The U.S. saw a surge in cardiovascular-related deaths during the first year of the pandemic, and voices from South Dakota's health community hope it spurs more work to prevent these outcomes.

New findings from the American Heart Association showed more than 920,000 heart-related deaths in 2020 - the highest total since 2003. The report stated it shows how COVID-19 can impact cardiovascular health, including connections to risk factors for heart disease and stroke.

Chrissy Meyer, senior regional director of marketing and communications for the American Heart Association, said it is vital for people to get CPR training, knowing most cardiac arrests happen inside the home.

"If you're ever called upon to give CPR, it most likely is going to be for a family member or a friend, or someone you know and love," Meyer pointed out. "That's really kind of where the urgency comes in, so that everyone is trained and knows how to respond in a cardiac emergency."

Meyer added it is also important to consider healthier lifestyle choices, from eating to exercise, to keep those risk factors at bay. Meanwhile, the Heart Association said the Asian, Black and Hispanic communities saw the biggest increases in heart-related deaths, prompting the need to improve access to preventive care from providers and health agencies.

Shannon Bacon, senior health equity and partnerships manager for the Community HealthCare Association of the Dakotas, said many social and structural barriers can affect health outcomes. She explained community health centers are now tailoring their patient screenings to look at what she describes as the "social drivers of health."

"And so, this is a recognition that we can provide excellent clinical care, and yet, we also need to pay attention and ask questions like, 'Does someone have enough food at home? Do they have a place to sleep? Are they at risk of losing housing?' " Bacon outlined.

She noted it can spark conversations about how to access other types of resources. Bacon added South Dakota's recent move to pass Medicaid expansion under the Affordable Care Act will play a role in establishing more equitable health outcomes. The new statistics from the Heart Association coincide with the start of American Heart Month.

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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Oregon's nonprofit hospitals are not doing enough to provide assistance on medical bills for low-income patients, but a bill in Salem aims to change it.

Nonprofit hospitals are required by federal law to alleviate medical costs for patients who cannot afford them.

Matt Swanson, political strategist for the Service Employees International Union Oregon State Council, said investigations have found the institutions are not going far enough to help.

"People really aren't getting the assistance they need," Swanson explained. "Instead, they're getting every last dollar really wrung out of them in order to satisfy a bill that they really can't pay, and it's risking other things in their life, like housing and food and the ability to get over their health issue."

House Bill 3320 is designed to ensure people get the financial assistance they need and hospitals are transparent about their assistance practices. In written testimony on the bill, the Oregon Association of Hospitals and Health Systems said it agrees with parts of the legislation but wants lawmakers to keep in mind insurers are part of the cost picture as well.

Swanson added it is important for people who cannot afford medical bills to know they have assistance available.

"The purpose of this bill is to really tighten up what compliance looks like," Swanson emphasized. "And ensure that everyone gets screened before they are sent a bill, so that the hospital is giving a hand to folks who need the help, instead of letting them get lost in systems that are often confusing and overwhelming at a time when they're really struggling."

The bill received a public hearing last week and is scheduled for a work session Wednesday.


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