State News

A report from the Oregon Health Authority found that the annual family health insurance premiums averaged over $19,000, and that doesn’t include out-of-pocket costs, according to The Lund Report. Using data from 2019, the report found that a family’s premium and out-of-pocket costs totaled 13.5% of the median family income. The report said that rising health care costs jeopardize the financial security of families, consume some families’ savings and prompt some residents to forego needed care and emphasizes the value of the state’s new cost growth benchmark.

Healthcare leaders across the state signed a compact to accelerate the adoption of advanced value-based payment models, according to the Rhode Island Office of the Health Insurance Commissioner. These efforts, led by local stakeholders, represent critical strides toward reducing the rate of healthcare spending growth through transforming the way healthcare is paid for and pinpointing the key drivers of healthcare cost growth in the state. The coalition hopes that shifting towards prospective budget-based payment models and away from fee-for-service can improve affordability and quality of care.

The Dane County Health Council, the Foundation for Black Women’s Wellness and numerous community health partners have launched ConnectRx Wisconsin, reports Madison365. The initiative is a new care coordination system supporting Black pregnant birthing persons to improve access to healthcare and stabilizing resources, such as food, financial assistance, housing, employment and transportation. The aim is to reduce the occurrence of low birthweight infants and improve birth outcomes for Black birthing persons and babies in the county. Advocates note that in Dane County, babies born to Black mothers are twice as likely to have low birthweight than those born to white mothers. They also note that by providing care coordination and solutions for social needs, they may improve the health of both infants and parents, and hopefully eliminate health disparities.

Washington State passed legislation requiring the creation of a Prescription Drug Affordability Board by June of 2023, according to NASHP. The Board will conduct affordability reviews of the costliest prescription drugs–brand name drugs costing more than $60,000 per year or with price increases of 15 percent or more in the past year, or 50 percent over the last three years—as well as some biosimilars and generics. Starting January 2027, the Board may then establish upper payment limits for state payers on up to 12 drugs per year. In addition, the legislature lowered the cap on insulin prices from $100 to $35 per month and extended the cap through 2024 while the state’s Total Cost of Insulin Work Group studies long-term cost-lowering strategies.

Georgia Governor Brian Kemp signed into law a bill intended to pressure private insurers to improve coverage for mental health conditions, according to an AP article in The Journal Record. The new law asks private insurers to follow established federal requirements to provide the same level of benefits for mental health disorders as they do for physical illness and requires insurers to submit data to the state about their compliance. 

A survey of New Mexico residents has found that roughly one in two respondents didn’t seek medical care in the past two years due to cost, according to NM Political Report. Notably, Latino/Hispanic and Black respondents were the most worried about paying for care. Most respondents blamed the federal government for the high cost of healthcare, and seventy-two percent said they support a government-administered health plan, sometimes referred to as a public option.

New legislation signed by Maine’s governor will direct the state’s new Office of Affordable Health Care to take a targeted approach to improving affordability by studying existing affordability barriers and identifying policy solutions focused on making healthcare more affordable for Maine residents and small businesses, according to Consumers for Affordable Health Care. The legislation builds on previous legislation that established the Office and charged it with developing policy solutions to help rein in those high costs and improve efficiencies and coordination within the healthcare system, in addition to providing staff support to Maine’s Prescription Drug Affordability Board.

A new analysis from Colorado’s Center for Improving Value in Health Care shows that Coloradans received more than one million unnecessary and potentially harmful low-value healthcare services, reports AboutHealthTransparency.org. Low-value services—defined as certain treatments, diagnostic tests, and screenings where the risk of harm or cost exceeds the likely benefit for patients—were identified with 2018-2020 data from Colorado’s all-payer claims database. These services resulted in $134 million in excess costs for Coloradans and health insurers.

California’s health insurance marketplace is using automated enrollment and subsidies to reduce un- and under-insurance, according to The Commonwealth Fund. After the end of the COVID-19 public health emergency, California will automatically enroll nearly one-third of people losing Medicaid coverage into low-cost silver plans. The state will also pay the nominal premiums attributed to abortion services, which federal subsidies cannot cover, making more people eligible for $0 premiums. Finally, the marketplace will automatically upgrade some consumers from bronze plans to silver plans that cost the same amount due to subsidy enhancements, effectively lowering individual deductibles from $6,300 to $75.