State News

Beginning in September, Maryland residents will have the opportunity to present to the Prescription Drug Affordability Board how they’ve been impacted by the cost of medications, as the board prepares to present their ideas in the coming months, reports Maryland Matters. In 2019, Maryland lawmakers launched an effort to force down the price of prescription drugs by creating a Prescription Drug Affordability Board, making Maryland the first state to do this. However, after three years, the board’s initial mandate remains narrow—to determine which medications cost too much, then to set up a legally defensible method of capping the amount that state and local government health plans can be forced to pay to provide these medications to employees. There is hope, however, now that a funding source has been identified, an executive director hired and a Stakeholder Council put in place to provide community and industry input.

California will become the first state to remove immigration status as a barrier to healthcare, making all low-income undocumented residents eligible for state-subsidized insurance regardless of age, according to the Sacramento Bee. The governor announced a budget deal he struck with the legislature that included a new Medi-Cal expansion covering more undocumented adults. The program’s launch, starting no later than Jan. 1, 2024, is expected to provide full coverage for approximately 700,000 undocumented residents ages 26-49 that were not included in previous coverage expansions and will lead to the largest drop in the rate of uninsured Californians in a decade.

California passed legislation limiting cost-sharing for abortion care services, according to the Office of Governor Gavin Newsom. Senate Bill 245 prohibits state-regulated health plans from charging separate deductible, coinsurance, copayment or any other cost-sharing requirement on coverage for all abortion-related services. However, patients with high-deductible health plans still must meet their deducible before the protection goes into effect.

The Centers for Medicare and Medicaid (CMS) granted Colorado’s Section 1332 state innovation waiver to create its own state-specific public option next year, reports Fierce Healthcare. The public option plan will be sold on the state’s marketplace and is expected to lower premiums by an average of 22 percent. Under state law, the public option plan also must lower premiums by five percent in 2023, 10 percent in 2024 and 15 percent in the third year. The state’s public option plan will operate within Colorado’s reinsurance program, which is authorized to continue under the waiver through 2027. CMS will pass through any savings that the federal government receives to the state, which will in turn use that money to offer subsidies to further lower the cost of healthcare.

Kansas policies leave patients vulnerable to high medical bills, according to KCUR. Based on the Medical Debt Policy Scorecard, Kansas has limited policies reducing how often people incur medical debts and zero policies increasing patients’ ability to resolve debt out of court. The researchers suggest that Kansas can improve protections by requiring hospitals to tell patients about charity care and preventing hospitals from sending bills to collection agencies while patients are still negotiating amounts or making incremental payments, among many other strategies.

The Kentucky governor announced the state’s efforts to establish counties as “Recovery Ready Communities,” to provide high-quality recovery programs across Kentucky, reports Spectrum News 1. Cities and counties can apply for certification upon offering transportation, support groups and employment services at no cost for people seeking treatment for drug or alcohol addiction. Kentucky’s Office of Drug Control Policy and other community partners, including Volunteers of America, is launching the certification program.

A report from the Office of Health Strategy and the Office of the State Comptroller focuses on the Connecticut Healthcare Affordability Index (CHAI), which measures the impact of policy models on Connecticut families’ ability to make ends meet. The findings measured the impacts of the cost of basic needs, income inadequacy rates and affordable healthcare rates by using the following policy models: American Rescue Plan (ARPA) Premium Tax Credit, Covered Connecticut and the Cost Growth Benchmark. The model estimates that if the temporary ARPA provision was available in 2019, nearly 31,000 additional households would have had affordable healthcare. It also estimates that expanding eligibility of the Covered Connecticut Program helped more than 17,000 additional households attain affordable coverage. Finally, by tying the rate of hospital spending growth to the cost growth benchmark, the model estimates that 14,000 additional households would attain affordable healthcare.

Illinois lawmakers passed legislation that extends continuous coverage for individuals without a source of income and lowers the eligibility age for undocumented immigrants from 55 to 42, reports mystateline.com. The new laws authorize the state to seek federal approval to allow individuals without a source of income at the time of their medical benefits redetermination to be considered for renewal. The package also expands coverage for midwifery services by adding certified professional midwives to the program.

A recent survey found that roughly one in four California respondents enrolled in individual market plans experienced difficulty affording premiums, out-of-pocket costs and delaying or avoiding care due to cost, according to California Health Care Foundation. Notably, enrollees with poor health status and chronic conditions more frequently reported difficulty affording plans and delaying/going without care. The survey also found that 28 percent of respondents cut necessities or borrowed money due to healthcare costs.