10 Best and Worst States for Health Insurance Costs

By Elyssa Kirkham, Finance Writer

Health insurance costs are up for 2016. Monthly premiums for the most popular plans offered on Affordable Care Act state exchanges in 2016 are 10.1 percent higher on average than they were in 2015, according to the Kaiser Family Foundation. The tax penalty for those without health insurance is also set to increase in 2016 from $325 per adult or 2 percent of household income to $695 or 2.5 percent of household income, reported the The New York Times.

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GOBankingRates conducted a study of popular health plans offered on ACA exchanges in each state and the District of Columbia to see which states residents are paying less for health insurance and what theyre getting for their money. Click through to see if your state is among the best or worst for health insurance costs.

The 10 States With the Highest Health Insurance Costs

To find the states with the highest costs, GOBankingRates compared the lowest-cost plan at the ACAs silver tier in each state. Comparing monthly premiums, deductibles and copays based on a single, 40-year-old, non-smoking male with an annual income of $40,000, the study highlighted the 10 states with the highest health insurance costs.

If you live in one of these states, you should expect to pay more each month for your insurance. Unfortunately, youll also be paying more for each doctor or emergency room visit, as the worst plans charge higher co-insurance rates and copays. Starting with the 10th-worst to the No. 1 worst state for health insurance costs, these are the states where residents pay more for coverage.

Related: 401k to Healthcare: How to Save Money This Open Enrollment

10. Colorado

Colorado residents enrolled in the states cheapest silver plan, the CO Silver 2750 option from Kaiser Permanente, will pay a $266 monthly premium thats right in line with the national median. The deductible is also relatively reasonable at $2,750.

This plans unfavorable co-insurance charges put Colorado in the bottom 10 of this list. A 20 percent co-insurance charge will apply for all visits to a primary physician as well as for emergency care, which means that the policyholder might still face high out-of-pocket costs even after theyve met the deductible.

9. Wyoming

The lowest-cost silver plan offered in Wyoming, BlueSelect Silver ValueTwo, carries a premium of $315 a month, 18.4 percent more than the national median of $266 for this type of plan, as found by this study. Thats with a substantial tax credit of $105 a month, without which the premium is $420. The plan has an average deductible of just $3,000, but plan participants pay co-insurance charges at 20 percent even after the deductible is met, meaning costs could be high for people who require healthcare services more frequently.

Wyoming residents and legislators are currently debating whether to expand Medicaid in the state under Obamacare, which would bring the state $268 million in additional funding over two years and enable it to help approximately 20,000 uninsured residents get coverage. Wyoming Gov. Matt Mead expressed support for the expansion, reported the Wyoming Tribune Eagle.

8. Delaware

The lowest-cost silver health insurance plan offered on the ACA exchange in Delaware is the Health Savings Embedded Blue EPO 3400 plan from Highmark Blue Cross Blue Shield Delaware. Priced at $320 a month after tax credits ($3,840 annually), it costs well above the $266 national median identified by the survey and has a higher-than-median deductible of $3,400; however, the plan offers 100 percent coverage after this deductible is met.

These costs are higher than this states residents paid last year. Delawares ACA exchange premiums rose 22.1 percent on average for 2016 compared with insurance costs for 2015 plans, according to DelawareOnline.com. Deductibles and out-of-pocket costs also rose year over year. Similarly, Delaware state employees might be facing higher health insurance costs or lowered benefits due to a spending gap anticipated in 2017, reported Delaware Public Media.

7. Indiana

The number of Indiana residents enrolled in insurance plans through the ACA marketplace doubled in 2015 to close to 180,000, reported The Journal Gazette, and the state expanded its Medicaid through the ACA in 2015. Despite these changes, Indiana still has some of the highest health insurance costs in the nation.

The lowest-cost silver plan, the MDWise Marketplace Silver Basic, costs $3,432 a year with its higher-than-average monthly premium of $286. The plan also has a high deductible of $5,000, and even after the deductible is met, the policyholder can expect a $200 copay for urgent or emergency care visits. Out-of-pocket costs are capped at $6,600.

6. Oklahoma

The cheapest silver health insurance plan offered to Oklahoma residents, Blue Advantage Silver PPO 103, has a monthly premium of $283, totaling $3,396 annually. This cost is higher than the median, and the plans high deductible of $4,000 and higher copays, such as $15 per visit to a primary doctor and 20 percent co-insurance even after the deductible is met, contribute to making this one of the most expensive plans in this study. The plans out-of-pocket maximum is $6,850.

