HARRISBURG, Pa. – Almost a million Pennsylvanians would lose their health insurance with even a partial repeal of the Affordable Care Act, according to a new report. Congressional Republicans say repealing the ACA will be high on their agenda in the coming year. But a new study shows that, nationally, a partial repeal would increase the number of uninsured people by almost 30 million by 2019, compared to leaving the ACA in full effect.

Joan Alker, executive director of Georgetown University's Center for Children and Families, said that would apply to children as well.

"The number of uninsured kids would double if Congress takes away health coverage by repealing the ACA without first doing the hard work of negotiating a replacement plan and 'stapling' it to that same bill," she said.

The report by the Urban Institute said in Pennsylvania, some 956,000 would be without health insurance, a difference of more than 130 percent.

And according to Alker, more than 80 percent of those who would lose their insurance are in working families.

"The majority of those are non-Hispanic whites, and 80 percent of the adults becoming uninsured would not have college degrees," she added.

The report also found that with the elimination of the Medicaid expansion, premium tax credits and cost-sharing, federal spending on health care would drop by $109 billion by 2019.

But Aiker pointed out that, though insurance may be lost, families' health-care needs won't go away.

"And the responsibility for responding to that will fall squarely into the states' laps, and we'll have huge gaps in our health-care safety net," Aiker explained.

The report estimates that an ACA repeal would cost Pennsylvania alone $36 billion in lost federal Medicaid and Children's Health Insurance Program dollars over ten years.


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Health-care advocates are vowing to continue their fight to expand Medicaid in Kansas - despite this week's election, which expanded the Republican supermajority.

Gov. Laura Kelly, D-Kansas, supports expanding the program to more low-income families under the Affordable Care Act - but conservative lawmakers passed a law forbidding the move.

April Holman, executive director of the Alliance for a Healthy Kansas, is among those calling for change.

"I think the bottom line is we have really been focused on building a grassroots movement that is too large and too loud for policymakers to ignore, and that's what we're going to continue to do, even with the most recent election results," she said.

Data from the Kansas Department of Public Health shows a maternal mortality rate of 11 deaths per every 100,000 live births. The agency found 13 maternal deaths from 2016 to 2018 and found all but one were preventable. And two-thirds of mothers were racial and ethnic minorities.

Holman noted that more than 14% of babies born to Black mothers in Kansas have low birth weights, and Black mothers are 200% more likely to have a low-birthweight baby.

"We think that in part that has to do with access to affordable health care, not only later in their pregnancy but also at the beginning and even pre-pregnancy," Holman continued.

The Kansas Health Institute estimates that almost 152,000 Kansans - including more than 45,000 children - would enroll in KanCare if Medicaid were to be expanded.


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Amid a nationwide shortage of respiratory therapists, an "earn while you learn" initiative is underway to build a skilled workforce in Virginia to meet growing respiratory care demands.

Sentara Health and Tidewater Community College have launched a respiratory therapy apprenticeship program, which covers educational expenses of nearly $18,000 over two years, while providing hands-on experience at Sentara Norfolk General Hospital.

Kristian Vasconcellos, one of the program's first apprentices, likes the linking of the classroom to the workspace.

"You know, us cleaning the vents or cleaning the machines or the equipment, I do get that experience of being in school and saying, 'Oh my gosh, I know what that is, I know how this works,'" Vasconcellos explained.

Students spend 32 hours each week in academic and clinical training and an additional eight hours working at the hospital, where they encounter a range of real-world medical situations involving asthma, sleep apnea and others. Industry experts have noted a growing need for respiratory therapists, especially following the COVID-19 pandemic, which has led to increased worker burnout and hospital staffing shortages.

Tara Almony, manager of respiratory care and pulmonary diagnostics at Sentara Norfolk General Hospital, expressed enthusiasm about the program's potential to ease the staffing shortage and prepare students for the realities of the job.

"We were looking and thinking outside the box of how we could be creative and how to bring respiratory therapists in, help them," Almony outlined. "Then also, how we as a Norfolk General could help them grow and kind of create a pipeline for ourselves in a way. "

The demand for respiratory therapists has surged, with the U.S. Bureau of Labor Statistics projecting a 14% increase in job openings by 2031. The median annual salary for a respiratory therapist is currently $77,960.


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A Wyoming helpline connects callers to a variety of health and human services, including help with health insurance during open enrollment.

Olivia Schon, deputy director of Wyoming 211, said the service fields 20 to 30 calls a day. Specialists then connect callers with appropriate resources from a database of nearly 3,000 options, ranging from small nonprofits to state and federal programs.

Schon pointed out the top issues people call about are rent and utility payment assistance programs, food insecurity and transportation to health providers. She noted initial conversations often unveil more areas in which the caller can use assistance.

"We average four times the amount of referrals going out based on phone calls coming in," Schon reported. "They call with what their first issue is and then they leave with more than one solution to other problems that they also have going on."

When callers need assistance enrolling in health insurance, they're connected with Wyoming 211's "sister program," Enroll Wyoming. Open enrollment starts Friday.

The rate of health insurance enrollment in Wyoming through the marketplace has increased 75% since 2020, according to KFF. In a round of federal funding announced in September for health insurance navigators, Enroll Wyoming received a $1.5 million grant to continue offering its services for free.

Caleb Smith, marketing director for Enroll Wyoming, said making important decisions around health care can be intimidating.

"It doesn't hurt to have somebody who's on your side," Smith explained. "Who's willing to act as an advocate for you to make sure that you have your questions answered, that you have what you feel like you need to be able to make an informed, empowered decision."

Wyoming 211 is available by dialing 211 from any phone in the state.