Pennsylvania ranks 23rd among states for the overall health of women and children in a new America’s Health Rankings report by the United Health Foundation.
The Keystone State comes in 24th for its maternal mortality rate, the rate of deaths after pregnancy. The figure improved from last year, but nationwide, maternal mortality is up 29% since 2019.
Dr. Sharee Livingston, OB/GYN and department chair at the University of Pittsburgh Medical Center in Lancaster, said there is always room for improvement in Black maternal health, as Black women are three to four times more likely than white women to die after giving birth.
“Those social determinants of health that have a negative impact on their pre-pregnancy health, their pregnancy health, and most importantly, their postpartum,” Livingston explained. “Four out of five postpartum deaths are preventable. Most women who die post-childbirth are dying 43 days and greater beyond delivery.”
Livingston pointed out COVID-19 exposed major health disparities in the U.S., and added the report emphasized maternal mortality rates have gotten worse for people of color.
Livingston cofounded the Health Equity Now committee at the university, noting the goal is to decrease maternal morbidity and mortality in racially and ethnically diverse populations in Pennsylvania.
“It’s forcing us to do three things,” Livingston outlined. “Pay attention to the patients: How are they feeling about their care? How are they presenting to pregnancy? What’s happening when they’re in pregnancy? So, we’re looking at data. Policies … nothing happens without legislation, right? We have to change policy.”
Livingston added the 70-member committee includes doulas, and data show diversifying the prenatal workforce and including doulas improves maternal health outcomes, especially for people of color.
Dr. Lisa Saul, national medical director of maternal child health for UnitedHealthcare, said a healthy pregnancy boils down to health care access.
“Access to obstetric care, access to hospitals, is something that is an issue in our country,” Saul contended. “We know about maternity care ‘deserts,’ where sometimes women might have to travel for two hours to not only see their physician or their OB provider, but also to give birth.”
Saul stressed the importance of “calling out” the disparities in pregnancy outcomes for people of color. The report also includes some good news, including a decrease in the percentage of teen births, and fewer Pennsylvania teens using electronic vaping products.
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With just a few weeks left until the end of Medicare open enrollment, experts in West Virginia say now is the time to compare current coverage to next year’s plan, and make changes to avoid large out-of-pocket expenses.
Kimberly Taylor-Newsome, state program director for the West Virginia Aging and Disability Resource Center, said Medicare ‘Part D’ and Medicare Advantage plan details often change every year, so individuals should not assume they can rely on the same benefits.
“They can change their drug formularies, they change premiums, they can change deductible amounts, they can change the pharmacies that they work with,” Taylor-Newsome outlined.
Taylor-Newsome pointed out resource counselors are available through the state’s Aging and Disability Resource Center who can help people carefully review current coverage and compare plans. They can also check to see if people qualify for other assistance to help save them money. Counselors can be reached Monday through Friday from 8 a.m. to 4 p.m. at 866-981-2372.
At a time when many of the state’s older residents are struggling financially with inflation, Taylor-Newsome added not selecting the right plan could lead to more people foregoing needed medications and care.
“If you don’t maintain your health, if you can’t get your medications and the medical care that you need, you can’t care for that other person,” Taylor-Newsome stressed.
A recent KFF survey found people with Medicare are more satisfied with their health coverage compared to adults with other types of insurance. But cost concerns for monthly premiums and prescription drugs remain high, especially among people with disabilities who rely on the program.
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Health care premiums are increasing again under the federal Affordable Care Act, but experts said continued subsidies should protect most Mainers from any additional cost.
In fact, eight of 10 Mainers with a marketplace plan are expected to qualify for premium subsidies to lower their monthly payments.
Kate Ende, policy director at Consumers for Affordable Healthcare, said it is important for anyone looking to start a new plan or continue their current plan to do their health care homework.
“That’s the key part: shopping around, to ensure that the plan that you enroll in for 2024 covers what you need it to but also stays in your price range for premiums,” Ende urged.
Ende pointed out open enrollment runs from Nov. 1 through Jan. 16 but folks must sign up by Dec. 15 if they want coverage to begin at the start of the year.
More insurers are expanding their mental health coverage and offering more virtual care options, which gained popularity during the pandemic.
In Maine, Gov. Janet Mills signed legislation to ensure a person’s first behavioral health visit each year would be fully covered, and a copay would cover the cost of the second and third visit.
Ende acknowledged it can be tempting to choose the plan with the cheapest premiums, but warned people to pay attention to the details.
“It’s really important to check provider directories and drug formularies,” Ende explained. “Make sure whatever plan you’re choosing covers the doctors and providers you need, and the medications that you take as well.”
Ende added deciding on a health care plan can be confusing but there’s help available. Consumers for Affordable Healthcare offers enrollment assistance both in-person and through its help hotline, at 800-965-7476.
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If you do not have health insurance or if your employer-sponsored plan is too expensive, you may be in luck.
Open enrollment starts today for the state marketplace known as CoveredCA, the state health insurance marketplace. An estimated 1.3 million Californians are eligible for free Medi-Cal or a low-cost plan.
Jessica Altman, executive director of CoveredCA, the state health insurance marketplace, said subsidies make the plan affordable
“Ninety percent of the enrollees on CoveredCA receive financial assistance, two-thirds of whom have access to comprehensive health insurance coverage, for a cost of $10 or less per month.”
This year premiums are going up by 9%, but many people will not feel the increase thanks to federal subsidies from the Inflation Reduction Act, and the new California Enhanced Cost Sharing program, which lowers expenses for anyone making up to 250% of the Federal Poverty Level, which works out to income of about $35,000 a year for an individual, or about $70,000 for a family of four.
Altman noted help is available to navigate the process.
“In addition to being able to visit us at CoveredCA.com, to call us on the phone, we do also have over 14,000 enrollment assisters in communities across the state, who speak numerous languages and are here to help,” Altman emphasized. “Always free, always confidential for any Californian.”
This year, income-eligible DACA recipients will be able to sign up for a plan on CoveredCA, thanks to a policy change by the Biden administration. The open enrollment period lasts through the end of January, but you must sign up by New Year’s Eve in order for coverage to start on Jan. 1.
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