Insurance options offered to Oklahomans through the ACA exchange are more limited for 2016, down from five providers to just two — and one of the remaining insurers has further limited its offerings in the past year, reported local outlet NewsOK. With fewer choices, Oklahoma insurance shoppers have fewer chances to get a deal on health insurance in 2016.

5. Mississippi

Mississippis lowest-cost silver plan, Ambetter Balanced Care 2 from Magnolia Health, is $278 per month, or $3,336 annually. Its the plans high deductibles, however, that make it one of the most expensive. The insured party under this plan needs to meet a deductible of $6,500, the second-highest deductible cost of the health plans surveyed in this study, and each visit to a primary doctor has a copay of $30.

Mississippi also has the worst health system of any state, according to a 2015 study on state health system performance by the CommonWealth Fund. The state had the third-worst score for accessible and affordable healthcare, largely due to its high rates of uninsured adults and failure to expand Medicaid. As the state with the highest poverty rate of nearly a quarter of its residents — 24.3 percent, according to The Stanford Center on Poverty and Inequality — health insurance is still outside the financial reach of many Mississippians.

4. New Jersey

New Jerseys lowest-cost silver plan, Oscar Market Silver, landed among the worst in the US because of its high co-insurance costs of 50 percent. While it has a lower-than-average deductible of $2,500, a plan participant will still be responsible for half of the healthcare costs after this deductible is met. Additionally, the plans monthly premium of $317, or $3,804 annually, is higher than average.

3. Alabama

The combination of a high monthly premium, high deductible and high copays make Alabama the third-worst state for health insurance costs. The states lowest-cost silver plan, the Silver Compass 5000 plan offered by UnitedHealthcare, has a high deductible of $5,000, after which the enrollee is still responsible for 20 percent of care costs and a $20 copay for primary doctor visits. These lackluster benefits come at an above-median cost of $288 a month, or $3,456 a year.

The state has not opted to expand Medicaid. In November 2015, a task force appointed by Gov. Robert Bentley recommended that the state government work to extend coverage to the hundreds of thousands of Alabamans who currently earn too much to qualify for Medicaid but dont make enough to reasonably afford health insurance, according to AL.com. Opting into a federally funded expansion of Medicaid could help the states low-income residents get better access to healthcare.

2. South Carolina

In South Carolina, the cheapest silver plan is the Blue Option Silver 6850 offered by BlueChoice HealthPlan, which ranked as the second-costliest because of its $6,850 deductible, the highest of any silver plan in this study. This high deductible is the plans maximum out-of-pocket cost, and no co-insurance is required once this is met; however, a primary care doctor visit will incur a $25 copay.

People in South Carolina also get poorer quality healthcare, according to CommonWealth Funds study of state health systems, which ranked South Carolina in 40th place. The study reported that South Carolina is among the worst states for accessible and affordable care, has less equitable healthcare and is home to residents with overall poorer health and lifestyles.

1. New York

New York has the most expensive health insurance, with factors scoring poorly across the board. The states cheapest silver plan, offered by CareConnect, has a higher $3,000 deductible and the highest monthly premium at $366 ($4,392 annually). The insured party will pay some co-insurance charges, such as 25 percent on emergency care. The plans maximum out-of-pocket costs are capped at $6,850 per individual.

Although New York is featured here for its high costs, it made healthcare news in late December 2015 when Gov. Andrew Cuomo signed a bill that adds pregnancy as a qualifying event, which enables pregnant women to enroll in an insurance plan at any time, including outside of typical enrollment periods. With this law, New York is the first and only state that requires health insurers to accept pregnant women as new policyholders at any time.

The 10 States With the Lowest Health Insurance Costs

In the study of states health insurance plans, some plans stood out as offering higher value while charging lower premiums — the lowest is less than half of the cost of the most expensive health plan identified in this study. Lower premiums enable plan participants to save money in their monthly budgets, and lower deductibles and copays mean residents of these 10 states are also more likely to pay less when they need to use their insurance. Click through to see the 10 states where health insurance providers give customers better deals.

Read: When to Use Your Emergency Fund

10. Idaho

Idaho is one of the worst states for accessible and affordable healthcare, with 22 percent of people experiencing high out-of-pocket costs relative to income and rates of uninsured adults remaining high near 20 percent, according to data from the Commonwealth Fund. Because the state has opted not to expand Medicaid through federal funding, the state also has 78,000 residents who have incomes too high to qualify for subsidies or Medicaid but too low to afford monthly premiums, reported the Associated Press. Idahos Gov. C. L. Otter, however, has introduced a new $30 million legislative plan that would use state funds to address the issue.

