TALLAHASSEE, Fla. – Dos tercios de los estados han ampliado sus programas de Medicaid, pero Florida no es uno de estos. En consecuencia, dice un reporte, los residentes con menores ingresos del estado carecen de seguros de salud, en cantidades mayores que en otros estados. Comenta Anne Swerlick, defensora y analista de políticas, en el Instituto de Políticas de Florida ("Florida Policy Institute"); y Joan Alker, coautora del estudio y directora ejecutiva del Centro de la Universidad Georgetown para los Niños y las Familias ("Georgetown University Center for Children and Families").

La Florida no es uno de los 33 estados que ampliaron su programa "Affordable Care Act" - pero si hubiera sido, más residentes rurales de bajos ingresos tendrían seguro médico. Un reporte reciente de la Universidad Georgetown muestra grandes vacíos de cobertura en estados que no expandieron Medicaid. Anne Swerlick, del Instituto de Políticas de Florida ("Florida Policy Institute"), dice que principalmente los pueblos pequeños están perdiendo en términos de la salud y el progreso económico que el acceso a la atención ha traído a otros estados. En vez de eso, dice Swerlick, Florida está entre un montón de estados con altos índices de adultos de bajos ingresos que no tienen seguro, en las áreas de mayor necesidad.

"En las areas rurales llega hasta el 37 por ciento, contra el 24 en areas urbanas. En algunos condados de Florida, como Columbia y Jackson, las tasas son incluso mas altas, en el rango del 40 o 42 por ciento."

El reporte muestra que la tasa de no asegurados entre los adultos de bajos ingresos ha bajado en la última década en casi todos los estados, pero los descensos más marcados están en pueblos pequeños y áreas rurales, donde los programas de Medicaid fueron ampliados. Luego de dudar un poco, el Gobernador Rick Scott y la Legislatura controlada por los Republicanos rechazaron la expansión por motivos de costos.

La co-autora del estudio, Joan Alker, de la Universidad Georgetown, dice que realmente hay ahorros en las tarifas de mejor cobertura y un sistema más estable de atención a la salud.

"Realmente es un uso mas inteligente de los dolares de los contribuyentes para proveerles la atencion preventiva primaria que viene para empezar al tener seguro medico, para que no se enfermen y terminen en la sala de emergencias."

Swerlick dice que en todo el estado, muchos que andan sin seguro son padres de hijos pequeños.

"Florida tiene una elegibilidad extremadamente restrictiva para que estos padres entren a Medicaid; apenas el 34 por ciento del nivel de pobreza, que se traduce en $7,000 al ano por familia de tres."

Las comunidades no metropolitanas de Florida, con la mayor participación de adultos en 2015 y 2016, fueron los condados de Columbia, Jackson, Putean, Okeechobee y Suwannee.

Florida no esta entre los 33 estados que ampliaron su programa Medicad bajo la Ley de Cuidado Asequible (Affordable Care Act), pero si hubiera sido, mas residentes rurales, mas residentes de bajos ingresos tendrian cobertura de salud. Un reporte de Trimmel Gomes (trim-MELL GOAMZ).

...Republicanos rechazaron la expansion por motivos de costos.

El informe: ccf.georgetown.edu/topic/rural-health/.


get more stories like this via email

United States Secretary of Health and Human Services Xavier Becerra and U.S. Rep. Yadira Caraveo - D-Thornton - recently paid a visit to Salud Family Health Centers' mobile clinic.

Each year, Salud serves up to two thousand migrant farmworkers who travel from other states and countries to plant and harvest leafy greens, corn, wheat, sugar beets, and other crops in North Central and Northeastern Colorado.

Director Deborah Salazar said her team always gets a very warm welcome.

"And it's usually the same guys that come to the same farms or greenhouses," said Salazar. "And so it's like seeing old friends. They know who we are, they know what we can do for them, and they trust us. There is trust because we have been doing this for a very long time."

In addition to its 12 brick and mortar health centers, and ten school sites, the mobile unit provides primary health services three to four evenings per week - primarily in rural areas.

They screen workers for diabetes, hypertension, cervical cancer, and anemia. Workers can also get lab tests, and flu and tetanus vaccines.

Salud is a federally qualified community health center that provides medical, dental, pharmacy, and behavioral health care services to all patients regardless of their ability to pay.

The first clinic on wheels was acquired in 1980, and Salazar said a brand new unit was rolled out in 2022.

She said her team works to build relationships with farm owners and supervisors to find the best time to plan a visit.

"If they need us to come out and start our visit on the mobile unit at 7 p.m, we can do that," said Salazar. "We are super flexible, because we don't want to interrupt their work day."

Salazar said the medical staff on the mobile unit might be the only people migrant workers see when they are not out planting and harvesting crops.

"These are the folks that put food on our table," said Salazar. "To give them quality, integrated health care - and go to them, so that they are taken care of - this is the least we can do."




get more stories like this via email

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.


get more stories like this via email

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.