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Study: Fewer Struggle with Medical Costs as Coverage Grows

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This Nov. 12, 2014 file photo shows the HealthCare.gov website, where people can buy health insurance, on a laptop screen, shown in Portland, Ore. Not only do more Americans have health insurance, but the number struggling with medical costs has dropped since President Barack Obama's health care law expanded coverage, according to a study released Thursday Jan. 15, 2015. (AP Photo/Don Ryan, File)

This Nov. 12, 2014 file photo shows the HealthCare.gov website, where people can buy health insurance, on a laptop screen, shown in Portland, Ore. (AP Photo/Don Ryan, File)

RICARDO ALONSO-ZALDIVAR, Associated Press

WASHINGTON (AP) — Not only do more Americans have health insurance, but the number struggling with medical costs has dropped since President Barack Obama’s health care law expanded coverage, according to a study released Thursday.

The Commonwealth Fund’s biennial health insurance survey found that the share of U.S. adults who did not get needed care because of cost dropped from 43 percent in 2012 to 36 percent last year, as the health care law’s main coverage expansion went into full swing.

The proportion of people who got treatment but had problems paying their bills also dropped, from 41 percent in 2012 to 35 percent last year.

It was the first time that either measure of financial distress declined since the survey began asking the questions, in 2003 and 2005, respectively.

“Expanded insurance coverage is helping people get the care they need by reducing financial barriers to care,” the study said.

The health care law offers subsidized private insurance to people who don’t have coverage on the job, combined with expanded Medicaid in states that agree to broaden eligibility for that safety-net program.

Soon after the coverage expansion launched last year, a large ongoing survey by Gallup started documenting a sustained drop in the number of uninsured people. The Commonwealth Fund survey fills out that picture by adding details about the affordability of care.

The New York-based Commonwealth Fund is a private foundation dedicated to expanding coverage and improving the quality and cost-effectiveness of the health care system. While those goals generally align with Obama’s health care law, the group is nonpartisan.

The findings come at a crucial juncture for Obama’s law, as the Supreme Court prepares to hear another challenge from opponents committed to rolling it back. Republicans newly in charge of Congress are also planning more repeal votes.

Plaintiffs in the court case argue that the law as written only allows the federal government to subsidize coverage in states that have set up their own insurance markets. Supporters of the law say that while its wording may be confusing, Congress intended for subsidies to be available across the country, regardless of state actions.

Since Washington is currently running the insurance markets in 37 states, a ruling favoring of the plaintiffs would unravel coverage gains in many states.

Among the survey’s other highlights:

—The improvements in affordability are tempered. Many insured people still have problems paying medical bills, partly due to skimpy coverage that shifts costs to patients. That puts even many low-income workers with health insurance in a predicament. Thirty-three percent of insured adults with incomes under 200 percent of the federal poverty level ($47,100 for a family of four) said they did not get needed care in the past year because of costs.

—While nationally the share of Americans without health insurance declined from 20 percent in 2010 to 16 percent by the second half of 2014, a divide has opened between states that agreed to expand Medicaid and states choosing not to. Thirty-five percent of adults below the poverty line remained uninsured in states that did not expand eligibility, compared with 19 percent in states that did.

—Hispanics continued to lag other ethnic groups in coverage, despite the health care law. In 2014, 34 percent of Latinos were still uninsured, compared to 18 percent of African Americans and 10 percent of whites.

The Commonwealth Fund survey was conducted by Princeton Survey Research Associates International from July 22 to Dec. 14, 2014. The report’s analysis was based on interviews with 4,251 adults age 19-64. It has a margin of sampling error of plus or minus 2 percentage points.

Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Doctors Seeing More Cases of Preventable Childhood Illnesses

OAKLAND POST — Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

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By Stacy M. Brown

Doctors across the United States say they are treating children for illnesses that routine vaccinations once made increasingly uncommon, raising concerns that years of declining immunization rates are beginning to reverse decades of public health progress.

Pediatricians have described seeing more cases of whooping cough, rotavirus infections, bacterial pneumonia and other potentially life-threatening illnesses that vaccines have long helped suppress. Some physicians reported treating conditions they had rarely encountered during their careers, while others said that growing vaccine hesitancy is changing how emergency rooms and hospitals care for children.

The reports come as measles outbreaks continue to spread across multiple states and vaccination coverage remains below federal public health targets.

Johns Hopkins University’s International Vaccine Access Center reported 2,077 confirmed measles cases nationwide as of May 29. Researchers warned that outbreaks reported across the country have raised concerns about continued transmission, additional hospitalizations and deaths, and the possible loss of the nation’s measles elimination status.

Public health experts have long viewed measles as a warning sign because of its ability to spread rapidly through communities with lower vaccination coverage. The New York Times reported that physicians increasingly fear the resurgence of measles may be followed by the return of other vaccine-preventable diseases.

Doctors say that is already happening.

Dr. Meghan Hofto, a pediatric hospitalist at the University of Alabama at Birmingham, said she has already treated roughly as many children with rotavirus this year as she saw during the previous decade. Rotavirus once caused tens of thousands of hospitalizations annually before vaccines sharply reduced its spread. None of the children she treated this year had been vaccinated.

Hofto also described caring for infants with pertussis, commonly known as whooping cough.

“It’s hard to know when they’re safe to go home,” Hofto told The Times.

The rise in whooping cough cases has been particularly striking. More than 28,000 cases were reported nationwide last year, compared with approximately 7,000 in 2023, according to figures cited by The Times. Many of the affected infants were too young to receive vaccinations themselves and relied on broader community protection to reduce their exposure.