The good news for Idaho residents is that their health insurance costs are already relatively low. The lowest-cost silver plan in the state, Mountain Health Co-Op Link Silver, has a monthly premium of $266, which is the national median, and it has a lower deductible of $2,150. Flat fees for visits to emergency rooms and primary doctors also keep costs low.

9. Oregon

Several new healthcare laws went into effect Jan. 1, 2016, in Oregon that expand many residents insurance coverage. The provisions require health insurance providers serving Oregon residents to cover a full year of birth control, 90 days worth of most prescription medicines, and medical services provided via videoconference, reported Portland Business Journal.

Despite the expansions to health insurance coverage for Oregonians in 2016, the costs are still some of the lowest in the nation. Silver plans start at $230 a month with the Connect 2000 Silver plan from Providence Health Plan. Its deductible is a low $2,000. Plan participants should expect to be responsible for some of the costs beyond the deductible, however; emergency services carry a $250 copay after the deductible is met, and the copay for care from a primary doctor is $25, with out-of-pocket costs capped at $6,850.

8. Hawaii

Despite having one of the nations highest costs of living, Hawaiis health insurance costs are some of the most reasonable. Along with one of the better low-cost silver plans, Hawaii also has one of the best health systems in the nation, ranked as the third best in the nation by the CommonWealth Funds study.

The states lowest-cost silver plan, HMSA Silver HMO, has a monthly premium of $260, which is slightly better than the $266 median, and it has a relatively low deductible of $2,500. It also charges flat copays for emergency care and visits to primary physicians, which help to limit plan holders costs when they need to use their insurance.

7. District of Columbia

The District of Columbia has some of the best health insurance costs. The Districts cheapest silver plan, BlueChoice HMO HSA Silver, has a monthly premium of $229, or $2,748 annually.

The deductible is just $1,350 — one of the lowest of any of the plans reviewed for this study — which also helps limit out-of-pocket costs for policyholders, such as the $300 emergency room copay.

6. Michigan

Michigan is another state with low a monthly premium — just $210 a month, or $2,520 annually. The low-cost silver plan with this premium, Humana Silver 3800/Detroit HMOx, does have a $3,800 deductible, however, which is higher than most states silver plan deductibles, but costs are kept low with other fees, such as the $20 primary doctor visit fee and the $250 emergency room copay before deductible.

These low costs are offset somewhat by Michigans 0.75 percent tax on health insurance, which funds Medicaid coverage for low-income residents of the state. Even with this tax, however, health insurance is relatively affordable in Michigan, and 311,000 state residents have signed up for health plans through the ACA exchange since Nov. 1, 2015, according to the Associated Press.

5. Pennsylvania

Competition between Pennsylvanias 19 health insurers selling individual plans on the ACA exchange has led to better prices and plans for residents. The states lowest-cost silver plan from Independence Blue Cross, for example, has one of the lowest deductibles in this study: $1,500.

This deductible, paired with flat copays that make it easier to predict and control costs, are the top factors that put Pennsylvania at No. 5 among states with the lowest health insurance costs, even with the plans monthly premium of $276.

4. Texas

Health insurance plans offered on the healthcare exchange in Texas are some of the best in the nation. The states cheapest silver plan, Molina Marketplace Choice Silver Plan, offers a low $2,000 deductible with a competitive $253 monthly premium for an annual premium total of $3,036. Flat fees on health services also reduce the overall cost.

Despite its low healthcare costs, Texas still has some catching up to do. Texas is one of the most populous states that opted not to expand Medicaid, according to the Kaiser Family Foundation, and although its uninsured rates have dropped since ACA took effect, 20.8 percent of residents were still without insurance in the first half of 2015, according to Gallup data — the highest of any state.

3. California

In the nations most populous state, more than 238,000 California residents joined the Covered California health exchange, reported The Orange County Register. The states cheapest silver plan, Silver 70, costs $360 less a year than the national median because of its lower $236 monthly premium. The plan also has other affordable features, such as a low $2,250 deductible and flat fees on many health services.

These low costs might soon be increased by a tax on all health insurance plans proposed by California Gov. Jerry Brown, according to the San Jose Mercury News. The tax would raise an estimated $1.35 billion each year, which Gov. Brown hopes to use to expand programs and services such as those for Californians with developmental disabilities.

