Los centros de salud comunitarios de Colorado, que atienden a todos los pacientes independientemente de su capacidad de pago, llevan ya un mes en su nuevo año fiscal. Pero el Congreso aún no ha aprobado su financiación anual.

Stephanie Einfeld es consejera delegada del Northwest Colorado Health, que atiende a residentes rurales en Craig y Steamboat Springs. Afirma que la alta calidad de la atención médica, conductual, dental y de otro tipo que prestan los centros de salud está en peligro. Necesitan fondos federales para evitar que se reduzcan las horas de funcionamiento y las listas de espera.

"Para continuar haciendo lo que hacemos, necesitamos apoyo federal," asegura Einfeld Y nuestros legisladores necesitan escuchar eso. Necesitan priorizar primero, continuar con nuestra financiación federal y luego aumentarla."

A diferencia de la mayoría de las empresas que se enfrentan a los aumentos de costos laborales y de otro tipo, afirma que los centros de salud públicos no pueden transferir esos gastos a los pacientes. Los centros de salud atienden de forma desproporcionada a pacientes de Medicaid y son especialmente vulnerables al aumento de los costos de atención no compensada tras el fin de la cobertura continua a principios de este año, una medida que dejará sin seguro a 325,000 habitantes de Colorado.

Los centros de salud tienen múltiples fuentes de ingresos, como la facturación a los pacientes y los subsidios.

Pero el Dr. Simon Hambidge, de Denver Health, dice que la financiación federal es importante y que los centros de salud han contado con un fuerte apoyo bipartidista durante más de 60 años. Con frecuencia, los centros de salud son los mayores empleadores de las comunidades a las que atienden, emplean directamente a más de seis mil personas en Colorado y crean un total de más de 11,000 puestos de trabajo indirectos.

"Se calcula que el impacto económico total de las operaciones de los centros de salud en Colorado supera los 1.7 billones," informa Hambidge. "Y los ingresos fiscales que generan los centros de salud en sus comunidades superan los 1.2 billones."

Los centros de salud comunitarios también hacen lo que parece estar fuera del alcance de prácticamente todos los demás aspectos del sistema de atención de salud del país: ahorrar dinero a los contribuyentes. El año pasado, los centros de salud de Colorado ahorraron a los Centros de Servicios de Medicare y Medicaid más de 15 millones de dólares al atender a casi 14 mil pacientes.

"Existe un retorno documentado de la inversión de los centros de salud. Los centros de salud ahorran a Medicaid el 24% de los costos totales por cada paciente de Medicaid que es atendido," concluye Hambidge.



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United States Secretary of Health and Human Services Xavier Becerra and U.S. Rep. Yadira Caraveo - D-Thornton - recently paid a visit to Salud Family Health Centers' mobile clinic.

Each year, Salud serves up to two thousand migrant farmworkers who travel from other states and countries to plant and harvest leafy greens, corn, wheat, sugar beets, and other crops in North Central and Northeastern Colorado.

Director Deborah Salazar said her team always gets a very warm welcome.

"And it's usually the same guys that come to the same farms or greenhouses," said Salazar. "And so it's like seeing old friends. They know who we are, they know what we can do for them, and they trust us. There is trust because we have been doing this for a very long time."

In addition to its 12 brick and mortar health centers, and ten school sites, the mobile unit provides primary health services three to four evenings per week - primarily in rural areas.

They screen workers for diabetes, hypertension, cervical cancer, and anemia. Workers can also get lab tests, and flu and tetanus vaccines.

Salud is a federally qualified community health center that provides medical, dental, pharmacy, and behavioral health care services to all patients regardless of their ability to pay.

The first clinic on wheels was acquired in 1980, and Salazar said a brand new unit was rolled out in 2022.

She said her team works to build relationships with farm owners and supervisors to find the best time to plan a visit.

"If they need us to come out and start our visit on the mobile unit at 7 p.m, we can do that," said Salazar. "We are super flexible, because we don't want to interrupt their work day."

Salazar said the medical staff on the mobile unit might be the only people migrant workers see when they are not out planting and harvesting crops.

"These are the folks that put food on our table," said Salazar. "To give them quality, integrated health care - and go to them, so that they are taken care of - this is the least we can do."




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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.