Odalys Avila’s job is finding answers—answers for families who are used to being told “no.”

"We do have a lot of clients who are undocumented, and so, when you're undocumented, unfortunately, you know, they don't qualify for anything," she said.

Avila works at Servicios de la Raza, a social services organization that serves Denver Colorado’s Latino community. She helps members of the community navigate different health systems and sign up for insurance, which gets complicated even if there are US citizens in the household.

"We do have some families who fear, 'if we apply for our kids or for my husband, how is that gonna, you know, affect me as an undocumented person?'" she said.

She sees firsthand how that uncertainty turns into real health complications.

"Not being able to cover medications or not being able to get preventative care and then coming at the last minute, looking for some sort of assistance because you know, now they have these like major health issues that they need to get taken care of," Avila said.

According to 2020 US Census Data, the Hispanic population is the least insured in the country: 18% of Hispanic people of all ages in America were uninsured, compared to 10% of Black Americans and 8% of white Americans.

By age groups: 25% of working-age Hispanics and 9.5% of Hispanics under 18 were uninsured.

"Families are in a really tough spot to decide: do I get healthcare for my child who needs a transplant or do I make sure that we can stay in the United States and not go back somewhere that we had to flee because of violence?" said Rayna Hetlage, senior policy manager at Colorado’s Center for Health Progress, an organization that helped get bills turned into law that allows health insurance access to undocumented immigrants and low-income people.

"When the Affordable Care Act was passed, concessions were made to get it to passed and some of those concessions were things like leaving out DACA recipients, leaving out undocumented immigrants from having any access to coverage," said Hetlage.

A new law will expand Medicaid and CHIP coverage to undocumented pregnant people and children in 2025, and beginning next year, state funds will be able to help qualifying residents who are a certain level below the federal poverty line purchase insurance.

Advocates, like Rudy Gonzalez of Servicios de la Raza, says these solutions are necessary to level the playing field for low-income members of his community.

"We're going to be able to get them insured. I mean, that's the biggest part of this new law," he said.

Several states like California, New Jersey, Texas, Michigan, and New York have worked to create similar solutions, like expanding Medicaid access to undocumented children and pregnant people, with more reaching out to Colorado.

"We've had conversations with other states who are really curious to hear what we're doing here," said Hetlage.

For Avila, she hopes the more access increases for low-income or undocumented folks across the board, the more people will see the need that exists.

"I hope that they support future laws that are possibly put in place. I hope they support this law and this program to be expanded," she said.

The federal government is making it easier for farmers to grow food as the nation faces record inflation and supply chain issues.

The USDA is allowing farmers to insure a second crop planted and harvested on the same piece of land — a practice known as double or relay cropping.

One farmer in Iowa started planting a second crop back in 2016.

Until this week, it was illegal to insure his second crop — soybeans.

"That's why we have these meetings to help other farms understand what we're doing. That's why we push so hard with the insurance program. I went on my own without insurance. I could handle that, but I know for other farmers to transition they need that crutch," Loran Steinlage said.

The USDA said the goal is to help avoid a food shortage.

Watch the video above for the full story.

WASHINGTON —

Related video above: Doctors give their top tips for maximizing an appointment

The next time you message your doctor to ask about a pesky cough or an itchy rash, you may want to check your bank account first — you could get a bill for the question.

Hospital systems around the country are rolling out fees for some messages that patients send to physicians, who they say are spending an increasing amount of time poring over online queries, some so complex that they require the level of medical expertise normally dispensed during an office visit.

Patient advocates, however, worry these new fees may deter people from reaching out to their doctor and that they add another layer of complexity to the U.S. health care system's already opaque billing process.

"This is a barrier that denies access and will result in hesitancy or fear to communicate and potentially harm patients with lower quality of care and outcomes at a much higher cost," said Cynthia Fisher, the founder of Patient Rights Advocate, a Massachusetts-based nonprofit that pushes for hospital price transparency.

The explosion of telehealth over the last three years — driven by the COVID-19 outbreak and relaxed federal regulations for online care — prompted many doctors to adopt more robust telecommunication with their patients. Consultations that once happened in an office were converted to computer or smart phone visits. And health care systems invited patients to use new online portals to message their doctors with a question at any time, American Medical Association president Jack Resneck Jr. told The Associated Press.

"When people figured out this is cool and could improve care, you saw hospitals and practice groups saying to patients, welcome to your portal ... you can ping your physician with questions if you want," Resneck said. "We found ourselves as physicians getting dozens and dozens of these a day and not having time built in to do that work."

