The open enrollment period to purchase health insurance through the federal marketplace begins Nov. 1, and experts urge consumers to do some research about exactly what you are getting.

Last year, Tennessee's uninsured rate was 9.3%, according to the U.S. Census Bureau.

Michele Johnson, executive director of the Tennessee Justice Center, said open enrollment enables people to buy affordable, comprehensive health insurance to protect their savings and their family.

"One thing that I think many people are concerned about is, can they afford the premiums," Johnson pointed out. "And in a wonderful way, the federal government is subsidizing the cost of premiums. And so, the vast majority of people who are applying will be able to get a plan for $10 a month or less."

The Inflation Reduction Act included a provision to extend premium subsidies through 2025, so the same subsidy in effect this year will continue for 2024. Look online on HealthCare.gov to determine your eligibility.

Johnson said about 300,000 people are without health coverage across the state, as Tennessee has not expanded its Medicaid program, known as TennCare. The state has taken large numbers of people off the Medicaid rolls since the pandemic's Public Health Emergency ended.

Johnson pointed out about 75% of those who have been dropped from Medicaid coverage are still eligible but were cut off due to procedural reasons.

"Depending on their income, they might be eligible to stay on Medicaid, which is free and comprehensive, and has certain protections that really are unmatched," Johnson stressed. "But if their income has gone up and they don't qualify for Medicaid anymore, they too should apply for the Affordable Care Act."

Dr. Rhonda Randall, chief medical officer of Employer and Individual for UnitedHealthcare, said when shopping for new health coverage, comparing plans is critical. She recommended people pay close attention to the coverage for specialty benefits such as dental, vision, hearing, critical illness and mental health.

"You want to know what specifically, you're going to have access to," Randall explained. "How big is the network of therapists and psychiatrists, mental health professionals? Some employers offer navigation or advocacy services to help you find a good fit; somebody who has an appointment available, who has the right skills for the concern that you have."

Randall noted the Medicare open enrollment period is Oct. 15 to Dec. 7. She added it is important to learn the difference between Medicare Parts A, B, C and D, Medicare Advantage plans and prescription drug coverage. She recommended the website MedicareEducation.com as one source of this information.

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.