RICHMOND, Va. – States that expand Medicaid are seeing benefits across their health-care systems and beyond, according to new research.

Study co-author Jack Hoadley, a research professor at the Georgetown University Center for Children and Families, said they studied safety-net hospitals and clinics in seven states and confirmed that in the states that have expanded Medicaid, it's relieved a lot of the pressure on health-care providers that struggle to serve the working poor. Hoadley said they've seen dramatic evidence that the benefits extend beyond those doctors and patients.

"It's not just benefiting the patients that are going to come in," he said, "but it's having effects on the budgets of the safety-net institutions and really creating savings for the states and their budgets."

Virginia is one of 19 states that have not expanded Medicaid under the Affordable Care Act. Republicans in the General Assembly have argued that the state can't afford the risk of extending health care to households below one-and-a-third times the poverty rate.

Jill Hanken, a staff attorney specializing in health care for the Virginia Poverty Law Center, said the state's health-care providers favor Medicaid expansion so strongly that they're willing to pay the cost to the state for covering the up to 400,000 Virginians who might qualify.

She said many rural Virginia hospitals fear they won't survive without broadening the program.

"The evidence becomes clearer and clearer that this is the right thing to do and a smart thing to do," she said, "especially to hospitals in rural areas, which in many parts of the country and in many parts of rural Virginia are, in fact, struggling."

In the last Legislature, the Virginia Hospital and Healthcare Association offered to support a voluntary tax on state health-care institutions to fund expansion. In contrast, Hoadley said, similar institutions in expansion states say they can now do a much better job meeting the needs of the populations they serve.

"Behavioral health services, some are adding dental services, more specialty care," he said. "The dollars that are brought into these institutions really are used in ways that fundamentally change the way care is delivered."

The report is online at ccf.georgetown.edu.


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Summer is usually a fun time to enjoy the outdoors with family and friends, but experts said Missourians should be taking precautions to keep a day of fun in the sun from causing serious health concerns.

With climate change, summers have been measurably hotter in the Midwest than in previous years.

Dr. Peter Panagos, professor of emergency medicine and neurology at Washington University-Saint Louis, said if you are going to be outside, choose the right time of day.

"Typically in the Midwest this time of year, it's quite hot with ambient temperatures above 90," Panagos pointed out. "If you can avoid the hottest part of the day, with often can be around noon, between, like, 10 and 2 p.m. or 3 p.m., where the sun is at its highest and its hottest."

Panagos noted it is best to plan activities for early morning or early evening. If you are exercising or hiking, he suggested you go around 7 or 8 in the morning. He advised hikers and runners to take plenty of water and a wide-brimmed hat or baseball cap to help keep your face shaded and your head cool.

Even if you take precautions, being outdoors in the summer can lead to dehydration and sometimes, heat-related illnesses. Panagos emphasized knowing the signs of heat stress can help you deal with it before it becomes a serious matter.

"You may notice things such as dry mouth, kind of all of a sudden shutting down or lack of sweating, dizziness, confusion, headaches, muscle ache," Panagos outlined. "That is your body's way of telling you that it's advancing from just heat exposure to potential heat exhaustion."

Kids love the outdoors, and favorite summer activities include playing their favorite sports, bike riding or going to the pool to cool off. But children are often more susceptible to injuries than adults.

Dr. Donna O'Shea, chief medical Officer of population health for UnitedHealthcare, said a video chat with your doctor can help you decide whether to treat a problem at home or seek medical help.

"Virtual care can help you determine how much, how long to wait, before you go to the emergency room," O'Shea recommended. "Same thing even for sunburns, or for bike safety: 'Do I need to go in?' 'Do you think I need stitches?' And we don't think about that."

Until the pandemic, telehealth and telemedicine were still outliers in health care but they have gone mainstream, especially benefiting underserved and rural New Mexico communities.

Heather Dimeris, director of the Office for the Advancement of Telehealth at the Health Resources and Services Administration, the primary federal agency tasked with improving access to health care services for people who are uninsured, isolated or medically vulnerable, said a national conference being held today will bring public- and private-sector leaders together to discuss topics related to best practices.

"Telehealth licensure, agreements between states to help practitioners practice across state lines, as well as access to broadband," Dimeris outlined. "This is free and virtual and it's open for the public."

Dimeris explained government data show patients who get telehealth services have the same, and in some cases better, outcomes as in-person visits.

Dimeris noted underserved communities often see benefits and improvements in their quality of life through behavioral-health services via telehealth. And those who qualify can leverage the federal Lifeline program, a free government phone service through the Federal Communications Commission.

"Internet is really a foundation of good telehealth services and we can do audio-only appointments, or appointments over the phone, but it's always nice to at least have the video chat," Dimeris pointed out. "That connectivity can be really hard in remote areas of New Mexico."

She added expanding virtual visits could cut down lengthy waitlists for urgent appointments. And she acknowledged many people seeking mental health services prefer to talk with a doctor in order to bypass stigma sometimes experienced with office visits in small communities.

A new analysis from Washington state shows passing an initiative making a long-term care benefit program optional could cost taxpayers millions.

Initiative 2124 would make optional the WA Cares program, in which workers contribute a little more than 0.5% of their paychecks for access to long-term care benefits. The Office of Financial Management estimates passage of the initiative would cost the state between $12 million and $31 million within three years.

Kristin Hyde, press secretary for the group No on 2124, said other analyses have found even greater consequences.

"This initiative would effectively actually end the program, it would shutter it, it would bankrupt the program," Hyde contended. "By 2027, in effect benefits would not be able to be paid out for the nearly 4 million workers who have been vesting in the program."

Supporters of the initiative, including Rep. Jim Walsh, R-Aberdeen, said the program provides little practical effect and people should have choice on whether to contribute to the program. Under the program, Washingtonians will have access to up to $36,500 in benefits from the WA Cares Fund starting in 2026.

Hyde noted the program can be used to pay home aides, for instance, which could help more than 800,000 family caregivers in the state. She added many caregivers are women who sometimes have to choose between work and taking care of family members.

"Long-term care is not covered by regular health insurance and it's also not covered by Medicare," Hyde pointed out. "It's this gap and so we're really in a rock and a hard place here. We don't have anywhere to turn."

Hyde explained it is why state lawmakers approved the WA Cares Fund. She stressed the benefits are flexible and available for use on expenses like home modifications as well.


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