Other doctors described similarly troubling cases.

Dr. Jessica Kirk, a pediatric hospitalist in Alabama, recently treated an unvaccinated toddler hospitalized with pneumonia caused by simultaneous infections of Haemophilus influenzae and Streptococcus pneumoniae. Vaccines exist to protect against both illnesses. The child required oxygen and antibiotics to recover.

Researchers at Johns Hopkins have been tracking vaccination trends nationwide and found continuing signs of vulnerability.

At the same time, vaccine policy has become increasingly contentious in state legislatures.

Johns Hopkins researchers reported that lawmakers across the country continue to introduce bills affecting childhood vaccination requirements, vaccine access and non-medical exemptions. Researchers also noted that state policies governing exemptions remain a significant factor in vaccination coverage and disease transmission risks.

Physicians have said vaccine skepticism has expanded beyond childhood immunizations. Doctors also reported growing resistance to other preventive treatments.

For doctors confronting the return of illnesses that vaccines once pushed to the margins of American medicine, the challenge is becoming increasingly personal.

“It just feels like you’re a tiny little boat with a giant tidal wave coming at you,” Dr. Erin Charles, a regional pediatric hospitalist at Seattle Children’s Hospital, told reporters. “And you might convince one family here and there.”

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Community

Asm. Isaac Bryan’s Environmental Reparations Bill Passes on Assembly Floor

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

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Asm. Isaac Bryan (D-Ladera Heights). File photo.

By Bo Tefu, California Black Media

On May 26, the California State Assembly passed legislation to provide direct financial assistance to families harmed by pollution from a major urban oil field in South Los Angeles.

Assembly Bill (AB) 1661, introduced by Assemblymember Isaac Bryan (D-Ladera Heights), cleared the Assembly floor with a 44-10 vote after lawmakers concluded debate on the measure.

The bill would direct money from a community repair fund toward families who suffered negative health effects from living near what Bryan described as the state’s largest toxic urban oil field. The repair fund was created under legislation approved two years ago that shut down the oil field and required polluters to contribute financially to community recovery efforts.

“All this bill does is allocate resources from that repair fund and direct cash assistance to families that have had negative health impacts as a result of living next to that oil field,” said Bryan during remarks on the Assembly floor.

Bryan called the proposal “the largest environmental reparations opportunity for South LA” and told lawmakers the bill had not received opposition during the legislative process.

The legislation is part of California’s broader push to address environmental justice concerns in communities historically exposed to industrial pollution. South Los Angeles residents and environmental advocates have long raised concerns about health risks associated with oil drilling operations near homes, schools and parks.

Supporters say the measure represents a new approach to environmental accountability by ensuring that communities affected by pollution directly benefit from funds collected from responsible companies.

After debate concluded, Assembly leadership opened the roll call vote, and the measure passed with majority support from lawmakers.

AB 1661 now moves to the Senate for further review.

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Activism

Rep. Kamlager-Dove Introduces Bill to Protect Women in Custody After Reports Detailing Miscarriages and Neglect

The Pregnant Women in Custody Act would expand safeguards beyond the federal prison system to include women detained by U.S. Immigration and Customs Enforcement, U.S. Customs and Border Protection and the Office of Refugee Resettlement. The proposal follows reports of pregnant women being shackled, denied medical care and suffering miscarriages while in immigration detention.

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By Bo Tefu, California Black Media

Congresswoman Sydney Kamlager-Dove (D-CA-37) on May 7, reintroduced updated legislation aimed at strengthening protections and healthcare standards for pregnant and postpartum women held in federal custody, including in immigration detention facilities.

The Pregnant Women in Custody Act would expand safeguards beyond the federal prison system to include women detained by U.S. Immigration and Customs Enforcement, U.S. Customs and Border Protection and the Office of Refugee Resettlement. The proposal follows reports of pregnant women being shackled, denied medical care and suffering miscarriages while in immigration detention.

The legislation builds on a bipartisan version previously passed by the House during the 117th Congress. The updated bill includes new standards for healthcare access, mental health and substance use treatment, high-risk pregnancy care, family unity protections and increased federal oversight.

“Proper pregnancy care is a human right, regardless of your immigration or incarceration status,” Kamlager-Dove said in a statement. “It’s unacceptable that there are virtually no legal safeguards for pregnant women in federal custody.”

The bill would also limit the use of restraints and restrictive housing for pregnant women, improve data collection on maternal health in custody and require additional staff training and enforcement measures.

Supporters of the measure said the legislation is intended to address long-standing concerns about maternal healthcare and safety in detention settings, particularly for Black women and low-income women who are disproportionately impacted by incarceration and health disparities.

“Pregnant women in custody should never be subjected to dangerous and inhumane treatment that threatens their health, dignity, or the well-being of their babies,” said Patrice Willoughby, chief of policy and legislative affairs for the NAACP and a longtime public policy and government affairs strategist, in a statement.

A 2021 report estimated there are about 58,000 admissions of pregnant women into U.S. jails and prisons each year. Kamlager’s statement also cited a recent investigation by NBC News and Bloomberg Law that identified allegations of severe mistreatment or medical neglect involving at least 54 pregnant women or families in county jails between 2017 and 2024.

Federal policy under the Department of Homeland Security restricts the detention of pregnant, postpartum and nursing immigrants except in extreme cases. However, the agency reported that ICE deported 363 pregnant, postpartum or nursing women between January 2025 and February 2026, including 16 recorded miscarriages during that period.

The bill is cosponsored by several House Democrats and backed by organizations including the NAACP and the Vera Institute of Justice.

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