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."

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.


get more stories like this via email

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.

A southeast Arkansas healthcare system is using grant money to help increase its patients' access to healthy foods.

Mainline Health Systems will use the funds to focus on healthy eating habits for people who are expecting.

Work will include showing families how to grow their own fruits and vegetables, and establishing farmers markets that cater specifically to the needs of pregnant women and new mothers.

Health System Registered Dietitian Jane Pelkki said they will teach new moms the basics of eating healthy.

"Eating healthy doesn't have to cost a lot, that it's doable and that there are food assistance programs such as WIC and SNAP, food stamps," said Pelkki. "And we're also going to provide some food to help moms understand what a healthy meal looks like."

Mainline is one of eight health systems nationwide to participate in the National Innovation Incubator program.

It's sponsored by the National Association of Community Health Centers and the global healthcare company, Abbott.

Research shows almost 13% of U.S. households experience food insecurity - or don't have access to an affordable, nutritious diet.

Merrill Warschoff-Press - senior vice president at NACHC - said the facilities play an integral part in improving the overall health of patients, and address social issues that may cause illnesses.

"They reach far beyond the walls of the traditional exam room, not only to prevent illness and treat it, but also to really address the social drivers that may cause poor health," said Warschoff-Press, "so whether it's food insecurity and poor nutrition or even housing, joblessness, mental illness, substance use disorders."

At the end of the six-month pilot program, results will be shared with 1,400 health centers nationwide. That could impact the overall health of more than 31 million patients across the country.