The charges vary for each patient and hospital system, with messages costing as little as $3 for Medicare patients to as much $160 for the uninsured. In some cases, the final bill depends on how much time the doctor spends responding.

Health systems that have introduced these new policies, many in recent months, say they automatically alert patients that they may be charged when they message their doctor through online portals, such as MyChart, an online system that many organizations now use for scheduling appointments or releasing test results to patients.

Under new billing rules devised during the pandemic, doctors are permitted to bill Medicare for as little as 5 minutes of time spent on an online message in a seven-day period, according to the Centers for Medicaid and Medicare.

Doctors need to be paid for the time they spend doling out expert medical advice — even over messages, said University of Chicago health economist Katherine Baicker. But it's also important that hospital systems are transparent about what patients can expect to pay as they roll out these new charges, she added.

"Co-pays do not accomplish anything when they are not clear for patients ahead of time," Baicker said.

Physicians at University of California San Francisco Health field roughly 900,000 email threads — 3 million total messages — in a year, according to Jess Berthold, a spokesperson for the system.

The hospital announced in November 2021 it would start charging for some of those messages, after noting a spike during the pandemic. During a year's time, 1.4% of email threads, or about 13,000, have resulted in a bill.

Only certain messages trigger a charge. Patients won't be charged, for example, for prescription refills, scheduling an appointment, asking a follow-up question about an office visit within the last seven days, or if their doctor advises they should schedule a visit in response.

What types of messages will prompt a bill? Sending your doctor a picture of a new rash, asking for a form to be filled out or requesting a change in medication.

Navigating how much you might end up owing can be trickier.

At UCSF, patients on Medicaid who message their doctor won't have any out-of-pocket costs, and those on traditional Medicare may have to pay $3 to $6. Patients on private insurance will be billed a co-pay — typically about $20 — as will patients on Medicare Advantage, the private insurance plans for Medicare.

Cleveland Clinic in Ohio, the latest major hospital system to announce charges for online messages, rolled out similar guidelines late last month, with messages costing as much as $50 for those on private insurance. And at Northwestern Medicine in Chicago, which charges $35 for some messages, fewer than 1% of those correspondences resulted in a bill, spokesman Christopher King said.

All of those systems use the online portal MyChart. Epic, the privately owned software company that runs MyChart, does not track which health systems charge patients for messages, spokeswoman Barb Herandez said in an email. The company did not answer questions about whether it receives a share of the fees from those charges.

Giving patients advice online can save a patient time or money in the long run, hospital systems argue. If the doctor can answer a patient's question over email, the patient can cut out wait times for an appointment and avoid taking time off work to go to the doctor's office.

Plus, some patients simply prefer the convenience of getting a quick answer from the doctor on an app, Berthold of UCSF added.

"If patients can have access to a doctor right when questions or concerns arise, they can seek care more quickly and be treated more quickly," Berthold said.

But Fisher argues it could have the opposite effect with patients thinking twice before they message a doctor. Instead, some people may turn to free, unreliable advice online.

"It becomes a slippery slope, and that slippery slope is not in favor of the patient," she said.

The gift of life came in the nick of time for an Ohio man.

WLWT, a Hearst station, first interviewed Mark Plummer in April 2022.

He was suffering from interstitial lung disease, an incurable lung disease that causes stiffening of the lungs, and his insurance would not cover the transplant he needed.

Less than a year later, he has a new set of lungs.

Doctors still don't know what caused him to develop the disease, but Mark Plummer said he is eternally grateful to the person who saved his life by being an organ donor.

"It is absolutely a second chance at life," he said. "We started calling it the gift."

Mark Plummer was admitted to a hospital in Columbus, Ohio, in early April. Family, friends and complete strangers helped pay the bill.

"I got donations from all over the country. We were amazed. Your story got picked up by stations all over the place," Mark Plummer said.

Ohio State's Wexner Medical Center covered the rest through financial aid.

Mark Plummer received his life-saving transplant on April 19.

"I was very, very, very sick, so my recovery was much rougher than most people," he said.

After the surgery, his kidneys went into shock. He was on dialysis for a month and spent a total of eight weeks in the intensive care unit. Then he spent time in rehab and another three weeks in Columbus for observation before heading home to Cincinnati.

"I knew he had it in him, but it was scary," Mark's wife, Linda Plummer, said. "I don't have to worry about him as much anymore. I don't wake up and — how loud is he breathing, is he breathing OK, checking his numbers."

He is now healthy enough to return to work and started a new job with Capabilities Driving School, teaching teens and young adults with disabilities how to drive. He is back to playing with his grandkids, including an adorable new grandson, and walking his two dogs around the neighborhood.

