Texas is one of 12 states to not expand Medicaid, and a new report showed it is one reason the state is falling further behind others in providing access to health care.

The Build Back Better Act would have given Texans with incomes below the poverty line a free health insurance option, but the legislation stalled in the Senate and will not be considered again until next year.

Peter Clark, communications director of Texans Care for Children, said the latest report from United Healthcare illustrates the challenge families face.

"When I looked at this report, I'd say it's really disappointing to see that Texas gets a failing grade when it comes to health care," Clark asserted. "But that is the reality of the choices that our state leaders have made."

The percentage of American adults who reported their health as very good or excellent climbed by 13% starting in 2012, but progress plummeted as the COVID-19 pandemic took hold, with a 17% increase in the U.S. death rate between 2019 and 2020.

The report showed Texas has a higher-than-average teen birth rate, and significant levels of food insecurity.

Dr. Nicole Brady, chief medical officer for UnitedHealthcare, said in contrast, multiple chronic conditions are not excessive among Texans.

"So, it may not be that we actually got healthier as a nation, from a chronic disease standpoint," Brady contended. "It may be that there's just more undiagnosed disease out there as a result of the way that care changed during the pandemic."

One undiagnosed disease could be cancer, according to Clark. Currently, more than 700,000 Texans fall into the Medicaid coverage gap and don't see a doctor with any regularity.

"The report shows that Texans are missing out on cancer screenings, which means that by the time you realize you have cancer, it's already spread," Clark explained. "It's more dangerous, and it's more expensive to treat."

Dr. Arethusa Kirk, chief medical officer for UnitedHealthcare Community and State, reported breast cancer screenings in the U.S. declined by 17% from 2019 and 2020, and the number was even higher for people missing colon cancer screenings, at 23%.

"Get back into your primary care office," Kirk urged. "Make sure you get all of the screenings that occur in preventive care."

March is Sleep Awareness Month and health experts say Americans are not getting enough of it.

United Health Foundation data found more than 32% of those surveyed said they got fewer than seven hours of sleep, although the rate was slightly better in Oregon at about 28%.

Dr. Kimberly Hutchison, associate professor of neurology and sleep medicine at Oregon Health and Science University, said our culture devalues sleep, with the perception people who get the sleep they need are lazy or not working hard enough.

"Because we live in this accomplishment-driven culture, it results in people sacrificing sleep in order to get other things done," Hutchison explained.

Hutchison pointed out sleep is as important for our health as the food we eat or exercising. The recommended amount of sleep for adults is seven to nine hours in a 24-hour period. For teens and adolescents, it can be as much as 10 hours. For older adults, the number is closer to seven.

Dr. Ravi Johar, chief medical officer for UnitedHealthcare, said one of the best ways to ensure you are getting enough sleep is to have a regular schedule.

"That's something that's really important, just having a routine, whether it's brushing your teeth, changing into pajamas, doing some kind of activity before you go to sleep," Johar outlined. "Yoga, listening to music, reading, things of that sort, setting your alarm for the same time every day."

Johar added people should see a health professional for medical issues such as insomnia or sleep apnea.

"Sometimes there may be underlying medical problems that are making it difficult for you to sleep," Johar noted. "The other thing that's really important that people don't realize is how much stress and behavioral-health issues can factor into their sleep."

It's been 13 years since more than 156,000 West Virginians gained health insurance coverage through the Affordable Care Act.

As sweeping and sometimes controversial as the ACA has been, its longer-term effects are still being felt today at the state level.

Gary Zuckett, executive director of the West Virginia Citizen Action Group, pointed to a new West Virginia law capping insulin copays at $35 per month. The law goes into effect January 1.

"I think we now have the best insulin copay cap legislation in the country that we just helped get passed in a very 'red' legislature," Zuckett noted. "Which does show you that health care is not partisan."

Federal data shows since the launch of the federal health insurance exchange, enrollment in health insurance plans has doubled from 8 million to more than 16 million nationwide.

According to the West Virginia Center on Budget and Policy, the Medicaid expansion included in the ACA allowed more than 200,000 West Virginians to gain access to health coverage.

Zuckett cautioned when the "continuous coverage" rules enacted during the pandemic expire April 1, the state will begin re-evaluating people's eligibility, which could signal a setback in progress.

"A lot of people won't qualify or won't fill out the paperwork, and they'll lose their health insurance in West Virginia," Zuckett explained. "That could be as many as 50 or 100,000 people. So, that's going to be a step backwards."

According to America's Health Rankings, around 6% of West Virginians were uninsured in 2021, far fewer than the nearly 16% of the state's population who lacked coverage prior to the Affordable Care Act.

Beginning next year, more Kentuckians will have expanded access to biomarker testing - which helps doctors customize cancer treatment. Advocates of the new law say it will save lives and improve patients' quality of life.

Signed into law by Gov. Andy Beshear, House Bill 180 requires both private insurers and Medicaid to cover biomarker testing after a cancer diagnosis.

Doug Hogan - director of government relations for the American Cancer Society Cancer Action Network (ACS CAN) - explained that without biomarker testing, doctors typically try several rounds of chemotherapy or other treatments, without knowing which will work best for the patient.

He said biomarkers increase the odds of matching the right treatment to a specific cancer.

"We will be the fifth state in the country to adopt an enhanced access to biomarker testing law," said Hogan. "And so, we're on the cutting edge. This is the way that we can utilize technology to improve health outcomes."

The bill passed unanimously in both the House and Senate. According to the American Cancer Society, more than 30,000 Kentuckians will be diagnosed with cancer this year.

Hogan added that the new law will allow care teams to use the latest technology to make the best decisions for their patients.

"It is so important for these patients to get that right treatment at the right time," said Hogan. "It really will improve their health outcomes. It will save lives in many instances, and certainly will improve the quality of life."

Research shows biomarkers can in many cases reduce the cost of therapy, especially for lung cancer and colorectal cancer patients.

Cancer-care costs are expected to top more than $245 billion by 2030, according to the American Association for Cancer Research.





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