The Missouri Foundation for Health has released two reports that reveal significant obstacles Missourians face in accessing affordable health care. The first report from "Speak Up MO" covers Missourians' health-care experiences, while the second, "Medical Debt in Missouri," focuses on policy solutions. The findings highlight disparities in access to care and the financial burden of rising healthcare costs. Alarming statistics show one in five Missourians reported being without health insurance at some point in the past year.

Samantha Bunk, health policy strategist with the Missouri Foundation for Health, warned the high cost of health care is causing further hardships for Missourians.

"When you can't afford your health care, obviously that can affect things like if you can afford your housing, your basic needs, food, paying your bills, things like that - and then when we get into talking about medical debt, which was the other report, that can always have effect in other ways as well," she explained.

22% of Missourians report struggling to secure a car loan, and one in five face difficulties when applying for an apartment or mortgage. The foundation plans to work on resolving the challenges with evidence-based policies and by working closely with communities.

The reports reveal that about two-thirds of respondents found accessing physical health care "very" or "somewhat easy." However, the findings highlight disparities across different groups, with women, LGBTQ+ individuals and people with disabilities reporting more significant difficulties in receiving the care they need. Bunk noted that rural residents encounter the biggest obstacles in accessing affordable health care.

"There are obviously fewer health-care facilities, one issue having to travel longer distances -- and then when it comes to medical debts, we also reported higher rates of medical debt with our polling as well," she comtinued.

The foundation is set to release its next report on economic well-being and personal finances, with a follow-up on civic engagement expected later this fall.

Groups that advocate for clean water are applauding the Environmental Protection Agency's new rule on replacing lead pipes - but they warn that the drinking water in Wyoming schools remains at risk.

The agency has set a 10-year deadline for most utilities to replace lead service lines, but omitted requirements for schools to replace the water fountains or plumbing that have lead components.

John Rumpler, clean-water director for the Environment America Research and Policy Center, said it's up to school superintendents and legislators to ensure students' water is safe.

"This final rule now dispels the illusion that the federal government is going to come and do the clean-water homework for the state," he said.

The Wyoming Department of Environmental Quality in 2021 offered a voluntary program, funded by the EPA, to test drinking water in state schools and child-care facilities. According to results published in February, of more than 250 tests, a dozen led to the start of remediation projects. Only three were completed.

Several decades after the dangers of lead pipes were established, more than nine million remain in use. The toxic metal is particularly dangerous for children and can lead to brain or nervous-system damage, delayed development and behavioral problems.

Rumpler said the EPA missed an opportunity to better protect students, although a growing number of states and cities are now requiring lead filtration systems.

"If you're a school district," he said, "consider doing what Philadelphia, San Diego, Detroit, Milwaukee and so many other school districts are doing voluntarily to get the lead out and ensure safe drinking water for kids."

To help rural towns and cities comply with the new rule, the EPA is making an additional $3 billion available through the Bipartisan Infrastructure Law. The measure initially provided $15 billion to help cities replace their lead pipes, but government officials estimate the total cost will be several times higher.


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Clean water advocates in Maine are applauding the Environmental Protection Agency's new rule on lead pipe removals but warned drinking water in schools remains at risk.

The EPA set a 10-year deadline for most utilities to replace lead service lines but omitted requirements for schools to replace any fountains or plumbing with lead components.

John Rumpler, clean water director for the Environment America Research and Policy Center, said it is up to school superintendents and legislators to ensure students' water is safe.

"This final rule now dispels the illusion that the federal government is going to come and do the clean water homework for the state of Maine," Rumpler pointed out.

Rumpler argued Maine should follow Michigan's lead in requiring all schools to install filters certified to remove lead on all taps used for drinking or cooking. A recent report gave Maine a grade of "D" for its efforts to reduce exposure to lead in K-12 schools.

Several decades after the dangers of lead pipes were established, more than nine million pipes remain in use. The toxic metal is particularly dangerous for children and can lead to brain or nervous system damage, delayed development and behavioral problems. Rumpler added the EPA missed an opportunity to better protect students but a growing number of states and cities are requiring lead filtration systems themselves.

"If you're a school district, consider doing what Philadelphia, San Diego, Detroit, Milwaukee and so many other school districts are doing voluntarily to get the lead out and ensure safe drinking water for kids," Rumpler urged.

To help rural towns and cities comply with the new rule, the EPA is making an additional $3 billion available through the Bipartisan Infrastructure Law. The measure initially provided $15 billion to help cities replace their lead pipes, but government officials estimate the total cost will be several times higher.


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When it comes to stroke care, experts say, "time is brain." Now, a program launching in South Dakota will coordinate and strengthen stroke care across the state.

Nearly 400 South Dakotans died due to stroke in 2022. A new program from the American Heart Association of South Dakota, "Mission: Lifeline Stroke Initiative," aims to integrate all components of stroke care into a smooth system serving all patients quickly and effectively, whether they live in a city or a rural area.

Michele Bolles, national executive vice president of quality outcomes research and analytics for the American Heart Association, said it starts with early stroke identification.

"Generally, it's an acronym, FAST," Bolles outlined. "You look at someone's face, their arms may droop, their speech may be slurred, and ultimately the T stands for time. So, time is of the essence."

The initiative will also refresh emergency medical service providers on signs of stroke to kick-start the correct chain reaction for care, including assembling a hospital's stroke team and connecting patients with high-quality post-acute care. The Lifeline Stroke program has already rolled out in neighboring states including North Dakota, Montana, Nebraska and Iowa.

More than 90% of stroke patients live with a form of disability following their initial stroke, according to the American Heart Association.

Walter Panzirer, trustee of the Helmsley Charitable Trust, which provided a grant for the initiative, said patients will need different types of post-acute care, like physical therapy or speech pathology. The new program will provide certification for certain facilities.

"It's basically a gold seal of approval," Panzirer noted. "They can guarantee that every facility that meets it has the same standards."

Panzirer added while some people may have high-quality care nearby, others may need to travel.