RALEIGH, N.C. - Health-care groups say it's time for Gov. Pat McCrory to make good on his promise to release a plan to expand Medicaid in North Carolina.

The governor delayed a decision pending the Supreme Court's ruling on the constitutionality of state health-care exchanges. With Thursday's favorable ruling, Adam Linker, co-director of the North Carolina Justice Center's Health Access Coalition, said state leaders now should extend the benefit of affordable health insurance to the 500,000 people left in the Medicaid gap.

"There are a lot of conservative states now that have expanded Medicaid to these people, and we should be doing the same," he said. "And now that the Affordable Care Act is here to stay, we should take advantage of that and get the money and jobs that come along with that."

The state Legislature would need to approve Medicaid expansion. The leaders of both the House and Senate have said they are opposed, and others claim it would be too costly. But Logan Smith, communications manager for Progress North Carolina Action, argued that it's a critical matter to address, pointing to research that shows that more than 1,000 North Carolinians will die every year without expansion.

"It's not just an arbitrary concept. It's not only just dollars and cents. It's real human lives," Smith said. "And so the longer Gov. McCrory waits, the more money we lose and the more people who die. This isn't just something that you can twiddle your thumbs on. He needs to act now."

It is the second time the Supreme Court has upheld the Affordable Care Act, and it means that more than 400,000 people in North Carolina will maintain tax credits that make health insurance more affordable. Linker said it also means it's time to build a solid health-care system and end the partisan divide.

"I'm hoping that these two Supreme Court decisions upholding the constitutionality of the Affordable Care Act will mean we can move past that," he said. "There are certainly reforms that need to happen to it, but hopefully we can implement those and make the law better instead of just tearing it down."

After the ruling Thursday, McCrory said expansion needs more examination and there needs to be a balance between helping those who need coverage and keeping the system running for those who currently have insurance.

Research on Medicaid expansion is online at healthaffairs.org. The high court's decision is online at supremecourt.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.