Caregivers in Connecticut are calling on state officials for better conditions and higher pay.
They're seeking a $25 an hour minimum wage, paid time off, affordable healthcare, and a pension for retirement planning.
Chase Bolling is a Personal Care Attendant and member of 1199 Service Employees International Union Northeast.
Originally, he was a machinist, but became a PCA because it wasn't easy to juggle caregiving for his mother-in-law with his full time job.
Bolling said any improvements to caregiver's working conditions must begin with better funding.
"I think the foremost thing would be increasing our budget," said Bolling. "You know, nothing happens in this world without money and you kind of can't take any steps forward or any initiatives towards improving our conditions without first improving our pay, and providing access to benefits."
He added that better funding will be able to provide long-term job security.
Along with PCA's, unpaid family caregivers are facing similar challenges.
According to an AARP report, unpaid family caregivers across the U.S. provided care valued at $600 billion in 2021. That's a $130 billion increase over 2019.
During the Covid-19 pandemic, PCA's - like many of Connecticut's healthcare workers - were dealing with strained working conditions.
During the first few months of the pandemic, there was a shortage of personal protective equipment.
While many healthcare providers have fought for and seen changes in their working conditions, Deidre Murch - vice president and homecare director for SEIU 1199 Northeast - said it hasn't been the same for PCA's.
"What we see is that there are a lot of examples where PCA's have been treated, literally, as invisible," said Murch, "without any of the same recognition or support in wages and benefits as other healthcare providers have."
From here, Murch added that it's now up to state elected officials to take bold steps in uplifting this workforce out of poverty-inducing wages and lacking benefits.
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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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