2. Utah

For Utah residents, low-cost health insurance is within reach even though the state has not adopted the federal Medicaid expansion. The states least expensive silver plan, Molina Marketplace Silver Plan, has a premium of just $214 a month ($2,568 annually). Utah residents on this plan can also look forward to more affordable out-of-pocket costs. The plan has a low $2,000 deductible and flat fees for many health services. It also caps out-of-pocket expenses at $6,850.

1. New Mexico

With the lowest monthly premium for a silver plan of any state, New Mexico residents can get covered for just $181 a month, or $2,172 annually, on the Molina Marktplace Silver Plan. Along with a low premium, this plan also offers a low $2,000 deductible and flat-fee copays for many health services.

Despite low costs, many New Mexico residents have encountered issues getting their health coverage. Due to a high volume of health insurance applications, many applications submitted in December 2015 remained unprocessed even past the date when insurance coverage should have kicked in, reported the Santa Fe New Mexican. Enrollees whose applications werent processed quickly enough experienced problems such as being unable to visit a doctor or receive care using their new policy.

50 States and DC Ranked by Health Insurance Costs

Here is the full ranking of the 50 states and the District of Columbia from best to worst, according to their health insurance costs for the silver plan with the lowest monthly premium in each state.

Clinton v Sanders

HEALTH-care policy has become one of the most glaring areas of disagreement between Hillary Clinton and Bernie Sanders in the campaign for the Democratic presidential nomination. In last week’s debate, the two leading contenders laid out starkly different visions, with Mr Sanders taking a pie-in-the-sky approach while Mrs Clinton cemented herself as a pragmatic incrementalist. After a Republican debate a few days earlier in which the discourse over health-care amounted to the rather empty mantra of “repealing and replacing” Obamacare–without a single detail from any of the contenders on what a replacement might entail–the Sanders-Clinton exchange was refreshingly substantive.

The first mention of health-care came in the candidates’ opening statements, when moderator Lester Holt of NBC News asked which “top three priorities” the candidates would pursue in their “first 100 days in office”. For Mr Sanders, the no-holds-barred leftie, this was the ideal lead-off question. “Well, thats what our campaign is about”, he noted, chomping at the bit. “It is thinking big. It is understanding that in the wealthiest country in the history of the world, we should have health-care for every man, woman, and child as a right”. This is the kind of rhetoric that has ignited surprisingly large and vocal crowds for the socialist senator from Vermont over the past few months and ushered him to a position no one expected: he is now neck-and-neck with Mrs Clinton in Iowa and appears to be walloping her in New Hampshire. When it was her turn, Mrs Clinton served up the equivalent of a four-square sensible dinner, sans dessert: “I would…present my plans to build on the Affordable Care Act and to improve it by decreasing the out-of-pocket costs by putting a cap on prescription drug costs; by looking for ways that we can put the prescription drug business and the health insurance company business on a more stable platform that doesnt take too much money out of the pockets of hard-working Americans”.

The more detailed exchange that followed was a study in caricatures: lofty principle vs. mannered pragmatism, unreconstructed liberalism vs. cautious bipartisanship, shoot-for-the-moon vs. settling for grounded compromise. The Sanders style obviously plays much better in a debate and stirs quite a bit more emotion in the Democratic party base, while Mrs Clinton’s style reflects years of struggle and disappointment with grander measures that have failed when the political reality of Washington, DC intervened. So while she insisted off the bat that she is “absolutely committed to universal health-care”, Mrs Clinton quickly dialed back from that position. “I have worked on this for a long time”, she said, without quite sounding hard-bitten. “People may remember that I took on the health insurance industry back in the 90s, and I didnt quit until we got the childrens health insurance program that ensures eight million kids”. Rather than “tear [Obamacare] up and start over again”, Mrs Clinton pleaded, let’s “defend and build on the Affordable Care Act and improve it”. Mr Sanders’ radical measure to insure all 320m Americans is just a non-starter. “I dont to want see us start over again with a contentious debate”, she said twice.

As red-meat applause lines go, “let’s not have contentious debate”–uttered sternly in the middle of a contentious debate–is not high on the list. And Mr Sanders made the most of his much more radical approach to health-care, which would, as his website makes plain, revolutionise the American health-care system: “Health-care must be recognized as a right, not a privilege. Every man, woman and child in our country should be able to access the health-care they need regardless of their income. The only long-term solution to Americas health-care crisis is a single-payer national health-care program”. In the debate, Mr Sanders sketched a noble pedigree for this idea: “What a Medicare-for-all program does is finally provide in this country health-care for every man, woman and child as a right. Now, the truth is, that Frank Delano Roosevelt, Harry Truman, do you know what they believed in? They believed that health-care should be available to all of our people”.

