LITTLE ROCK, Ark. – Low-income families in Arkansas have seen significant improvements in health care under the state's expanded Medicaid program, but proposed changes could put those gains in jeopardy.

A new study says states, including Arkansas, that expanded Medicaid under the Affordable Care Act have had greater access to care and better health outcomes, compared to states such as Texas that chose not to expand the program.

Study co-author, Benjamin Sommers, associate professor of health policy at the Harvard T.H. Chan School of Public Health, says researchers found under Medicaid expansion, low-income adults came out way ahead.

"The coverage rates went way up in Arkansas and Kentucky,” he points out. “They went up by a little bit in Texas, but not nearly as much. And that this coverage really led to dramatic changes in a variety of different ways as to the types of medical care that people were getting."

Sommers says in Arkansas, Medicaid has cut the uninsured rate by more than 20 percent, significantly increased the number of patients with a regular source of care and has more Arkansans saying their health is excellent.

But policy changes under consideration in Little Rock and Washington could erode those gains.

Marquita Little, health policy director with Arkansas Advocates for Children and Families, says state officials have proposed a plan to cut Medicaid enrollees, despite what she sees as pockets of poverty with an overwhelming need for expanded coverage.

"Chronic illnesses and poor health outcomes really disproportionately affect the rural counties, where access tends to be much more limited,” she states. “So, that certainly would have a major impact, and really impede some progress that we are making in our state."

Little worries that proposed changes to the ACA could make health insurance too expensive for some Arkansans.

Sommers agrees, and maintains its proposed replacement, the American Health Care Plan, could stymie health care progress in the state.

"Any change by state or federal policymakers that would lead to loss of coverage would put a lot of these benefits at risk, and could have a real negative impact, especially for poor adults and those with chronic diseases," he stresses.

At the moment, Arkansas officials await federal approval to reduce the Medicaid rolls by about 20 percent, while Congress is formulating a replacement for the ACA.




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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.