State News

Oregon legislators have failed to pass legislation banning copay accumulators for the third time in the past three years, reports Oregon Public Broadcasting. Copay accumulators, also known as copay maximizers, were designed to keep patients from choosing expensive medications when a generic alternative is available, but can result in patients paying thousands of dollars more than they may have expected, especially for specialty drugs where there isn’t a low-cost alternative. Sixteen states have banned copay accumulators, and while Oregon legislators have proposed legislation banning these programs in recent years, the efforts have failed to pass.

Minnesota has passed legislation to set the foundation to introduce a public option for residents with incomes above 200 percent of the federal poverty level, reports Axios. The measure requires the state to submit a waiver application to CMS seeking approval to implement a public option and to conduct a study and actuarial analysis prior to the implementation of the program. The program is expected to augment the existing MinnesotaCare program and begin offering coverage in 2027.

New Orleans is partnering with the nonprofit RIP Medical Debt to wipe out millions in medical debt for eligible residents, reports Axios New Orleans. The program will buy debt owed by residents whose incomes are less than four times the poverty level, or who owe more than five percent of their annual income. About 22 percent of Louisianans have medical debt, which disproportionately affects people of color; the program could help an estimated 80,000 New Orleans residents by cancelling about $130 million in debt.

Minnesota has expanded their MinnesotaCare program to allow all low-income residents, regardless of immigration status, to enroll, reports the Minnesota Reformer. The state plans to start enrolling undocumented residents by 2025. Approximately 17 percent of Minnesota's uninsured population consists of undocumented individuals, and the proposal is expected to expand coverage to an additional 40,000 residents.

Montana passed legislation that caps the co-pay for a 30-day supply of insulin at $35, reports the Daily Montanan. The legislation aims to address the high cost of insulin, which averages $800 annually for privately insured individuals and $1,925 annually for those who are uninsured, according to a 2020 Commonwealth Fund study. The new law will take effect on January 1, 2024.

Indiana has passed multiple laws aimed at monitoring the growth of private health care prices reports Fox 59. House Act 1004 requires a third-party contractor to review the prices non-profit hospitals are charging, compared to 285 percent of the Medicare reimbursement rate. In addition, Senate Act 8 requires pharmacy benefit managers, who are responsible for negotiating drug prices with manufacturers, to pass on at least 85 percent of their cost savings from rebates and discounts on to consumers.

Colorado passed legislation eliminating the practice of “spread pricing,” that is, up-charging up prescription drugs by middlemen, on state-regulated individual and group policies and the state’s Medicaid program beginning January 2025, according to the Colorado Department of Health Care Policy and Financing. The legislation contains a provision enabling self-insured employers to opt-in to the policy. Eliminating spread pricing is estimated to save currently impacted employers an average of 10-25 percent on their prescription drug costs. The legislation also requires transparency reporting from pharmacy benefit managers and insurance carriers.

The Oregon Health Authority published the annual report on cost growth trends in the state, finding that total health care expenditures per person increased between 2018-2019 and slightly decreased between 2019-2020, reports AboutHealthTransparency.Org. Expenditures decreased the most for Medicaid between 2019-202 by 6.3 percent, and the least for the commercial market, at 1.6 percent. Retail pharmacy spending continued to increase during the pandemic, while spending in most other service categories declined during this time period.

Nevada has expanded their Medicaid services to now include annual dental coverage up to $2,500 for adults over 21 with disabilities, according to Nevada Current. With attributes such as dental clinics refusing or opting out of providing dental services, those with intellectual and developmental disabilities have higher rates of poor oral care and oral diseases. Nevada’s expansion of dental services has caused a network of trained dentists to create a safe network to provide services for disabled persons on Medicaid throughout the state.