Here Ms Mitchell called the Vermont senator on how he would be able to push through such a plan in a country where exceedingly more modest measures are still unpopular. Noting that universal health-care failed to attract sufficient support even in the liberal haven of his home state, Ms Mitchell pressed him to explain “how can you sell it to the country…if you couldnt sell it in Vermont”. In a revealing double-pivot, Mr Sanders first drew laughter by reminding the audience that he’s just a senator from Vermont, not its governor. Then he blamed the dim prospects for radical change in health-care policy on the main bogeyman of his presidential campaign: a “campaign finance system that is corrupt”. He may be right about that. But he provided no persuasive account of how, as president, he would manage to transform the way elections are funded.

The debate isn’t about numbers. Mrs Clinton correctly notes that about 19m more Americans are covered under Obamacare; Mr Sanders is right that this still leaves about 30m Americans uninsured. The dispute between the leading Democrats is over what to do about the remaining 10% of the country at risk of financial ruin or worse, should an unwelcome diagnosis crop up. There is little doubt that insuring everybody is a laudable goal. But Mrs Clinton is right that the political constraints on implementing a plan to do that are more formidable than one charismatic liberal president could overcome. As Paul Krugman of the New York Timeswrites, whatever the virtues of a single-payer system, “it’s just not going to happen anytime soon”. The real question about Mr Sanders plan, along with his overall devil-may-care approach to public policy, is whether ignoring political realities is enticing enough to Democrats to earn him a spot onthe ballot in November. And the question for steady-as-she-goes Mrs Clinton is whether her sensible shoes may trip her up in a primary season where voters seem decidedly uninterested in wonkishness and modest proposals.

Four Key Issues In Health Law That Are As Relevant As Ever In 2016

Spring may be the season of renewal and growth, but each year, January offers a chance for reflection and hope, learning from the past and taking on new challenges. The same is true in the world of health policy. As we embark on the new year, it’s the perfect time to take stock of which major issues remain outstanding from years past and which are coming down the pike.

Contraceptive Coverage Mandate

Any annual list of key issues in health law policy will be subjective, but it’s safe to say that the Affordable Care Act (ACA) would top any one of them. In the immediate wake of the law’s passage, the focus was on general implementation issues (including roll-out of the Exchanges), and of course constitutionality and attempts at repeal.

Attempts at repeal keep coming, but with the current balance of power in Washington, they seem to be more posturing than anything else. Although much of the litigation has finally died down, that has not been the case with regard to application of the contraceptive coverage mandate stemming from the ACA’s requirement to cover free preventive care.

Burwell v. Hobby Lobby Stores made a big splash in 2014 when the Supreme Court ruled that a secular, for-profit business owned by a religious family did not have to comply with regulations that would have required the company to cover free contraceptives on its employee insurance plans.

The Court left open the question of whether the accommodations that had been offered to religious non-profits would satisfy the legal standards protecting religious freedom, but will decide that question this term, in response to challenges brought by religious organizations claiming that they should be completely exempted from the coverage requirement. Litigation has also been brought by those with secular objections to contraceptive coverage, although those cases have not yet reached the Supreme Court.

Incremental Progress v. Total Reboot

Back to the ACA more generally, the real work continues with regard to Medicaid expansion, the ultimate fate of the “Cadillac tax” (which has already been delayed by two years), and most importantly, whether the required coverage is really affordable or adequate for consumers, and whether Exchanges will prove to be economically viable markets. With the presidential election on the horizon, the most important health policy question of 2016 is whether we’ll build on the reforms we have, or start again from scratch.

Controlling Costs

Relatedly, efforts to stem health care costs have been at the top of the list for some time, and will certainly remain there for the foreseeable future. Concerns are ever present about hospital system and insurance company mergers, resulting in restricted competition and raising serious antitrust issues.

Substantial attention is also increasingly being paid to common-sense efforts to link payment to the value of the care provided, rather than just the quantity of services, although there is debate about how and how quickly to push this approach. Since the ACA entrenched employers as a key provider of health insurance, more employers have begun to experiment with various incentives to encourage their employees to protect and improve their health through workplace wellness programs, thereby reducing employers’ costs overall.

