DENVER -- Además de carecer de pruebas la ropa protectora adecuada para los trabajadores de la salud, los centros de salud de Colorado autorizados a nivel federal enfrentan enormes retos financieros al ajustar sus prácticas con motivo de la dispersión del coronavirus.

Los centros comunitarios de salud de Colorado hicieron una remodelación completa de sus esquemas de prestación de servicios en respuesta a la crisis del COVID-19, y están listos para recibir un enorme golpe en su capacidad de continuar brindando cuidados, si el Congreso no aprueba un fondeo crítico.

Polly Anderson, vice presidenta de estrategia y financiamiento en la Red Comunitaria de Salud de Colorado (Colorado Community Health Network), dice que además los centros no tienen suficiente vestimenta de protección para el personal, ni suficientes equipos de pruebas.

"Los centros de salud necesitan fondos de inmediato para seguir operativos y seguir sirviendo en la primera fila en esta crisis de salud pública. También necesitamos que el Congreso actúe y vuelva a autorizar los fondos federales para estos programas y no estar en aprietos cada mes, cuando más nos necesitan."

Los recursos federales para el bache provisional de fondos de los centros, aprobados en diciembre, expiran el 22 de mayo, y Anderson dice que muchos miembros del personal podrán enfrentar licencias sin más apoyo. A los Centros se les reembolsará por los servicios de "telehealth" (tele-salud) a través de proveedores autorizados por Medicaid para facturar, luego de que el Gobernador Jared Polis declarara un alivio temporal.

Pero Anderson señala que la medida sólo cubrirá parcialmente los costos totales de los centros.

Anderson dice que el Congreso también debería permitir reembolsos por cuidados "telesalud" a pacientes en serio peligro de complicaciones por el COVID-19. Además de animar a los clientes a seguir las recomendaciones CDC para reducir la velocidad de la curva de infecciones, los centros ya separan las visitas de pacientes saludables, de las de pacientes con síntomas.

"Los centros de salud están aquí para ti. Llama antes de venir, para que puedan seguir en pantalla sus procedimientos localizados y asegurarse de no exponer a la gente al contacto innecesario con otros individuos."

Anderson dice que los centros de salud que atienden a los coloradeños sin importar su capacidad de pago seguirán haciendo todo lo que puedan con un equipo de trabajo que está orientado a su misión, dedicado a sus pacientes y sus comunidades, mientras tratan de encontrar cómo mantener sus propias familias sanas y salvas.

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.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.