Research shows many people in low-income California communities are having a hard time filling their prescriptions because pharmacies in their area are struggling and even closing.

One in four communities in Los Angeles County, for example, is now considered a "pharmacy desert."

Dima Qato, associate professor of pharmaceutical sciences at the University of Southern California, and her team have developed a mapping tool that reveals the extent of the problem, which she said hits communities of color hardest in both urban and rural areas.

"I think that it's getting worse," Qato observed. "In the next several years, a lot of chains have announced plans to close many of their stores. At the same time, one and three independents are at risk for closing."

Qato would like to see Congress reform the practices of pharmacy benefit managers, who decide where a patient can go to fill their medications, how much a pharmacy will be paid and which pharmacies are considered "in network" for health insurance. The bipartisan Pharmacy Benefits Manager Accountability Act, currently in Congress, would increase oversight of the industry.

Qato argued stronger policies could keep more independent pharmacies from going out of business, which could also improve health equity.

"It's due to the role of pharmacy benefit managers and low reimbursement rates, and the growth of pharmacy networks, which restrict where patients can and cannot go," Qato outlined. "Sometimes, patients have to bypass the nearest pharmacy to go to another pharmacy that's within their network."

University of Southern California researchers have called for policies encouraging pharmacies to locate in pharmacy deserts, including increases to Medicaid and Medicare reimbursement rates for those most at risk for closure.


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Health advocates in Virginia are calling to protect the Affordable Care Act as it faces scrutiny from some national Republicans.

More than 300 people signed a petition to Rep. Jen Kiggans, R-Va., asking her to defend Obamacare. The pressure comes as others in her party, like former President Donald Trump have vowed to replace it.

Laura Packard, executive director of the nonprofit Health Care Voter, said a lot of people take the Affordable Care Act for granted.

"Things like birth control, access, wellness checkups for free, various free preventative exams, like a mammogram or a colonoscopy," Packard outlined. "All those things didn't used to be guaranteed or free."

The Affordable Care Act remains popular among Americans. In Virginia, more than 400,000 people signed up for a plan for this year through the federal marketplace and another 700,000 plus people have coverage through Medicaid expansion.

Kiggans is a nurse practitioner and her campaign said in a statement she has taken concrete steps to protect Social Security and Medicare.

Packard is still hoping for more clarity about the Affordable Care Act specifically. In 2017, she was diagnosed with stage four cancer and was able to get chemotherapy and radiation treatments through her insurance. She is in remission today, she said, because of Obamacare protections for people with preexisting conditions.

"People truly may not remember or may not have ever faced the times when insurance companies could drop you for any reason at all, just because they didn't want to pay for your care," Packard pointed out.

The Affordable Care Act also allows adults under the age of 26 to stay on their parents' insurance.


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Many Mississippians could see higher credit scores if a rule proposed by the Consumer Financial Protection Bureau goes into effect.

The proposal would effectively remove medical bills from credit reports, potentially improving credit scores for millions of people. Mississippi is among the states with the highest share of adults with medical debt, at just over 15% of the population.

Kiren Gopal, senior counsel for the Consumer Financial Protection Bureau, said the rule would prohibit lenders from considering medical bills when making credit decisions, such as for car loans or small business loans.

"Right now, 15 million Americans still have almost $50 billion worth of outstanding medical bills on their credit reports," Gopal explained. "It's punishing them by blocking them from really important life opportunities like buying a home, for example."

The Consumer Financial Protection Bureau is taking public comments on the proposal through Aug. 12, online at regulations.gov. Gopal added they are working toward a final rule to take effect in 2025.

Gopal pointed out the bureau published research last year showing people in Mississippi are considerably more likely to have a medical collection listed on their credit report, compared to consumers nationally.

"Nationally, we see about 17% of consumers have a medical collection on their credit report, whereas in Mississippi, it's 22% respectively," Gopal reported.

He added if the new rule is enacted, people with medical debt on their credit reports would see their credit scores rise by 20 points, on average. Overall, it could lead to about 22,000 additional home mortgage applications being approved each year.


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Virtual healthcare gained steam during the pandemic, by allowing doctors to reduce in-person contact and still render services to patients.

And while social restrictions have eased, the convenience of remote visits remains popular.

Family Physician and Community Health Network Medical Director for Telehealth, Dr. Stephanie Russ, said there are three different types of appointments.

Electronic questionnaires - or e-visits - communicate health concerns to a medical provider, telehealth services are phone-only visits, and video visits are face-to-face appointments.

"It's really been nice for patients because of the convenience," said Russ. "They don't have to take off a day of work. They don't have to wait in the doctor's office. Usually, the wait times are much less for telehealth than what it is in person."

Russ said while the pandemic drove utilization, doctors continue to see increased usage.

Another benefit is the availability of health services for rural areas that lack access to an in-office physician.

A 2020 Indiana University Center for Rural Engagement report finds that 29 Indiana counties had a shortage of primary healthcare services.

Most insurance companies cover virtual visits. Patients with common summertime infections - such as swimmer's ear, pink eye, and allergies - can download pictures for their virtual appointments.

Despite the convenience and time saved with remote visits, Russ cautioned that specific conditions require an in-office visit.

"Acute abdominal pain, chest pain, shortness of breath," said Russ, "anything that would be considered more emergent would not be appropriate, or anything where the provider needs to be able to listen to your heart and lungs or do a physical exam. "

Russ said medical providers can only practice in the state that they're licensed in and most telehealth options offer multi-state providers to assist patients who are traveling or in different locations.

According to the site Market USA, in 2022, the usage of telemedicine increased from 64% to 76% among people who are 55 years old or older.






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