Although these approaches may take advantage of certain “nudging” techniques, questions have been raised about their effectiveness and their legal permissibility in light of employer access to health information that may be used for discriminatory purposes.

Other attempts to stem costs focus on calibrating intellectual property rights in pharmaceutical products and medical devices, seeking the elusive balance between incentivizing appropriate innovation while promoting reasonable costs. This is not a new issue, of course, but it remains woefully unresolved, perhaps as best exemplified by Martin Shkreli’s controversial price hike of Daraprim, and other high profile cases in which companies have taken advantage of what some have called “loopholes” in FDA market exclusivity programs.

Regulatory Pathways

Beyond price issues, getting new products to patients who need them as quickly as possible is an ongoing theme in health law policy, but one that has increasingly picked up steam as the drug safety scandals of the 2000s appear to be fading from memory.

The 21st Century Cures Act is winding its way through Congress, with the goal of promoting the development and speeding the approval of new drugs and devices. As Jerry Avorn has explained, the proposal would provide a welcome and substantial increase in the National Institute of Health’s (NIH) budget, but could result in product approvals with substantially less data, putting patients at risk.

For their part, patients are increasingly clamoring for drugs even before they get approved, demanding a “right to try” experimental therapies when other options have run out. Several states have passed “right-to-try” laws (deemed dubious by some), and companies have responded by developing new policies to handle patient requests. At the same time, there are other patients who are ready to die and seek aid in doing so, prompting a 2015 legislative change in California, and new proposals in other states.

And More…

Other top issues at the moment include the extent of FDA’s ability to regulate off-label promotion in accordance with First Amendment principles, how best to stem the opioid-addiction epidemic, responses to attempts to defund Planned Parenthood and curtail abortion rights around the country, and the future of regulatory oversight of federally funded human subjects research in light of the recent Notice of Proposed Rule Making to amend the Common Rule. Less traditional issues that must nonetheless be key priorities for health policymakers in 2016 and beyond include whether and how to respond to gun control as a public health issue, as well as implications of the #blacklivesmatter movement for health and health care.

How these issues play out will be influenced in large part by the upcoming elections, and it is apparent that the parties could not be further apart on their desired approaches. As evidenced by the fact that the major themes have not changed dramatically over timehealth care spending, the government’s role in health care markets, the proper purview of the FDA, and the likethese issues clearly are not easily resolved, but they are critical. One thing is for certain: health policy scholars will be busy again in 2016.

Authors Note

We will be discussing these issues and more at the 4th Annual Health Law Year in P/Review conference, to be held on January 29, 2016, at Harvard Law School in Cambridge, MA. We invite you to join us: The event is free and open to the public, but registration is required. Conference presenters will participate in a blog series to follow here at the Health Affairs Blog. Stay tuned.

This years P/Review is sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, The New England Journal of Medicine, Health Affairs, The Hastings Center, Harvard Health Publications at Harvard Medical School, and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund at Harvard University.

The Health Reporter Is In: Jan. 20, 2016

Have a health-related question?Submit it hereand veteran reporter Deb Pressey will chase down an answer.

This week:

Q:What is the name of the virus that is going around now here in Florida? What are the signs? How long will it last? What steps can be taken to relive or cure this virus?

A: It’s called Zika virus, and even though two Illinois women recently tested positive for it, there’s virtually no risk for Illinois residents unless they plan to travel to certain parts of the world, according to the state Department of Public Health. You can only become infected with Zika virus if you’re bitten by a certain type of infected mosquito, and it can’t be spread from person to person.

The two Illinois cases involved pregnant women who traveled to countries where Zika virus is found, according to the health department.

The three cases in Florida were also linked to foreign travel, in Columbia and Venezuela. The first US case was confirmed in Texas this month in a traveler who returned from El Salvador.

The Centers for Disease Control and Prevention has issued a travel alert to countries where Zika virus is being transmitted on an ongoing basis. That includes Brazil, Columbia, El Salvador, French Guiana, Guatemala, Haiti, Honduras, Martinique, Mexico, Pana, Paraguay, Suriname, Venezuela and the Commonwealth of Puerto Rico.

The CDC also has recommended screening pregnant women for Zika virus if they’ve traveled to a country where it’s a risk, and has also advised pregnant women to consider postponing travel to areas where the virus transmission is ongoing. Those who go ahead and travel anyway have been cautioned to take care to avoid mosquito bites, which are a risk both indoors and outdoors, mostly during the daytime.

