During February, Americans are urged to pay closer attention to their heart health. Experts say new findings suggest it can keep your brain in better shape, and South Dakota has an opportunity to help with prevention.
With American Heart Month underway, the American Heart Association's statistics update said in the past decade, global death rates from Alzheimer's and other forms of dementia have grown at a faster pace than heart-disease death rates.
Mitchell Elkind, neurology professor at Columbia University and immediate past president of the American Heart Association, said it coincides with research connecting heart disease risk factors and the likelihood of dementia.
"That boundary that we used to draw between vascular diseases of the brain, like stroke, and degenerative problems, like Alzheimer's disease, is beginning to fade away," Elkind explained.
The report showed efforts like keeping blood pressure low can reduce the risk of dementia later in life.
Meanwhile, groups supporting Medicaid expansion in South Dakota emphasized covering more people could go a long way toward keeping them healthier. Expansion is on the fall ballot, but is opposed by some leaders, including Gov. Kristi Noem.
Lindsey Karlson, director of quality improvement for the Community HealthCare Association of the Dakotas, said the clients they work with fall into the coverage gap; they make too much money to qualify for Medicaid, but can't afford other health insurance plans.
Community health centers will see them for primary care, but Karlson pointed out having insurance gives them more options.
"Medicaid expansion helps that patient get access to additional specialty care that they might need, so we're talking heart disease," Karlson explained.
South Dakota is among the last states holding out on Medicaid expansion, which is largely funded by the federal government under the Affordable Care Act.
Elkind added there is real concern with many people not having health care access or forgoing preventive care in the pandemic, the situation will only get worse.
"We are seeing an increase in cardiovascular disease and strokes, and that might lead to an increase down the line in people with not just dementia, but all sorts of long-term, chronic health issues," Elkind cautioned.
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For Pennsylvanians with disabilities, there may be unexpected side effects to ending so-called Diversity, Equity, Inclusion, and Accessibility policies.
President Donald Trump has opted to eliminate DEIA initiatives in federal agencies and federally funded programs.
His executive order signed in January characterizes DEIA policies as "discriminatory."
But in Pennsylvania, Mallory Hudson - the director of the disability justice program at the Keystone Progress Education Fund - said a memo went out ordering the Justice Department's Civil Rights Division to not file any new complaints, motions to intervene, agreed upon remands, amicus briefs, or statements of interest.
"That means that the Department of Justice Civil Rights Division has been instructed not to file any new civil rights cases, right?" said Hudson. "And that includes ADA complaints. So, those are - that is one of the few ways that disabled people can even protect their civil rights."
She adds the Americans with Disabilities Act was first passed in 1990 under President George H.W. Bush, and its legal precedent was based on the Civil Rights Act of 1964.
Hudson said another potential concern is the future of the Inflation Reduction Act under the new administration.
She noted that the IRA has allowed the Centers for Medicare and Medicaid Services to negotiate drug prices - and many are benefiting from its progress, like a $35 co-pay for insulin.
"Older adults and some folks with disabilities have been able to do that $35 copay, and for folks on disability, that's still a pretty big chunk of change," said Hudson. "But it was better than before - and then, that meant taxpayers were paying the difference."
Lower prices have been negotiated for 10 medications so far, cutting costs for patients and saving taxpayers billions.
It's estimated that if the IRA had been enacted in 2023, it would have slashed prescription drug spending by 22% - or roughly $6 billion.
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As health insurance premiums keep rising, Colorado lawmakers are advancing a bill to look at a universal Medicare for All option.
A 2020 report in the Annals of Internal Medicine finds administrative costs for private insurance, and the time doctors spend on billing paperwork, make up over one-third of all healthcare costs in the U.S.
Nathan Wilkes is a board member of with Health Care for All Colorado.
He said he believes the study called for in the bill will confirm previous research showing there is enough money to cover all Coloradans, by removing the middle-man.
"All of the public costs that we are paying, a lot of which are going to insurance subsidies and things like that," said Wilkes, "are more than enough to cover a system where there's a single pipeline."
Insurance industry executives say they've worked to lower administrative costs, and some politicians have argued private companies have better incentives to be more efficient than government services.
But administrative costs for private insurers in the U.S. are nearly six times the costs of Canada's single payer system.
Private insurers also argue they help keep overall costs down, in part by denying claims for procedures they see as unnecessary.
Wilkes said because of the industry's lobbying influence, voters will need to convince lawmakers to ensure all Coloradans can access health care.
"I think people recognize that there's a lot of profit extraction going on by companies that are not delivering any sort of healthcare services at all," said Wilkes, "while their family and friends are having to start 'Go Fund Me's' to pay for their cancer."
According to the Colorado Health Institute, some 265,000 Coloradans had no health insurance last year.
Wilkeds pointed out that Medicare's original aim was to eventually extend coverage to all Americans, not just seniors.
"Truth is that universal healthcare is as American as apple pie," said Wilkes. "Guaranteeing healthcare aligns with our nation's core values of life, liberty and the pursuit of happiness for everybody."
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A new report shows what it calls a "dental divide" in the Los Angeles area - finding that only 20% to 25% of people on Medi-Cal actually use their dental benefits.
Adult Medi-Cal recipients get one free exam and cleaning, plus covered dental services worth up to $1,800 a year - or more for medically-necessary care.
Marlyn Pulido - senior research manager with the California Pan-Ethnic Health Network, known as C-PEHN - said the difference in usage varies a lot between populations.
"In the Los Angeles data, we see that Asian beneficiaries consistently have the highest utilization across all service types," said Pulido, "while American Indian, Alaska Native, and also our Native Hawaiian and Pacific Islander beneficiaries consistently have the lowest utilization."
The report says many people don't realize that Medi-Cal covers dental work.
The state caused a lot of confusion by canceling Medi-Cal's dental coverage for adults several times - reinstating it most recently in 2018.
The report calls on the state to make the adult dental benefits in Medi-Cal permanent.
Ruqayya Ahmad, policy manager at C-PEHN, said finding a provider who accepts Medi-Cal is a challenge - because the state has a major shortage of participating dentists, especially providers of color.
"In 2021, only 21% of the dentists in California were part of the Medi-Cal program," said Ahmad. "And then of the dentists in California, 6% were from a Latino background, and 2% were from the Black community."
Report authors also suggest that California create a program to train and license more dental therapists to offer simple dental care services.
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