"I can pretty much do what anyone else can do, up to — I'm not ready to run a marathon yet," he joked. "Organ donation does save lives, and I'm sitting here talking to you as living proof that it really does save lives. And I'm looking forward to hopefully living at least another fifteen to twenty years because of that gift."

Now he plans to pay that generous gift forward.

"Why not? Why not pay it forward and help somebody?" Mark Plummer said. "Somebody helped me."

Several weeks ago, Mark Plummer saw a post on Nextdoor by a young woman named Bra'Naye Willis. She and her boyfriend rent an apartment at the Williamsburg Apartments of Cincinnati, and she was looking for advice. She said their apartment had no heat, there were leaks and air quality issues, among other problems.

"I had an asthma attack most recently in December because I couldn't breathe because of the air quality conditions," Bra'Naye Willis said. "It hurts me that people just really don't care about any of us."

The apartment complex has been in the news for months for a series of health and safety violations. The city of Cincinnati filed a lawsuit against the owners in January.

"Both her and her boyfriend, they suffer from lung issues, so that made a connection with me immediately," Mark Plummer said. "Someone who has asthma doesn't need to be in an environment like that."

He started a GoFundMe page for the couple to help them move somewhere else before their lease is up. He also made the first donation.

He is determined not to take his second chance at life for granted and said he is "eternally grateful" to the donor's family.

"On the worst day of their lives, they lost a loved one. That became the best day of my life," he said.

COLUMBUS, Ohio — Ohio lawmakers may increase the speed limit from 55 to 60 mph on all state routes and county roads, but two-lane roads could potentially get up to 65 mph.

Unless stated otherwise, highways in the state have a speed limit of 55 mph. Robert Dennison thinks most people see that as a suggestion.

"Most people are going those high speeds anyway," Dennison said.

Ohio lawmakers have proposed raising the speed limit from 55 to 60 mph for all highways outside of a municipal corporation, which would be county roads and state routes. This applies to each qualifying road that doesn't already have a different statutory limit.

The bill also gives authority to ODOT to raise the speed on two-lane state routes to 65 following an engineering study.

"It will reduce the number of tickets, but insurance rates are going to go up," Dennison said.

Since people are already going five to ten miles per hour over the speed limit already, getting an additional five is going to increase all speeds, he added.

Is a 5 mph increase a big deal? AAA says yes

A 2021 study by AAA found that even an additional five miles per hour has a dramatic increase in the risk of severe injury or death, going from a 60% risk at 50 mph to 80% at 55 mph.

Pro Driving School's training manager Mary Kaye Speckhart believes this will increase.

"You have to pay attention the faster you go," she said. "Speed kills. Most crashes happen because of being too close... [people] have to increase their following distance."

News 5 reached out to AAA to see if they had studied the impact of 60 mph, but it didn't. However, Legislative Affairs Director at AAA East Central Theresa Podguski confirmed Speckhart's concern.

"We know that higher speed limits cancel out the benefits of vehicle safety improvements," Podguski said. "We can't stress enough how big of an impact speed plays in a crash."

The faster a driver is going before a crash, the less likely it is that they'll be able to get down to a survivable speed, even if they have a chance to break before impact, she added.

Good and bad

The legislation has good qualities, Dennison said, understanding that raising the speed limit will get people to their destinations faster.

"It may get you there a second faster than somebody else, but sometimes is it really worth that second?" Speckhart asked. "A life is worth more than getting somewhere faster."

The Senate transportation team told News 5 that townships and counties will have the ability to lower the speed limit.

With all of these changes, Speckhart wondered who is going to pay for the brand-new street signs all over the state.

The Ohio Department of Transportation could incur additional costs for replacing/updating signs on applicable highways, the Legislative Service Commission said.

ODOT's primary funding sources are federal and state gas taxes — so it's likely drivers will be paying for the signs.

The bill will continue to be heard next week.

Follow WEWS statehouse reporter Morgan Trau on Twitter and Facebook.

As the nationwide unemployment rate continues to sit in unprecedented territory, the dramatic job loss numbers also mean millions of Americans have suddenly found themselves without health insurance.

Experts call it a cruel twist during the pandemic, meaning many people who get sick with COVID-19 may not get the health care help they need because they don’t have coverage.

“We have massive numbers of people who are worried about their health but who no longer have coverage,” said Michelle Johnson, who oversees the nonprofit Tennessee Justice Center.

Johnson says calls to her organization have increased dramatically in the last few months as Americans are finding themselves uninsured after losing their jobs due to COVID-19.

