RALEIGH, N.C. - Parents in North Carolina are among those feeling the effects of the state's decision to turn down federal dollars to expand Medicaid. A new report released this week by the Urban Institute examines the impact to the more than 300,000 North Carolinians who fall into the coverage gap; they don't qualify for publicly funded-health coverage, or an insurance policy through the Affordable Care Act. Genevieve Kenney, co-director in the Health Policy Center with the Urban Institute, says there's a growing disparity between parents in states that opted for the expansion, and those that did not.

"Parents in the states that have not expanded Medicaid have an uninsured rate that is close to 20 percent, where it's closer to 10 percent for the states that have expanded Medicaid," Kenney says.

The report says states that have accepted federal funding have seen nearly a 33-percent drop in the rate of parents without health insurance. North Carolina lawmakers turned down the funding because of concerns over costs to the state. The federal government is paying 100-percent of the cost until 2016 and will reduce its funding to 90-percent by 2020.

Adam Linker, policy analyst with the North Carolina Justice Center's Health Access Coalition, says knowing the expansion could have provided care for thousands of uninsured people is a bitter pill to swallow.

"The most frustrating thing is there's really no reason North Carolina is not expanding, other than ideological reasons," he says.

Seventeen percent of uninsured parents surveyed reported having fair or poor health, and slightly more said they had mental-health concerns. Linker says research indicates when parents have access to preventive coverage and care when they are ill, they're also able to care for their families.

"We know insured parents are able to be more present in their children's lives. They're able to take better care of their children, because they are not themselves sick," Linker says.

According to the research, nearly half of the uninsured parents studied lived in southern states and more than half were Latino.


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Groups across the state are working to reduce overdose deaths among minority populations.

According to state data, overdose deaths are on the decline but among Black residents, there were around 68 deaths per 100,000 people last year; more than 51% greater than the overall rate of deaths.

Matt Johnson, board member of the nonprofit CARES Coalition in Franklin County, said the county is struggling with a lack of emergency shelter and medical services for undocumented individuals. The coalition's Community Connectors Project aims to go door-to-door in neighborhoods to help residents access the services they need.

"People who don't necessarily have a visa or a green card, or even health insurance," Johnson outlined. "We need them to be able to go and receive services; for kids to be able to see dentists, especially within our minority population has been a challenge."

The coalition is one of 10 organizations awarded $50,000 grants from the Foundation for a Healthy Kentucky's Funding for Recovery Equity and Expansion program, a partnership with the Cabinet for Health and Family Services' Kentucky Overdose Response Effort.

In Western Kentucky, the Four Rivers Foundation has expanded mental health and health care services in underserved schools.

Dr. Alex Wright, CEO of Wright Medical who works with the foundation, said gaps in access often result in students either not receiving or experiencing long delays in care. He noted so far, more than 3,000 students have been served in the classroom.

"In some of our districts, we estimated up to 50% of children were lacking any continuity of health care," Wright reported. "Many of these children haven't had a pediatrician or primary care provider, usually since they were an infant or a toddler."

Research points to increased stigma surrounding substance use disorder and mental health in communities of color. According to the Yale School of Medicine, treatment inequities persist. Nationwide in 2018, the majority of Black and Hispanic people diagnosed with the substance use disorder did not receive treatment.


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By Cat Sandoval for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

Respiratory syncytial virus (RSV) is on the rise in Indiana, according to the Centers for Disease Control and Prevention, and it's forcing some hospitals to implement visitor restrictions.

Dr. Christopher Doehring, of Franciscan Health in Indianapolis, spoke with News 8 about why this respiratory virus increases during winter months and what hospitals are doing to prevent its spread.

"Like most of the respiratory viruses, as the weather turns cooler and people spend more time inside and around each other, its a just a highly contagious respiratory virus," Doehring said. "Like all respiratory viruses, we tend to see an increase in cases this time of year."

Holiday get-togethers can help spread the virus.

"You start to see around Thanksgiving time, you start having families coming together," Doehring said. "They're spending times in doors and it's multiple generations together. It's a natural epidemiologic phenomenon."

According to medical experts, RSV causes infections in the lungs. In healthy adults and older children, symptoms are mild, similar to the common cold.

RSV can be prevented by using good hygiene, such as washing hands and avoiding touching one's face.

Doehring said babies, premature babies, and immunocompromised elderly adults can experience severe cough, shortness of breath, and pneumonia, or even death. Doehring recommends getting vaccinated.

"Once you have the symptoms or are under the weather, take the time to recover, heal, and minimize exposing others as best as you can," Doehring said.

At Franciscan Health Hospital, masks and hand sanitizers stations are readily available to prevent the spread. Those under the age of 18 because younger visitors are more likely to spread respiratory viruses. Other hospitals in Marion County are doing the same.

Doehring says he has seen an increase of RSV cases, which is typical this time of year, but it's not alarming.

"Certainly in our hospitals and around other hospitals in central Indiana, we're not at a point where we're overrun or overcrowded in our ICUs or emergency department," Doehring said.


Cat Sandoval wrote this article for WISH-TV.


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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.