As Congress debates potential cuts to Medicaid, a new report from Georgetown University sheds light on how these changes could disproportionately impact rural communities. In Ohio, where over 18% of the population resides in rural areas - higher than the national average - Medicaid plays a critical role in ensuring access to healthcare for families.

Brittany Boulton, vice president of Groundwork Ohio, says proposed cuts - $2.3 trillion - could have significant consequences.

"Cuts to Medicaid of the scale that we've been hearing about potentially coming through Congress would make these problems far worse and leave thousands of Ohioans and rural families without access to coverage and care," she explained.

While the report highlights challenges in rural areas, urban communities in Ohio also face healthcare barriers. Transportation and financial issues often prevent families from attending preventive care appointments, even when facilities are available, worsening health disparities and underscoring the need for continued Medicaid support for vulnerable populations across the state.

Joan Alker, executive director of the Georgetown University Center for Children and Families and lead author of the report, says Medicaid doesn't just provide healthcare - it supports local healthcare systems, which are already under strain.

"These communities, which already face additional challenges, will be devastated by significant federal cuts to Medicaid. It is serving children. It is serving seniors in nursing homes, people with disabilities," Alker contended.

The report says 30% of children in Ohio's rural areas receive healthcare coverage through Medicaid, highlighting its importance. Boulton points to Ohio's troubling infant mortality rates, with Black infants faring worse.

"Our premature birth rate is over 10%, and Ohio does rank in the bottom 10 for infant mortality across the country, across all states. Cuts to the Medicaid program would absolutely be detrimental to those outcomes that we're trying so desperately to improve," Boulton continued.

Critics argue that reducing Medicaid funding could worsen health outcomes, especially in rural regions where maternal care deserts already exist, with 13 counties already completely lacking maternal health services.

Consumer advocates in Maine said the availability of enhanced subsidies have helped record numbers of people get the health care coverage they need.

Nearly 65,000 Mainers enrolled in health plans this year through the state's online marketplace.

Rachel Collamore, consumer assistance program manager at Augusta-based Consumers for Affordable Health Care, said more people are catching problems early and avoiding trips to the emergency room.

"It means that people who might otherwise kind of roll the dice don't have to anymore," Collamore emphasized. "They can get that security by having a health plan that is more likely to meet their budget and more likely to meet their health care needs."

Enhanced subsidies have cut some premiums, on average, by more than 40%.

Collamore noted open enrollment is closed until November but people can still get coverage if they experience certain "qualifying life events" like getting married or losing an employer-based plan.

The enhanced subsidies will expire at the end of the year unless Congress votes to extend them or make them permanent. Without action, the vast majority of marketplace premium payments will increase, and low-income enrollees will face the biggest premium hikes.

Collamore argued it should concern everyone because "healthy neighbors make good neighbors."

"We know that having access to medications that help you manage chronic conditions," Collamore pointed out. "Even just having access to affordable prenatal care; that those are really, really important and that kind of coverage is really out of reach for some many people if they don't have those tax credits."

Collamore added there are a lot of unknowns, but the Consumers for Affordable Health Care hotline is available for Mainers with questions about their coverage. She encouraged people to contact their elected officials to let them know the importance of keeping the enhanced subsidies in place.

February is American Heart Month and some Minnesota families are sharing their experiences with a sometimes overlooked disease among newborns: congenital heart defects.

Studies show congenital heart defects are the most common birth defect in the U.S., affecting nearly 40,000 babies each year. The American Heart Association said thanks to progress in the world of research and treatments, outcomes have improved. But families still find themselves in delicate situations.

Stephanie Johnson is a Minnesota mother whose son Henry was born with a syndrome restricting oxygen supplies to the body. Henry endured several surgeries and now lives a mostly normal life like kids his age but the worry is not over.

"We also know that the honeymoon period doesn't last forever," Johnson acknowledged. "At some point his heart's gonna get tired and he'll be looking at likely a heart transplant at that point."

Johnson hopes for additional medical breakthroughs but she and health experts noted congenital heart defect research is grossly underfunded. Another complication is government spending cuts sought by the Trump administration and the potential impact on agencies such as the National Institutes of Health. Policy experts say the research arm has already been dealing with flat funding levels.

In the absence of government support, current research heavily relies on awareness campaigns involving families navigating health scares. Johnson is among those trying to get the issue on the public's radar.

"We need to move science forward," Johnson urged. "Creating awareness for this is just incredibly important because awareness leads to funding, and funding leads to hope, and we're hoping for a cure."

Studies indicate congenital heart defects are underdiagnosed because milder symptoms are not always caught at birth. It means the disease is detected later in childhood or when the person becomes an adult.

Minnesota's Mayo Clinic and its HeartWorks program, as well as the Heart Association, are part of a network of health entities pushing for research advancements.

For Pennsylvanians with disabilities, there may be unexpected side effects to ending so-called Diversity, Equity, Inclusion, and Accessibility policies.

President Donald Trump has opted to eliminate DEIA initiatives in federal agencies and federally funded programs.

His executive order signed in January characterizes DEIA policies as "discriminatory."

But in Pennsylvania, Mallory Hudson - the director of the disability justice program at the Keystone Progress Education Fund - said a memo went out ordering the Justice Department's Civil Rights Division to not file any new complaints, motions to intervene, agreed upon remands, amicus briefs, or statements of interest.

"That means that the Department of Justice Civil Rights Division has been instructed not to file any new civil rights cases, right?" said Hudson. "And that includes ADA complaints. So, those are - that is one of the few ways that disabled people can even protect their civil rights."

She adds the Americans with Disabilities Act was first passed in 1990 under President George H.W. Bush, and its legal precedent was based on the Civil Rights Act of 1964.

Hudson said another potential concern is the future of the Inflation Reduction Act under the new administration.

She noted that the IRA has allowed the Centers for Medicare and Medicaid Services to negotiate drug prices - and many are benefiting from its progress, like a $35 co-pay for insulin.

"Older adults and some folks with disabilities have been able to do that $35 copay, and for folks on disability, that's still a pretty big chunk of change," said Hudson. "But it was better than before - and then, that meant taxpayers were paying the difference."

Lower prices have been negotiated for 10 medications so far, cutting costs for patients and saving taxpayers billions.

It's estimated that if the IRA had been enacted in 2023, it would have slashed prescription drug spending by 22% - or roughly $6 billion.