“We’re just going to continue seeing people who are losing their insurance,” she said.

According to the Kaiser Family Foundation, nearly 27 million people in the United States may have lost employer-sponsored insurance. Roughly half of Americans receive health insurance through their jobs. And while programs like COBRA allow people who have been laid off to continue their coverage, many can’t afford to pay those costs with no income.

Johnson says the problem is particularly troubling in state’s like hers where Medicaid expansion already meant there were hundreds of thousands of residents who were uninsured.

She hopes the federal government might consider opening enrollment in the Affordable Care Act to help those who have suddenly lost coverage.

Johnson’s biggest concern though, is the consequences may prove deadly as those without coverage now avoid trips to the doctor or emergency room for fear of getting stuck with bills they can’t afford.

“People will delay getting the care they need because they’re worried about being a financial burden,” said Johnson.

WASHINGTON — Whether it was flooding in Texas earlier this week because of Tropical Storm Nicolas or Hurricane Ida's destruction which stretched from neighborhoods in Louisiana to interstates in the Northeast, the last few weeks have shown why flooding is such a risk to Americans.

In fact, according to the Federal Emergency Management Agency (FEMA), flooding is the most common and most expensive natural disaster in our country.

And you don't have to live on the coasts to be at risk.

CONGRESS AND FEMA

While all this flooding may have you thinking about flood insurance, Congress is thinking about it for other reasons.

The National Flood Insurance Program is set to expire on Oct. 1.

While Congress is expected to extend the program, the bigger impact on your life may be the changes FEMA wants to make to flood insurance policies, changes that will likely impact rates.

Currently, policies are based on a home's elevation and whether it has a 1% annual chance of flooding.

Starting Oct. 1, factors such as the history of flooding, frequency of heavy rainfall, as well proximity to a water source will be factored in.

The numbers mean what you pay will be changing.

FEMA estimates around 73% of current policyholders will pay between $1-$20 more per month

It's expected 4% of existing policyholders will see price hikes of more than $20 a month.

But FEMA also says around 23% of flood insurance plans will be cheaper, an acknowledgment that some Americans have been paying too much for years.

"It all depends on where you happen to be," Dr. Ed Kearns says.

Kearns runs floodfactor.com which allows anyone to type in their address and see their own flood risk.

He says while FEMA's willingness to change is important, more climate change risks should be factored in.

“I'd really like to see how climate change is impacting those heavy rainfall events," Kearns said.

The reality, he says, is that some areas will be hit harder than others with floods in the coming years and Americans need to be insured and prepared to pay more.

"If you are living in a home that is on a grade slab and next to the ocean, or a low-lying area you should expect to pay your fair share.”

New policies will see rates change next month, current policyholders will see those changes next April.

If you're someone who wants flood insurance but can't afford it, keep an eye on Congress. A proposal to create new subsidies is currently included in the proposed multi-trillion-dollar spending bill.

WASHINGTON (AP) — The Supreme Court has agreed to decide whether it is unconstitutional to exclude people living in Puerto Rico from Supplemental Social Security Income.

The justices said Monday they would hear an appeal, first filed by the Trump administration, of a lower-court ruling that held that residents of the U.S. territory should have the same access to SSI benefits as older, disabled and blind Americans in all 50 states and the District of Columbia.

The administration argued that a pair of 40-year-old Supreme Court decisions already upheld the federal law that created SSI and excluded Puerto Rico and other U.S. territories from it.

In recent months, a federal judge ruled that Puerto Rico residents should have access to other federal welfare benefits from which they have been excluded as well. A federal judge in Guam said residents of that Pacific island also should be able to collect SSI.

A separate program, Aid to the Aged, Blind and Disabled, covers residents of the territories, but it has more stringent eligibility requirements and pays less generous benefits than SSI.

An Ohio man says he was turned away for a COVID-19 vaccine for not having health insurance.

The man, who asked to only be identified by his first name Kyle, said he drove almost two hours to go to his vaccine appointment. Kyle is from the Columbus area. As a diabetic, he became eligible for vaccination last week but could not find any appointments near Columbus.

He booked an appointment through Kroger's website for Saturday at 4:30 p.m. at Kroger in Piqua, near Dayton. He said he and his partner drove nearly two hours to the appointment where Kyle was directed inside to the Little Clinic.

"She asked me for my insurance and my ID," Kyle said. "I was like, 'Well I have my ID, but I don't have insurance until April because I just started a new job.'"

The insurance plan from his previous job had already expired.

"I'm like ok, 'Well, how am I gonna get this shot?' And they're like, 'Well, we can't,'" he said. "I argued with them for a good 45 minutes before being sent home."

