NASHVILLE, Tenn. -- Many low-income Tennesseans without health insurance would quality for 'zero-dollar' out-of-pocket health coverage under a new proposal in the Build Back Better Act.

Now in the U.S. Senate, the legislation would offer tax-credit subsidies for coverage purchased through the healthcare.gov marketplace. Experts say this would, at least temporarily, fix the coverage gap in Tennessee, since the state has consistently refused to expand Medicaid.

Kinika Young, senior director of health policy and equity for the Tennessee Justice Center, explained people who do not qualify for Medicaid currently have few options.

"Tennessee hasn't expanded Medicaid and there are an estimated 300,000 people in our state who don't currently have access to any sort of health insurance," Young reported. "So, we're excited about that provision."

Young pointed out the subsidies would be temporary, available through 2025. The Congressional Budget Office estimates the subsidies could cost the government more than $73 billion over the next decade, which has some Senators citing budget concerns about the legislation.

Young believes the tax credits would help more Tennesseans find doctors and get preventive checkups.

"So, we'll have a new group of people who are more focused on closing the coverage gap and making sure that, once the temporary fix goes away, the state is not allowed off the hook," Young contended.

The legislation would also permanently restore funding for the Children's Health Insurance Program (CHIP), which keeps children covered in households earning under $45,000 a year.

Young noted an estimated 80,000 Tennessee children were uninsured in 2019.

"As parents experience fluctuations in income, maybe because they're a seasonal worker, that doesn't impact the kid's access to well-child visits and other healthcare that they need throughout the year," Young emphasized.

Joan Alker, executive director of the Center for Children and Families, said the legislation could help reduce the number of uninsured kids nationwide.

"After we saw this troubling reverse in the progress we'd made as a country in reducing the number of uninsured kids -- which came to a halt in 2017 and started going in the wrong direction -- the Build Back Better bill would really turn that around and start moving the country in the right direction," Alker asserted.

The Build Back Better Act would also increase Medicaid and CHIP coverage for people who've given birth, from 60 days to one year postpartum. Experts say the change could help address the nation's maternal mortality crisis. Both programs cover about 43% of U.S. births each year.

As the new year unfolds, rural health providers in North Dakota and other states will continue to have extra latitude in using telehealth technology. But a temporary extension of key rules still leaves uncertainty.

When Congress avoided a government shutdown in late December, it approved a funding resolution that runs through mid-March. For the next few months, that plan keeps in place relaxed telehealth regulations for people on Medicare that started during the pandemic.

Even though telehealth use has declined since the COVID emergency ended, said Brad Gibbens, deputy director of the Center for Rural Health at the University of North Dakota School of Medicine and Health Sciences, this option is still useful in remote areas.

"People can not only stay in their own community and interact with a physician or another type of provider and not having to travel," he said, "they can actually, in many cases, do this right out of their home."

He added that because these interactions are timelier, telehealth cuts down on health-care costs by reducing hospital admissions. A number of health organizations want the relaxed rules made permanent, so providers can better plan for them and patients don't lose continuity.

Telehealth access has bipartisan support, but skeptics have voiced concerns about privacy breaches and lower quality of care.

Gibbens stressed that telehealth should not be seen as a replacement for in-person visits. When the situation allows, he said, doctors still prefer having a patient come see them.

"They feel they get more of a review of the patient by seeing their body language and how they react," he said, "and it's kind of the nature of medicine."

However, Gibbens disagreed with assertions that there's a dropoff in the level of care when the visit happens online. He said that for patents in areas with very limited provider access or transportation gaps, telehealth is better than no care at all. He added that broadband investments have helped smaller clinics overcome technology barriers in enhancing online appointments.


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Holidays are traditionally a slow time for blood donations, but recent events have made the need for people to give blood and plasma in the Magnolia State even more urgent.

Following the deaths and injuries from a terrorist attack in New Orleans in the early hours of New Year's Day, Mississippi officials have pitched in to supply blood for victims of the violence. As a member of the Blood Emergency Readiness Corps, Mississippi Blood Services is supporting the efforts of the Blood Center of New Orleans.

Kasey Dickson, Mississippi Blood Services' director of public relations and marketing, said they have immediate needs.

"We are desperately looking for individuals that are eligible to donate platelets," she said, "as well as individuals with the blood types of O, negative or positive, and B, negative or positive."

Dickson said the agency is contacting its list of regular donors as well as putting out a call for new ones. Donations can be made at the blood centers in Flowood, in Cleveland and Oxford, and at mobile vans around the state. To find one, look online at MSBlood.com or call 888-90-BLOOD (888-902-5663).
Dixon said donors need to be at least 17 years old, be in general good health and complete a health history questionnaire. Approved individuals can donate about every two months, platelets every seven days, and plasma once a month.

"Fortunately, the donors of Mississippi helped get our supply ready, and we were able to ship enough products to assist the Blood Center of New Orleans ahead of time," she said. "And now, we're wanting to replenish our supply, so we can continue those efforts to help them."

Dickson said it was an honor to help another state with blood in its time of need, but added that it's equally important to care for Mississippians. She said people need to remember that blood isn't created, it's given.

"Blood itself can only be donated," she said. "It cannot be manufactured in a tube or re-created in a tube, so it has to be given from person to person."


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With the 2025 legislative session around the corner, the nonprofit advocacy group Alabama Arise said it plans to take aim at poverty and systemic challenges that hit families the hardest.

Big issues like health care access, public transportation and unfair court fines often weigh on lower-income families.

Robyn Hyden, executive director of Alabama Arise, said it is time for state leaders to step up and tackle the concerns.

"Our state, because we underfund state government and we underfund our court systems, we heavily rely on fines and fees that really disproportionately hurt low-income families and working families," Hyden contended.

Hyden believes cutting court fines and fees could be life-changing for some, freeing up money for essentials like food and health care. She highlighted the need for Medicaid expansion, removing the grocery tax and protecting voting rights as top priorities for 2025. State legislators have so far refused to expand Medicaid.

One of the most pressing issues Alabama Arise wants to see addressed is health care during and after pregnancy since the state has among the highest rates of maternal and infant mortality. A new report from Pregnancy Justice shows Alabama led the nation with 104 prosecutions of pregnant people in the year following the Dobbs decision.

Hyden stressed she wants to see an end to the state criminalizing pregnancy-related issues and instead, improving access to prenatal care.

"We don't think that women should be prosecuted because they have a miscarriage," Hyden emphasized. "We believe that health care providers should be able to provide lifesaving care to women in those situations. And we believe that when women are given drugs during labor, which does happen, they should not then be incarcerated or have their children removed."

The legislative session begins in February. Hyden added Alabama Arise is planning an advocacy day in March to unite voices in support of low-income and working families.