Florida has dropped to the 31st position among states in national health rankings. It's a decline from last year's 27th spot.

Local public health experts say more resources could help them address some of the gaps.

The rankings are from an annual United Health Foundation report, which indicates strengths for Florida's low prevalence of cigarette smoking and drinking.

But the Sunshine State ranks 44th in the nation for public health funding and 43rd in people avoiding medical care due to cost. Dr. Frederick Anderson is a family physician in Miami.

"Being sick or not well is very expensive - especially if you're low-income and uninsured, you can imagine having to go to an emergency room for care," said Anderson. "There's a reason why people are smart and they try to avoid going to the emergency room if they are sick, because they can get hit with thousands of dollars of medical bills."

According to the report, about 13% of Floridians avoid medical care because of the expense, exceeding the national rate of 10%.

Gov. Ron DeSantis' health budget proposal, revealed earlier this month, includes an increase in funding for children's health care - but no overall Medicaid expansion for lower-income residents.

And avoiding needed medical care comes at a risk.

On a national scale, UnitedHealthcare Employer and Individual's Chief Medical Officer Rhonda Randall said they're seeing concerning trends for chronic health conditions, such as diabetes and heart disease.

"This is something that we have been concerned about for quite some time," said Randall. "And when we looked at the data in this year's report, it's really unfortunate to see that the number of adults living with chronic conditions in the United States is the highest we've seen it."

Florida ranks 26th in the nation for the percentage of adults with multiple chronic conditions. Randall noted that this trend comes amid a decline in licensed primary caregivers nationwide.

Florida's uninsured rate is high, at 11% - compared to the national average of 8% - contributing to its 46th place ranking in this category.

Alison Yager, executive director of the Florida Health Justice Project, said she believes that's because Florida is one of the ten states that has opted out of expanding Medicaid.

"By continuing to play politics with the Medicaid program," said Yager, "our state politicians have really done a disservice to our residents by closing off access to coverage for far too many Floridians."

With the exception of expanding Medicaid, DeSantis highlighted more than $46 billion in healthcare funding in next year's budget - including money for cancer research, Alzheimer's programs, child welfare, waivers for Floridians with disabilities and initiatives for the elderly.

However, the report shows mental healthcare access remains a challenge, with the state ranking 43rd.

World Hepatitis Day is this Sunday, and for the Oregon Health Authority, it's an opportunity to promote its plan to eliminate hepatitis across the state.

Released in March, the plan includes major goals and strategies to limit the spread of hepatitis A, B and C over the next six years. It's gotten new attention after 2,400 patients in Oregon hospitals were potentially exposed to hepatitis and HIV earlier this month.

Concerns are high, but epidemiologist Dr. Dean Sidelinger, Oregon's state health officer, said people should be aware of the threats of hepatitis, but not anxious.

"In day-to-day times, people should feel safe and confident in going to the doctor," he said. "The risk of exposure to these viruses is extremely low in most cases."

Hepatitis is inflammation of the liver, and contagious viruses are among the causes. Sidelinger said he's confident Oregon has the technology and resources to fully eliminate the threat.

While many people may have heard of hepatitis, they may not fully understand how prevalent it is in their communities. According to OHA data, the proportion of chronic hepatitis C cases among people in their 20s tripled between 2010 and 2019.

Sidelinger said there's a good chance most Oregonians know someone who is affected by chronic hepatitis.

"It can seem out of the blue to be talking about hepatitis and [a] hepatitis awareness day, but this is a disease that affects many individuals," he said. "But the good news is, everyone can take steps to protect themselves."

The OHA says you can help prevent the spread of hepatitis by washing hands and fresh produce, staying current on vaccinations, avoiding sharing needles, and getting tested regularly. These tips and more are part of the state's plan to eliminate hepatitis by 2030.


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CoveredCA announced Wednesday that the average premium for plans on the marketplace will rise 7.9% in 2025, but subsidies are expected to blunt the impact and even lower costs for many consumers.

The Biden-Harris administration's Inflation Reduction Act caps premiums at 8.5% of income for many, and goes even further for those with low incomes.

Rachel Linn Gish, director of communications for the nonprofit Health Access California, said the state has put the federal funds to good use.

"Because of this financial help," she said, "California has been able to take even further steps to lower costs for many CoveredCA enrollees by eliminating deductibles and reducing copays for many health services such as doctors' visits, lab work, generic drugs."

However, the enhanced premium subsidies in the IRA will expire next year, sending costs soaring unless Congress extends them. If not, Gish said, she expects premiums to rise 60% to 80%, costing thousands more per year. Opponents of the extension have cited the need to limit federal spending.

Gish said if the federal premium help ends, people could start seeing much higher deductibles.

"Without the federal assistance, California stands to lose $1.7 billion in assistance, which the state can only backfill a fraction of," she said, "which means consumers could again see deductibles of $5,000 or more."

Other big changes are on the way. Starting Nov. 1, about 40,000 income-eligible DACA recipients in California will be able to apply for premium subsidies through Covered California.

Connecticut insurance companies are requesting rate increases. Companies want a more than 8% increase for individuals and an almost 12% increase for small groups. However, insurance costs are already problematic for residents. A 2022 survey shows 46% of people delayed important medical care due to coverage costs.

Liz Dupont-Diehl, associate director of the Connecticut Citizen Action Group, said unaffordable insurance is all too common.

"It is an unfortunate American right of passage to spend hours a week appealing claims denials, or dealing with rising copays, and surprise costs. Even those of us lucky enough to think we have good coverage are continually surprised by hings that are not covered," she said.

Of the legislative solutions lawmakers can take, polls show voters across party lines support the government setting limits on out-of-pocket medical care costs for people with insurance.

Connecticut's Insurance Department will host an informational meeting for people to share their experiences and hear testimony. It will be held from 9 a.m. to 1 p.m. on August 20 at the Legislative Office Building in Hartford and over Zoom.

One way Connecticut's General Assembly can better regulate insurance companies is by increasing transparency surrounding pharmacy benefit managers. A recent Federal Trade Commission report finds the six largest pharmacy benefit managers manage 95% of the country's prescriptions.

Dupont-Diehl said this can help people better understand why certain claims get denied.

"We would be interested in knowing exactly which claims are denied based on ZIP code, based on race and ethnicity, based on age, based on gender," she continued.

She notes that much of what needs to be done to fix health care can be done at the federal level, although states can take the lead. Part of Connecticut's 2023 budget calls for the state's Insurance Department to work with the Office of Health Strategy to study ways to make care more affordable.