Christa Hyson, the Assistant Director for Emergency Response and Public Information Officer for the Health Collaborative, said no one should be denied for a COVID-19 vaccine due to lack of insurance.

The vaccine is free to everyone.

"It is taken care of through the federal government, so there should be no confusion whether you have insurance or not," Hyson said. "Some providers bill an administrative fee to your insurance. There is zero out-of-pocket cost to you."

Vaccine fees for the uninsured are covered through federal relief bill funding.

Hyson was not aware of any cases of people being denied a vaccine for lack of insurance in Cincinnati.

If you are told you cannot be vaccinated due to insurance, she said to ask for the clinician or pharmacist in charge.

Meanwhile, Kyle is looking for an apology. He said he was able to book an appointment through another provider for this upcoming Saturday.

WLWT reached out to Kroger's corporate office Monday afternoon and is still waiting for a response.

Federal regulators have approved the first new drug for Alzheimer’s disease in nearly 20 years, leaving patients waiting to see how insurers will handle the pricey new treatment.

Health care experts expect broad coverage of the drug, which was approved Monday. But what that means for patients will vary widely depending on their insurance plan. In some cases, that could mean coming up with several thousand dollars to pay for what the insurer didn’t cover.

And there's no guarantee that every case will be covered.

Here’s what you need to know:

WHAT WAS APPROVED?

The Food and Drug Administration said it granted approval to a drug from Biogen based on clinical research results that seemed “reasonably likely” to benefit Alzheimer’s patients.

It’s the only drug that U.S. regulators have said can likely treat the underlying disease, rather than just manage symptoms. The new drug, which Biogen developed with Japan’s Eisai Co., did not reverse mental decline. It slowed it in one study.

The FDA’s decision came despite the conclusion of its advisory committee that there wasn’t enough evidence that the drug slowed the brain-destroying disease.

WHAT DOES IT DO?

It aims to help clear harmful clumps of a protein called beta-amyloid from the brain. The medication will be marketed as Aduhelm and is to be given as an infusion every four weeks.

WHAT WILL IT COST?

Biogen said the drug would cost approximately $56,000 for a typical year’s worth of treatment, and it said the price would not be raised for four years.

HOW WILL INSURERS COVER IT?

They will likely request some documentation first that the patient needs the drug. Many plans will require doctors to submit records and other paperwork justifying the treatment before they agree to cover it.

Insurers also will likely require pre-approval for brain scans needed to determine that the patient is a candidate for treatment, said Lance Grady of Avalere Health consultants.

He noted that some plans also may want to see the results of a scan before they decide to cover the next infusion, which could delay treatment.

IS COVERAGE GUARANTEED?

Medicare is widely expected to cover the treatment. Insurers that offer private or commercial coverage also will pay for care that doctors deem medically necessary.

That may not mean every case, though. If the treatment is proposed for a patient with advanced Alzheimer’s, and research shows the drug isn’t effective in that population, then the insurer may not pay for it.

“That happens all the time with drugs,” said Robert Laszewski, a health care consultant and former insurance executive. “Just because the FDA says its safe doesn’t mean it’s appropriate for everybody.”

WHAT WILL PATIENTS PAY?

That’s impossible to say broadly.

It can depend on the person’s coverage and their out-of-pocket maximum, which is a plan’s limit for how much a patient pays in a year for in-network care before insurance picks up the rest of the bill.

Some patients who are already receiving a lot of care may not wind up with a huge added expense from the drug before they hit that limit.

Patients who have a supplemental plan for their Medicare coverage also may wind up with few out-of-pocket costs for the drug.

Patients with Medicare Advantage coverage, which is run by private insurers, or individual health insurance could pay several thousand dollars before they hit their plan’s annual limit, depending on the plan.

“That could be very burdensome for someone, especially if a person is looking at this cost every single year, and they don’t have an option to get a better health plan,” said Stacie Dusetzina, an associate professor at Vanderbilt University and drug pricing expert. “It can add up.”

ARE THE DRUGMAKERS HELPING?

Cambridge, Massachusetts-based Biogen plans to begin shipping millions of doses within two weeks.

The company says it will help patients figure out their options for financial assistance and find providers and care infusion sites. The drugmaker also is offering programs to help reduce the out-of-pocket cost for some patients with commercial coverage.

But people with Medicare and Medicare Advantage coverage cannot get drugmaker discounts like that. Health care researchers say most of the people who will need this drug will have some form of Medicare coverage.

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Follow Tom Murphy on Twitter: @thpmurphy

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.