SIOUX FALLS, S.D. - All across the state of South Dakota, bed bugs are making a comeback. The resurgence is attributed to increased travel, an overall lack of awareness and the stigma surrounding these hard-to-eliminate insects, according to Dr. Dini Miller, who is associate professor in Urban Pest Management at Virginia Tech. She says the blood-suckers can be found in all kinds of places, from hotel rooms and college dorms to apartment buildings. And now that they're back, she says, the best form of prevention is awareness.

"We don't think twice about putting our bag in the seat next to us if we go to the movies; about storing our son's or daughter's college furniture in our basement. These are all ways that bed bugs can get into the home."

Miller says it's important not to go after bed bugs with chemical insecticides on your own, without calling a professional. The EPA has expressed concerns over exposing children to such chemicals.

Miller says there are some non-chemical alternatives, such as food-grade diatomaceous earth, which can be placed around baseboards and on mattresses and bedding, and which is fatal to bed bugs; it robs moisture from their bodies. She says using mattress covers to keep them on the outside of the bed is a good idea. Washing sheets, clothing, stuffed animals and bags won't always get rid of them, but ten minutes in a hot dryer kills both the bed bugs and their eggs.

Clark Hepper, administrator for the South Dakota Department of Health, says that when you are on the road there are some precautions travelers can take.

"Store your luggage and your personal items not on the floor, maybe by hanging them. Store them in a manner that they aren't going to come in contact with the floor."

Mature bed bugs are roughly the size and shape of an apple seed, although immature ones can be much smaller.




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A coalition of Montana groups will rally at the Capitol Wednesday to advocate for the protection of Medicaid expansion, which legislators will debate this session before the program's scheduled expiration in June.

The state's 10-year-old Medicaid expansion program covers 75,000 low-income Montanans at an annual cost of about $1 billion, according to KFF Health News. The state picks up about 10% of the tab.

Kristen Stewart of Billings is a caregiver for her 90-year-old grandmother, and enrolled in Medicaid herself. As an organizer with the advocacy group Big Sky 55+, she noted many Medicaid enrollees work but the work is often undervalued.

"Medicaid supports a lot of people who are doing unpaid work," Stewart pointed out. "Things that were we to monetize, you would see an economic boost from their production level, often more than the cost of their care."

The Gianforte administration already tightened eligibility for the program, cutting the number of enrollees by nearly 40% between May 2023 and October 2024. The program currently covers nondisabled adults ages 19 to 64 who make less than $21,000 a year.

Jeannie Brown, a bus driver for the Belgrade Public School District and a full-time caregiver and legal guardian for her teenage granddaughter, said if Medicaid expansion does not get reauthorized, she will be on a "slippery slope."

"Because I'm 60 years old and I'm having my own health issues after being a caregiver, it's hard work and it takes a toll on you physically, financially and emotionally," Brown explained. "I'm hoping these legislators really take all of these things into consideration and reauthorize it."

Any laws passed on the issue could also affect the state's behavioral health services, which Gov. Greg Gianforte has made a priority.

Obtaining medical records can be a costly endeavor but there is hope Washington state lawmakers could find a fix this session.

Medical providers look for compensation when producing medical records because of the work involved in the process.

Holly Brauchli, an attorney at Seattle Injury Law, said an outdated process is used to determine the cost. Federal law requires all records to be digitized and Brauchli pointed out providers charge per page as if the records were on paper.

"We download it and we get a bill for thousands of dollars and the justification of that bill is that there's a per page charge," Brauchli explained. "I get these invoices that say copying charge per page. There are no copies."

Brauchli noted there are a variety of reasons why someone would want to obtain their medical records. For instance, the records could be important to an injury lawsuit or someone might want to check if their health insurance was billing them correctly.

Brauchli argued records should no longer be charged as if they are on paper.

"This seems like a really easy fix and certainly one that would help Washington citizens," Brauchli contended. "People have a right to know what's in their medical record and they have a right to be able to see it. So, to me, it's a really simple and elegant fix."

A bill has not been filed yet but is expected from Sen. Tina Orwall, D-Des Moines, soon. The 2025 legislative session starts today.

This Wednesday is the deadline to enroll in Affordable Care Act marketplace health coverage.

Advocates say this year is even more critical for those seeking a plan, because the expanded tax credits that allowed many Kentuckians to enroll in health coverage - at little or no monthly cost - are set to expire at the end of this year.

After Jan. 15, folks will have to qualify for a special enrollment period to take advantage of Advanced Premium Tax Credits while they still exist.

Priscilla Easterling, director of outreach and enrollment with Kentucky Voices for Health, said the state's uninsured rate could potentially increase if families can't afford coverage without the credits.

"I think we should all be very concerned," said Easterling. "Without these enhanced premium tax credits being extended, we're going to see enrollment drop off, because families will no longer be able to afford that monthly premium."

According to research from the Robert Wood Johnson Foundation, the elimination of expanded tax credits would especially impact older adults - who tend to have higher health coverage costs.

In 2024, people over age 50 made up more than one-third of total ACA enrollment.

Easterling said in many cases, for low-income individuals making around $22,000 per year, the credits covered the full cost of their plan, and have saved Kentuckians thousands of dollars a year.

"They have been around for the duration of the ACA," said Easterling, "but the enhanced part that was first expanded in 2021. They have, on average, saved most households over $500 per month."

Easterling said residents can find local experts at kynect.gov to help them take advantage of tax credits and find the best plan for them.

"There are 'kynectors' available in all 120 counties," said Easterling, "who can help and provide free assistance for anyone who needs help navigating Kynect.gov or trying to get enrolled in coverage."

During 2024, more than 71,000 Kentucky residents enrolled in a plan through the marketplace, according to the health advocacy group KFF.

Nationwide, a record 24 million people have signed up for insurance coverage through the Affordable Care Act, according to federal data.