The alerts and recommendations are based on reports of Zika virus being linked with poor pregnancy outcomes — most notably microcephaly, a birth defect in which the infant’s head is abnormally small.

Some things to know about Zika virus:

— There isn’t a vaccine to prevent it and there aren’t any medicines to treat it.

— 80 percent of people who are infected with Zika virus don’t have symptoms. For those who do get sick, the common signs of infection include fever, rash, joint pain and red eyes, with symptoms lasting from several days to several weeks.

— It is transmitted primarily by Aedes aegypti mosquitoes, which also can also spread dengue fever, chikungunya and yellow fever. They can be found in several US states and they’re aggressive daytime biters.

Champaign-Urbana Public Health District Administrator Julie Pryde said as far as she knows there arent any Aedes aegypti mosquitoes in Champaign County. But climate changes have caused some mosquitoes to move north, she said.

The health district used to think there weren’t any Asian tiger mosquitoes in the area, Pryde said. Asian tiger mosquitoes, which can carry the chikungunya virus, started turning up in Champaign County in 2011 and have also been found in Vermilion County.

Health department officials balk at proposed 25 percent cut to state aid

CHARLESTON, W.Va. The 49 local health departments in West Virginia will have to operate with 25 percent less funding for basic health services if Governor Earl Ray Tomblins proposed reduction to state aid for those departments remains in the final 2017 budget.

We were anticipating a five, maybe ten percent cut which would have hurt, but would be survivable, said Dr. Lee Smith, health officer and executive director of the Monongalia County Health Department.

This, I think, is going to create some real difficulties for, particularly, the smaller health departments.

Two health care providers vying to operate Petaluma Valley Hospital

Two bidders are vying for the right to operate Petaluma Valley Hospital, following a series of public meetings to gather input on four proposals, the Petaluma Health Care District announced this week.

St. Joseph Health, which is the current hospital operator, and Prime Healthcare Services, a for-profit hospital management company with headquarters in Ontario in San Bernardino County, both move on to the next stage of review. The district currently is engaged in a 60- to 90-day evaluation of potential bidders.

After the evaluation process is complete, the district board is tasked with making a recommendation to the public. That recommendation likely will go before voters in November.

Both proposals specify that the bidders will operate the hospital as a nonprofit entity.

Prayer Improves Health

Spiritual/religious practices are used around the world to cope with and treat health illnesses. These tools are commonly referred to as complimentary and alternative/integrative medicine. Although these holistic practices may be taboo or stigmatized, there is a growing body of science supporting some of these modalities. For more information on integrative and spiritual health click here.

One commonly under-reported but effective spiritual tool is praying. According to Professor of Psychology Thomas Plante, prayer is a conversation with the sacred, and all of the major religious traditions encourage prayer making it inclusive. Prayer can be as ritualistic as repeating statements or equally as spontaneous and unstructured.

Prayer is central to many spiritual peoples lives, and can be used as a tool to improve wellbeing. Although people are most likely to pray when their needs are greatest, more than 55 percent of Americans pray every day. Therefore, prayer may be done more frequently in times of crises, but it is also habitual and significant for the majority of Americans everyday.

Scientists organize prayer into the following types:

  • Contemplative-meditative prayer (eg, worshiping God, reflecting on the Bible)
  • Ritualistic prayer (eg, repeating statements)
  • Petitionary prayer (eg, asking God for things)
  • Colloquial prayer (eg, thanking God for things)
  • Intercessory prayer (eg, praying for others)

What are the health benefits?

Not only are there many kinds of prayers, but also there are many ways in which they can be used to improve mental health. Techniques such as psychotherapy, meditation, audiovisual resources, and pastoral services can all incorporate prayer to help improve wellbeing. Research suggests these spiritual techniques are associated with decreases in depression and stress, and may reduce clinical symptoms, especially anxiety.

Scientists used qualitative and quantitative methodologies to measure the relationship between prayer and spiritual health. They found private and public prayer predicted better levels of spiritual health. Specifically, they found that both forms of prayer increased participants closeness to God and having a stronger sense of identity. Scientists also suggest that praying for oneself and for others has been found to be beneficial for spiritual-health and relationships.

Moreover, prayer has statistically significant positive effects on health. It can be used as a preventative or coping strategy. By practicing prayer, patients can increase their self-esteem and overall mental health. Additionally, prayer can improve ones spiritual health and identity.

