Rural Dispatch: March 2024

Rapid Rise in Syphilis Hits Native Americans Hardest
By Cecilia Nowell With U.S. syphilis rates climbing to the worst level in seven decades, public health experts and the federal Indian Health Service are scrambling to detect and treat the disease in Native American communities, where babies are infected at a higher rate than in any other demographic.

How National Political Ambition Could Fuel, or Fail, Initiatives to Protect Abortion Rights in States
By Bram Sable-Smith and Rachana Pradhan As money flows to abortion rights initiatives in states, some donors focus on where anger over the "Dobbs" ruling could propel voter turnout and spur Democratic victories up and down the ballot, including in key Senate races and the White House.

Montana, an Island of Abortion Access, Preps for Consequential Elections and Court Decisions
By Arielle Zionts A 25-year-old state Supreme Court ruling protects abortion rights in conservative Montana. That hasn’t stopped Republicans and anti-abortion advocates from trying to institute a ban.

West Virginia City Once Battered by Opioid Overdoses Confronts ‘Fourth Wave’
By Taylor Sisk Years of struggle prepared residents in Cabell County, West Virginia, to confront the latest wave of the opioid epidemic as mixtures of fentanyl and other drugs claim lives nationwide.

Concerns Grow Over Quality of Care as Investor Groups Buy Not-for-Profit Nursing Homes
By Harris Meyer For-profit groups own more than 70% of U.S. nursing homes. Industry leaders and researchers wonder whether corporations and investors can succeed where not-for-profit organizations have struggled. Or, will quality of care suffer in the name of making money?

California Voters Are Skeptical That More Money Is the Answer to Homelessness
By Angela Hart California Gov. Gavin Newsom’s signature ballot measure to address mental illness, addiction, and homelessness with a $6.4 billion bond and other reforms, is barely ahead in the ongoing ballot count. The slim margin reflects a growing unease among Californians over the governor’s homelessness initiatives.

An Arm and a Leg: The Medicare Episode
By Dan Weissmann On this episode of “An Arm and a Leg,” host Dan Weissmann breaks down the complicated and expensive world of Medicare with practical tips to pick the right plan and avoid penalties.

Operating in the Red: Half of Rural Hospitals Lose Money, as Many Cut Services
By Jazmin Orozco Rodriguez A recent report finds half of America’s rural hospitals are losing money, and many are struggling to stay open. Researchers and advocates worry the hospitals’ financial spiral will have immediate and long-term health effects on their communities.

California Pushes to Expand the Universe of Abortion Care Providers
By Laurie Udesky A new California law allows trained physician assistants, also called physician associates, to perform first-trimester abortions without the presence of a supervising doctor. The legislation is part of a broader effort by the state to expand access to abortion care, especially in rural areas. Some doctor groups are wary.

America Worries About Health Costs — And Voters Want to Hear From Biden and Republicans
By Julie Appleby and Phil Galewitz The presidential election is likely to turn on the simple question of whether Americans want Donald Trump back in the White House. But health care tops the list of household financial worries for adults from both parties.

How a Friend’s Death Turned Colorado Teens Into Anti-Overdose Activists
By Rae Ellen Bichell High school students in Colorado are pushing for a change they say is necessary to combat fentanyl poisoning: ensuring students can't get in trouble for carrying the overdose reversal drug naloxone wherever they go, including at school.

Hacking at UnitedHealth Unit Cripples a Swath of the US Health System: What to Know
By Darius Tahir Change Healthcare, a firm recently bought by insurance giant UnitedHealth Group, reportedly suffered a cyberattack. The company processes 14 billion transactions annually, including payments and requests for insurance authorizations.

Bathroom Bills Are Back — Broader and Stricter — In Several States
By Jazmin Orozco Rodriguez State lawmakers are resurrecting and expanding efforts to prohibit transgender people from using public restrooms and other spaces that match their gender. Some have sought to ban trans people from “sex-designated spaces,” including domestic violence shelters and crisis centers, which experts say could violate anti-discrimination laws and jeopardize federal funding.

Journalists Examine Medicaid Unwinding, Farmworkers’ Mental Health, and the Big Opioid Payback
KFF Health News and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.