RICHMOND, Va. -- Today is the 10th anniversary of the launch of the Affordable Care Act, and health care advocates say the federal health insurance exchange is more important than ever as we face the coronavirus outbreak.

Even as his administration continues to attack the law in courts, President Donald Trump is considering allowing open enrollment at healthcare.gov to tackle the current public health crisis. Giving more people health insurance is crucial to containing the virus, said Laverne Jackson, a nurse and member of Virginia Organizing.

"If you don't have health insurance and you have symptoms, people are going to try to self-treat," Jackson said. "And that's only going to make the virus worse, because then you're going to expose other people."

Since the ACA became law in 2010, 20 million Americans have gained health coverage. More than 400,000 Virginians are enrolled in Obamacare policies through the exchange, and more than 385,000 gained coverage through the Commonwealth's Medicaid expansion in 2019.

The ACA has helped about 130 million Americans with pre-existing conditions gain protections when private insurance companies denied them coverage. Charlottesville resident Susan Perry said the insurance plan literally saved her life and her life savings. She said no insurance company would give her coverage when she had to leave her job and start chemotherapy for ovarian cancer in 2013.

"The infusions could run as much as $17,000 a month," Perry said. "And without the Affordable Care Act and having a cap on my insurance, basically over the years I would have had to declare bankruptcy."

Americans remain deeply divided over the Affordable Care Act. A 2019 Kaiser Family Foundation study found 51% of American adults polled viewed the federal insurance program favorably while 40% disapproved.


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The Episcopal Health Foundation wants Texas lawmakers to make health a priority during this legislative session.

The nonprofit focuses on the nonmedical drivers of a person's overall health, such as economic status, health behaviors and safe neighborhoods where people can exercise.

Ann Barnes, president and CEO of the foundation, said they would like to see legislation on maternal health, food security and diabetes prevention.

"These are health conditions that affect low-income populations and communities of color," Barnes pointed out. "We are looking for opportunities to support legislation that improves those outcomes."

Barnes noted during the last legislative session, lawmakers passed bills that approved Medicaid screenings for nonmedical factors that influence health and for doulas to serve as case managers for pregnant people. She looks forward to having those bills implemented.

A recent survey by the foundation found nearly half of adults in Texas say they live in a household experiencing diabetes or prediabetes.

Barnes argued not addressing the problem puts an economic strain on the entire state.

"Between $6 billion and $8 billion, that's billion with a B, is spent on the treatment of diabetes through the Medicaid program," Barnes emphasized. "That is about a quarter of all dollars spent on adults on Medicaid."

She added health care only affects about 20% of a person's overall health. The other 80% is determined by their environment.

The Los Angeles area wildfires will affect people's health for many years, according to disaster relief experts.

The fires can cause severe mental health issues, displacement and financial ruin, which make it harder for people to care for their health.

Talya Meyers, senior editor and writer at the nonprofit Direct Relief, said the disaster takes a heavy toll far beyond those killed in the fire.

"When a natural disaster hits a community, there are long-term impacts that cause increases in morbidity and mortality, but that aren't always accounted for in the death toll or in public perceptions," Meyers explained. "It's something that the larger public does need to start thinking about."

A lot of people were struggling to afford food and shelter in Los Angeles even before the devastating fires. Direct Relief is working to meet people's immediate needs, distributing medications, medical equipment and supplies to shelters like the one at the Pasadena Convention Center. And they provided N95 masks, now being handed out free at GAP stores in the area. They are also working to support health centers and community clinics, which will need to ramp up services for the long term.

Fernando Fierro, assistant vice president of nursing services for AltaMed Health Services, which runs community clinics in the Pasadena-Altadena area and is tending to patients in the shelter, said the donated supplies are crucial to helping people fill prescriptions lost in the fire and get continuing care.

"It's transitioned to more of just providing the day-to-day health care support," Fierro noted. "And it's flu season, so managing public health, but an infection prevention standpoint."

Clinics are also watching out for persistent environmental health risks because exposure to smoke can cause or worsen respiratory conditions. Bacteria and hazardous chemicals can stay in the soil and get into the water supply.

New research is finding extra responsibilities at work can take a heavy toll.

A report from Scripps Health shows a link between mental health disorders and work burnout.

According to the report, emotional, physical, and mental exhaustion from continuous and excessive stress can lead to burnout. Left untreated, this can cause short-term sleeping difficulties and digestion problems.

Keith Spencer, who writes résumés for the company Résumé Now, said burnout is more than feeling overwhelmed. And he warned that employees should heed the alert signs before their symptoms are unmanageable.

"Burnout can also lead to and exacerbate issues like anxiety and depression," said Spencer. "And in fact, signs of burnout often mirror other mental health symptoms, like chronic fatigue, irritability, and detachment."

Over time, researchers say extreme overload can contribute to unhealthy relationships and lead to more serious health issues - like heart disease and chronic muscle pain.

Spencer advised coping mechanisms like setting work boundaries or finding mental health support.

A 2019 study by JAMA Health found untreated mental illness cost nearly 430,000 Hoosiers more than $4 billion.

Researchers say as stress levels build, many workers delay taking a break from an unhealthy work environment. Reasons can include unwillingness to leave tasks behind for a co-worker, or no money for a vacation.

Spencer said if the environment is so toxic you think often of leaving, there are a few things to consider.

"I do think it's important to have that honest and ongoing discussion with yourself," said Spencer. "'Are there some boundaries that I can set at work that might alleviate some of these issues that I'm experiencing?' It's really hard to say, 'This is the moment when you should walk away' or, 'This is the moment where you should realize that nothing is getting better.'"

Spencer said striking a balance can help reduce stress or burnout if you can't leave your job. He said he believes you can prevent burnout, but it'll require some effort from you or the company.