Wisconsin women need reproductive health act

For the past few years, Wisconsin legislators eagerly have passed laws that disregard medical science, the well-being of patients, and the patient-doctor relationship. These laws are based on political agendas and junk science aimed at undermining access to reproductive health care. This unprecedented political interference into patients relationships with their trusted doctors undermines womens health in Wisconsin.

As licensed Wisconsin physicians, we are standing up against this devastating trend that compromises patient care and our ability to practice sound medicine. We are speaking out in support of a new legislative proposal — the Patients Reproductive Health (PRH) Act — authored by state Sen. Jon Erpenbach (D-Middleton) and state Rep. Chris Taylor (D-Madison).

As physicians with years of education and training, we believe our patients deserve the basic right to make their own health care decisions based on the best medical science, free from interference from politicians, and without having to face harassment or intimidation from extremists who oppose reproductive health care.

Unfortunately, our patients are often denied these rights by politicians pushing extreme agendas. When it comes to reproductive health care in Wisconsin, no one is guaranteed compassionate and medically accurate standards of care. That is why our state needs the PRH Act that ensures that when you are facing important decisions about your reproductive health, you can trust that your doctor has the right to provide you with information based on the best science available.

Politicians in our state have prevented doctors from providing the best available medical information to their patients by requiring them to perform medically unnecessary ultrasounds, provide patients with medically irrelevant informed consent information and impose burdensome waiting periods on any of our patients who wish to access abortion care. The PRH Act recognizes that reproductive health care is an incredibly important aspect of human health and would repeal many of the existing laws that undermine quality care and the doctor-patient relationship. Even more important, it would prohibit the state from imposing regulations on reproductive health care that are not firmly grounded in medical science.

The PRH Act recognizes and affirms that patients need medical professionals — not politicians — to provide them with expert advice about their reproductive health decisions. Most politicians are not doctors, and dont have the training or experience to tell doctors how to do their jobs. Its simply bad medicine when these politicians use their political beliefs to dictate care. Elected officials have many important jobs to do, but they need to leave the medicine to us.

The PRH Act also recognizes the significant barriers that prevent many women from accessing comprehensive reproductive health care in Wisconsin. Nationwide, the number of facilities providing abortion care decreased 38% from 1982 to 2000, and continues to decrease. Only three counties in Wisconsin have abortion care facilities. As a result, the PRH Act would require any hospital that provides maternity care services to also allow willing health care professionals on its staff to provide patients with comprehensive reproductive health care. This provision will ensure that women have access to comprehensive medical care wherever they live in our state, while also recognizing the long-standing commitment in our country to honoring the consciences of all individual providers.

Finally, the PRH Act also would ensure that you can seek care without facing harassment and intimidation. We all respect the right to an open discussion about public policy, but some of the things reproductive care patients and providers face are intolerable. As anyone who has openly provided abortion care knows, opposition to reproductive health care sometimes take the form of intimidation and violence directed against patients and providers. Many providers have shared powerful stories about the routine harassment and threats they face in the course of their day — both at work and at their private residences. Many doctors and their families have consistently faced harassment and threats. In Wisconsin, these intimidation tactics have included arson. In other states, providers have even been murdered. The PRH Act recognizes this disturbing reality and sends a powerful message that extremist tactics are not welcome in Wisconsin.

The most satisfying part of practicing medicine is helping patients get the care they need in the most compassionate way possible. But right now, your right to that care and to that compassionate treatment is sadly unprotected in our state.

We can change that by passing the PRH Act, so that you can make decisions about your life and reproductive health that are right for you.

Doug Laube and Angela Janis are physicians in Madison.

Sanders’s Health-Care Plan Is Missing Its Price Tag

So Bernie Sanders has a health-care plan. It sounds wonderful. It covers everything, from dental to long-term care. There will be no co-pays or deductibles. You will not have to hassle with an insurer over what’s covered. There’s just one small problem, which is how Sanders is planning to pay for this.

Yes, his health care plan lays out revenue estimates in great detail. But the revenue estimates and the cost estimates are perhaps just a trifle too rosy for me to take seriously.

To see what I mean, consider the National Health Expenditure data. It says we spent about $3 trillion on health care in 2014 from all sources — government insurance, private insurance, out of pocket. Now the government already spends $1.3 trillion, or thereabouts, so we can’t fairly count that against Sanders’s health care plan. However, that leaves us with about $1.7 trillion to go. Yet Sanders claims that his plan, despite providing vastly more generous health benefits than basically any plan in existence, will cost only $1.35 trillion a year. That’s a pretty big gap. How does he get there?