they improve patient outcomes - instead of the current fee-for-service model that encourages volume.

Anthony Wright, executive director of the nonprofit advocacy group Health Access, said the current system sets costs primarily based on the potential for profit, rather than effectiveness or equity.

"The price is not necessarily based on the best quality or outcomes," said Wright, "but is based on what the market can bear."

The bill is in the Appropriations Committee. Its backers are asking for $11.2 million to fund the agency for the first year. They say they're optimistic that Gov. Gavin Newsom will include the funding in his budget update, due a week from tomorrow.

Starting Friday, North Carolinians will have greater access to health care as the long-awaited Medicaid expansion is launched.

Medicaid will provide coverage to individuals ages 19 to 64 with higher incomes, allowing eligibility for those earning up to 138% of the federal poverty rate.

Kody Kinsley, North Carolina's Secretary of Health and Human Services, said this expansion will bring essential care to thousands, improving their health and overall well-being.

"That's 600,000 people who will be able to have their medications covered by insurance and that's 600,000 people who -- when they face an emergency event and they have to go to the hospital -- will have the peace of mind to know that they're not going to get stuck with a medical bill that they can't afford," Kinsley said.

In addition to the increased income threshold, the Family Planning Medicaid program will offer reproductive health care at no cost to people with incomes up to 195% of the Federal Poverty Level. This means even a single person earning up to $2,400 per month will have access to essential care.

Kinsley added individuals already receiving family planning benefits and meeting the requirements for full Medicaid will be automatically enrolled on Friday. They should expect to receive notification via mail. He said this expansion not only ensures health care for many throughout the state but also supports hospitals and empowers working families to thrive in the workforce.

"Medicaid expansion helps working families; 80% of the individuals that will benefit from expansion are in working families. It will increase access to mental-health and substance-use treatment and will help build a healthier workforce," he explained.

To support the expansion's non-federal share cost, more than 100 hospitals will also receive about $3 billion through the Healthcare Access and Stabilization Program. North Carolina is now the 40th state to expand Medicaid under the Affordable Care Act.


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Legislation to allow medical aid in dying bill has been introduced in New York State every year since 2015, and its backers say 2024 could be the year it finally passes.

The bill would allow terminally ill people with only six months to live to use this option rather than endure unending pain.

Proponents point out that numerous safeguards are key components of the bill, including requiring two physicians to approve the request.

Assemblymember Amy Paulin - D-Scarsdale, the bill's sponsor - said she is convinced the reason it hasn't passed yet is fear of the unknown.

"Any new concept - and this is relatively new, new for New York, anyway - takes time," said Paulin. "Death is certainly a very sensitive topic - it's going to happen to all of us one day, and people avoid thinking about it. In this context, the concerns are forcing someone to do it, protections around it, all of those things."

Given that it's a complex and emotional issue, Paulin said she finds it's taken quite some time to educate people about it.

Opponents often refer to medical aid in dying as "assisted suicide," but the latest Siena College poll finds more than half of New Yorkers would support a medical aid-in-dying law.

Currently, ten states and Washington, D.C, have medical aid-in-dying laws.

Corinne Carey - campaign director for New York and New Jersey with the nonprofit Compassion & Choices - said she was concerned the pandemic might turn people off to this concept.

Instead, she said she finds it got more people interested in pursuing what she calls a "good death."

"No death is a 'good death,'" said Carey, "but certainly New Yorkers know that they don't want a death where they are separated, isolated from loved ones and suffering at the end."

A substantial number of New York lawmakers cosigned the bill, and Carey noted that it's up to the state's leadership to get this legislation across the finish line.

The American Lung Association has released its annual State of Lung Cancer report - showing Maryland needs to do more for high-risk patients.

While Maryland scored at or above average on a number of metrics, the report found just under 3% of high-risk patients in the state are getting screened for lung cancer - which is below the national average of 5%.

Among Marylanders who are diagnosed with lung cancer the report shows most are getting treatment, as the state was ranked 7th for surgery and had an above average 5-year survival rate.

Aleks Casper, Maryland director of advocacy with the Lung Association, said more outreach needs to be done around screening.

"The good news is that people who are being diagnosed with lung cancer are living longer," said Casper. "Where we have to do some work is that we're still seeing only a fraction of people who are eligible to be screened are receiving that screening."

The U.S. Preventive Services Task Force updated the lung cancer screening guidelines in 2021, expanding them to include a larger age range and more current and former smokers.

Tobacco use is the leading cause of lung cancer, though the smoking rate in Maryland is below the national average.

The second most common cause of lung cancer is radon, an odorless and colorless gas that seeps into homes and buildings from the soil.

In Maryland, over 20% of radon tests results were at or above Environmental Protection Agency action level.

Lung cancer is more curable when detected early. Casper said despite the low screening rate in Maryland, the state is doing a good job of treating lung cancer patients.

"We're above average in making sure that people are getting connected to treatment," said Casper. "You know in Maryland, we're looking at an 11% improvement in our survival rate. So it's about kind of connecting that first piece of screening to all the other components."

Nationally early detection has improved five year survival rates by 22%. You can read the full report at lung.org.





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