HBO's The Wire Should Highlight Maryland's Health Care System

As outreach efforts intensify in the last three weeks before Open Enrollment on state healthcare marketplaces, many states worry that their uninsured populations won't receive the message.  Maryland is one state that worries about whether it can successfully enroll its state's 800,000 uninsured residents.

One of the main issues reaching Maryland's uninsured is the lack of available data to help state officials locate those residents. In an effort to change this, officials are using "upgraded electronic health records to develop maps highlighting where Marylanders overuse emergency rooms for care -- one indicator of the uninsured -- or where pockets of disease develop."  (Baltimore Sun, 9/7/13.)  While census data can identify concentrations at the city and county levels, this improved data will provide more targeted information that will help identify demographics down to the community level.

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Once communities with high numbers of uninsured are identified, state and community health leaders plan to target "pharmacies, grocery stores, and street festivals" to find those in need of care and inform them of their options.

This new data is important because enrollment in Medicaid under health care reform's expansion allowance could make or break the success of the new law which requires high levels of enrollment in order to succeed. New data identifying smaller pockets of uninsured will make targeted education efforts possible, which may, in turn, generate enrollment.

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With all these changes and data challenges afoot, perhaps Maryland's health care system would make a fascinating theme for The Wire, should producers decide to shoot an encore season.  It may be yet another way to educate communities about burgeoning health care options. And I'm sure its 4 million viewers wouldn't be disappointed, either.

Friday Variety: The Uninsured Gap, Veterans' Mobile Health, & (of course) Abortion

The Uninsured Gap

In the 27 states that have not committed to expanding Medicaid, many individuals and families could fall into a health insurance "black hole" where coverage would continue to be unaffordable.  In those states, individuals or families whose income amounts to 99% of the federal poverty level would not be eligible for Medicaid or premium subsidies on their state health insurance exchange. However individuals or families making 101% of the federal poverty level would be eligible for those premium subsidies that would make purchasing health coverage more affordable. 

According to a new analysis by the Kaiser Commission on Medicaid and the Uninsured, about 6.4 million people will be uninsured next year, unless those 27 states change their minds and agree to expand Medicaid coverage.  Nearly 2/3 of the uninsured live in 21 of the states that are not expected to expand as of January 1, and the six states that are on the fence.  The Kaiser Commission analysis reported that 55 percent of the uninsured live in Texas, Florida and Georgia alone.

Veterans' Mobile Health

The Department of Veterans Affairs has begun "testing the viability and potential of mobile health technologies after launching several pilot projects," according to Healthcare IT News. One such pilot is a Veteran Appointment Request App.  The App offers approximately 600 veterans the ability to request primary care and mental health appointments from their computer or mobile device.

Additionally, the Family Caregiver pilot is offering iPads to 1,000 caregivers of serious injured veterans of the Iraq and Afghanistan wars enrolled in the program.

Abortion Rights Groups to Challenge Texas Bill

On Thursday, Texas Governor Rick Perry signed the controversial abortion bill into law.  The law includes some of the nation's toughest restrictions on abortion, effectively forcing the closure of all but 5 of the state's 42 abortion clinics, unless those clinics can can upgrade their facilities within a year after the law takes effect this October.

Opponents of the bill may file a lawsuit against the state of Texas to stop the implementation of the law.  Executive Director of the Texas ACLU, of of several organization considering a legal challenge to the bill, stated, "There are no decisions about litigation, but I think that maybe the course we have to follow."

According to Planned Parenthood v. Casey, the Supreme Court case that followed Roe v. Wade, state laws cannot erect substantial obstacles to women seeking abortions.  If the Texas law causes the widespread closure that many have projected, this "serious obstacle" standard may have a fighting chance in court.