SALT LAKE CITY - Utah voters approved a ballot measure last year to enact full Medicaid expansion under the Affordable Care Act, bringing health care to 100,000 lower-income residents. But that isn't the last word. A bloc of conservative state lawmakers, saying there isn't enough money to pay for the expansion, are looking to "repeal and replace" Proposition 3 with a less-ambitious plan.

While the state Constitution allows lawmakers to make changes to ballot initiatives, Chase Thomas, executive director of the progressive group Alliance for a Better Utah, said this alternative plan seems designed to thwart the will of the voters.

"We understand small changes, to implement the propositions into existing law and also just to make them feasible," he said. "What we don't support are changes that implement new policy or change the policy desires of the people."

Thomas said legislators trying to limit the the Medicaid expansion are the same ones who have blocked it in the past. Their claim is that Prop 3 won't generate enough revenue for the program, but Thomas pointed to hundreds of millions of dollars in the state's surplus fund. Conservatives had proposed limited Medicaid expansion, contingent on federal officials granting the state a waiver, which it has failed to get.

According to Thomas, a bill expected in the upcoming session would drop Medicaid eligibility rates from 138 percent to 100 percent of the federal poverty level, add a work requirement for many people and extend the launch date well past April 1.

"Medicaid expansion, as we all know, is not a new discussion," he said. "It's been around for six years now, and they have been worried about costs. But the people wanted full Medicaid expansion, and they even increased taxes on themselves to fund it."

Under Utah law, Thomas said, ballot propositions can be modified or even repealed by the Legislature, but at lawmakers' political peril. He said Utah voters bypassed lawmakers on three progressive issues this past November.

"We had medical marijuana, Medicaid expansion and redistricting reform all on the ballot, and they've been coming up in the Legislature every single year for the past four to six years," he said. "It's just these high-profile progressive issues where the public wants to move faster than the Legislature's willing to do."

The new General Session starts on Monday.

Information on Prop 3 is online at ballotpedia.org.


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As the summer sun blazes, especially in the Sunshine State, it is easy to get caught up in the fun and excitement of the season. But according to health experts, staying mindful of hot weather health risks is crucial.

With searing temps causing a spike in emergency room visits for heat-related issues in some states, health experts said there are simple steps to stay cool and spot potential signs of overheating, including headaches, nausea or dizziness.

Dr. Del Carter, family medicine resident at Tallahassee Memorial Healthcare, said as a general rule, people should drink at least 64 ounces of water daily, or about eight glasses, and dress for the weather.

"Long, loosefitting clothing is helpful, sunscreen is definitely helpful to protect your skin as well," Carter outlined. "Then, really just trying to stay out of the environment when it is at its worst is going to be the most helpful things."

For being in and around water, he recommended ensuring protective barriers around pools, actively monitoring kids and wearing flotation devices. It is also smart to take swimming lessons and be CPR certified to ensure safety for all.

Heatstroke requires emergency treatment. Symptoms and signs include an altered mental state or behavior, nausea and vomiting, and a racing heart rate.

Donna O'Shea, chief medical Officer of population health for UnitedHealthcare, said virtual care is also an option for discussing symptoms with a health care professional.

"How long to wait before you go to the emergency room? Same thing, even for sunburns or for bike safety: 'Do I need to go in? Do you think I need stitches?'" O'Shea explained. "We don't think about that with virtual care, but the technology is really good."

O'Shea added among the benefits of virtual care is the ability to connect to someone for help 24/7, and most insurers offer it at no additional cost, including some of her company's plans.


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As summer kicks into full gear, North Carolina dentists stressed the importance of maintaining children's dental health.

Dr. Miranda Kalaskey, a dentist in Raleigh and member of the North Carolina Dental Society, said with more outdoor activities and changing routines, dental care can often be neglected, leading to cavities and dental trauma. Her advice is for parents to keep up with preventive care and encourage healthier eating habits.

"Try to pick a healthy summer snack. That can be fruit. That can be vegetables. Just not something dry, not something processed," Kalaskey outlined. "And the more processed you have, the more dried it is, the more likely it is to stick to their teeth."

She pointed out left-behind food can cause cavities. Tooth decay is the most common chronic disease among children in the U.S., with more than half of eight-year-olds having had at least one cavity in their baby teeth, according to the Centers for Disease Control and Prevention.

Warmer weather also means more outdoor play. Kalaskey highlighted the rise in dental trauma cases during the summer because of increased outdoor play and sports activities.

"Oftentimes, kids are going and playing basketball, and sometimes high schools are really good about, 'Hey, here's a mouth guard,' or 'You need to get a mouth guard for practice,'" Kalaskey noted. "But during the summer, a lot of times kids will play with other kids, which is great, but making sure they're aware that tooth trauma is a thing."

If a tooth gets knocked out, contact your dentist immediately. If it is after hours, she suggested the ToothSOS app for guidance.

She added another major key to dental hygiene for kids over the summer is a consistent schedule.

"Summer oftentimes is going to change that routine but your brushing, flossing routine does not need a change," Kalaskey recommended. "You still want to do brushing twice a day, flossing at least once a day. So kind of making sure we incorporate that, even though the kids might be waking up at 10 o'clock."

Kalaskey emphasized routine is also important for dental visits. She advised children should be seen by a dentist when they get their first tooth and then every six months afterward. In addition to keeping teeth healthy, she stressed it also builds a good relationship with dental visits in the long term.


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A Virginia community health center is part of a program addressing food scarcity.

The National Association of Community Health Centers' 2024 Innovation Incubator creates ways to expand healthy food access. Tri-Area Community Health Center's Laurel Fork location will have funding and guidance from experts to help them design and test community-based solutions.

Merrill Warschoff Press, senior vice president of partnership, development and innovation for the National Association of Community Health Centers, said the centers are uniquely suited to address local food issues.

"Health centers are highly effective and innovated with integrated models of care," Press explained. "They reach far beyond the walls of the traditional exam room, not only to prevent illness and treat it but to really address the social drivers that may cause poor health."

Food insecurity has grown since pandemic-era programs ended in 2023. Emergency allotments provided SNAP recipients with an added $95 per month for 470,000 families statewide. However, some people are above or below SNAP's qualifying threshold.

Other issues stem from food prices. The Consumer Price Index shows food prices grew between 2022 and 2023 but in recent months, prices have been declining.

A primary goal of the Innovation Incubator is to discover best practices for providing care for millions of people and share them with health centers nationwide. Press noted the methods being worked out can help varying populations.

"There are many health centers who have large populations of patients who come from other countries and are used to certain foods, and have different preferences," Press observed. "Being able to work with them in their own language with the foods that they like and trust is really valuable to improving access to food that'll make a difference in their lives."

Food pantries have been key to reducing food insecurity wherever possible. Virginia food banks saw a 5% to 10% increase in demand at the end of 2022, which is problematic since food banks nationwide are seeing donations decline and reduced commodities from the Emergency Food Assistance Program.