People from some racial and ethnic minority groups are more likely to have negative experiences during pregnancy and delivery affecting the quality of care and their health outcomes.

A report by the Centers for Disease Control and Prevention found about 30% of Black, Hispanic, and multiracial women reported mistreatment, compared with 20% overall, in maternity care.

Shanna Cox, associate director for science in the division of reproductive health for the CDC, said many of those surveyed reported similar experiences when visiting a hospital or a clinic.

"Receiving no response to requests for help, being shouted or scolded at, which can be termed as verbal abuse, not having their physical privacy protected, and being threatened with withholding treatment or made to accept unwanted treatment," Cox outlined.

Cox pointed out mistreatment and discrimination have a direct impact on how pregnant people experience care. Florida's Maternal Mortality Review Committee, which analyzes maternal deaths in Florida, reported the state's pregnancy-related mortality rate has increased every year since 2016.

Cox noted almost half of those surveyed said they shied away from asking questions or sharing concerns during their pregnancy or delivery. Many women said they were embarrassed to ask a question, felt their health care provider would think they were being "difficult," or they did not feel confident they knew what they were talking about.

Cox emphasized better communication is necessary.

"Some of this information was precipitated by some of the work that we do with the 'Hear Her' campaign," Cox explained. "Which is a campaign that we hope to promote awareness of the urgent maternal warning signs, and promote provider and patient communication."

Cox added health care systems need to provide respectful care, consider the patient's values, needs, and desires, and ensure they are engaged in their own health care, and feel heard and respected.

"This is a component of quality care that's been highlighted as a strategy to reduce the disparities in pregnancy-related death, as well as identify opportunities for support," Cox stressed.


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The Kentucky Cabinet for Health and Family Services is reporting a second confirmed measles case in March, in a child who was traveling through the state while seeking treatment.

The first reported case this year occurred in an adult Kentucky resident in February. Measles is a highly contagious respiratory virus spread through the air that can cause serious health complications.

Cody Kemmer, communications coordinator with Kentucky Voices for Health, said declining vaccination rates in the state have allowed measles to start spreading again.

"Kentucky already had one of the lowest MMR coverages in the nation, and that brings us to our lowest coverage in seven years," said Kemmer. "In fact, we've got lower statewide coverage than some of those states that are currently experiencing outbreaks, so we are vulnerable."

The Centers for Disease Control and Prevention said as of May 1, 935 confirmed measles cases have been reported nationwide. Nearly all involve people who were unvaccinated or unsure about their vaccination status.

According to state data, vaccination rates among Kentucky kindergartners have dropped to levels lower than before the pandemic.

Kemmer said the disruption caused by COVID-19 set many families off track.

"With the pandemic, many families fell behind on their routine checkups and wellness visits," said Kemmer. "That delay created a lag in staying current with the CDC schedule for recommended vaccines."

He added that the end of the school year is a good time to start making doctor's appointments, especially for new families navigating immunization schedules.

"We want to encourage families to be proactive and make an immunization plan for their family," said Kemmer. "Staying on track with those recommended immunizations, like the MMR vaccine, lets families enjoy their summer."

A recent poll by the health policy research organization KFF found nearly a quarter of participants believed false claims about measles vaccinations and have not had their child vaccinated.



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Groups advocating for better access to health care have introduced what they call "Care4All California," a package of 13 bills designed to shore up the health system as the state braces for the possibility of huge cuts in federal funding for Medi-Cal.

The bills aim to get more people insured, connect them to care and make health care more affordable.

Chris Noble, organizing director for the nonprofit Health Access California, explained the group's priorities.

"It's crucial that our State Legislature shows their commitment to advancing a universal, affordable and equitable health care system," Noble emphasized. "This year's package of legislative and budget priorities requires no interventions by the federal government and should be adopted to safeguard our health care system in case there are federal attacks."

One bill would make sure people with Medicare supplemental insurance cannot be penalized for having preexisting conditions. Another would require hospitals to prescreen all patients to see if they are eligible for discounted or charity care programs. A third bill would allow undocumented people access to health plans on the CoveredCA exchange. Opponents cited cost concerns.

Noble emphasized the bills build on the progress California has made to lower its uninsured rate.

"These priorities will continue to cover gaps within our health care system, ensure that when people are denied or delayed care, there's certain accountability, or ensure that folks are getting access to accurate and up-to-date provider directories," Noble outlined.

Advocates have also made a number of budget requests, including one to give kids who qualify for Medi-Cal continuous coverage from birth to age 5, rather than making their parents reapply every year.

As Republican lawmakers in Washington, D.C., consider cuts to Medicaid, a new report has found thousands of veterans in Virginia could be affected.

Virginia passed Medicaid expansion in 2018, which broadened who qualified for the program, including people under 65 and without children who make 138% or less of the federal poverty level. The report by The Commonwealth Institute showed more than 47,000 Virginia veterans receive health coverage through Medicaid.

Freddy Mejia, policy director at the institute, said work requirements or cuts to the Medicaid expansion would increase barriers to Virginians' access to health care.

"We just kind of want to raise the profile of how federal cuts to Medicaid could impact not only hundreds of thousands of Virginians, nearly 629,000 Virginians that have health coverage through Medicaid expansion, but also to veterans in particular here in Virginia," Mejia outlined.

Rep. Mike Johnson, R-La., the Speaker of the House, has said the Medicaid expansion under the Affordable Care Act allowed people who did not truly need the benefit to enroll. Republicans have called for major cuts in spending across the federal government but are split on which entitlement programs should be trimmed, and by how much.

Virginia is one of eight states with what is known as an automatic trigger law in place, where states would immediately end their expansion if the federal government lowers its funding of the Medicaid expansion below 90%.

Mejia argued veterans in the Commonwealth would get caught up in the cuts.

"If the federal government decides to reduce funding for Medicaid expansion by even 1%, our state law means that it would automatically end Medicaid expansion," Mejia pointed out. "That would immediately throw potentially thousands of veterans off of coverage."

More than 20% of Virginians access health care through Medicaid.


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