State News

The federal government approved Arkansas’ Medicaid expansion waiver, but will only allow premiums to continue into 2022, reports the Arkansas Times. Arkansas’ new waiver does not include work requirements, which have been blocked by a federal judge, but does impose premium requirements for enrollees above 100 percent of the federal poverty level. The Obama administration originally approved the premium requirements and work requirements were approved under the Trump Administration. The Biden administration approved Arkansas’ Medicaid waiver program to begin in 2022—which purchases private insurance coverage for beneficiaries on the Marketplace—but added an addendum requiring premiums to phase out in 2022. The waiver did not request work requirements after the Biden administration revoked them in 2021.

Legislation capping the cost of insulin in Rhode Island will go into effect on Jan. 1, 2022, reports the Providence Journal. The law prohibits insurers from charging more than a $40 co-pay for a 30-day supply of insulin and prohibits applying a deductible to insulin drugs.

Oregon is preparing to offer free coverage to residents, regardless of immigration status, beginning in 2022, according to the Lund Report. The legislation, “Cover All People,” passed during the 2021 Regular Session and will go into effect in July 2022, providing an avenue for low-income undocumented immigrants to gain access to health insurance coverage. With only $100 million initially allocated, the program will be open to people regardless of immigration status who are between 19 and 25 years old and 55 and older, and will cover primary and preventive care, dental care and behavioral health services. Oregon joins six other states who have extended coverage to undocumented immigrant adults.

Oregon legislators held a hearing on prescription drug costs and heard testimony from residents, reports New Mexico Consumers for Affordable Prescriptions. Joan Morgan shared her father’s experience with a life-saving drug went from $4,000 to $10,000 per month. Her family liquidated assets and took other measures to pay for the medication. She said her father is alive because her sister purchases the drug in Europe and flies it to the U.S. several times per year.

New Jersey’s Governor signed an executive order that launched the New Jersey Health Care Cost Benchmark Program that will provide everyone in the state with a shared understanding of how much healthcare costs are growing and factors contributing to high health costs and cost growth, reports ROI-NJ. Over time, the program aims to decrease how much healthcare costs grow each year and to contribute to making healthcare more affordable. The program also offers an important opportunity to implement market-based strategies rooted in broad stakeholder commitment and industrywide collaboration.

Despite having health insurance, Vermont carpenter Rick McDowell incurred more than $7,000 in medical debt following a stroke, according to Vermont Public Radio. Even though about 96% of Vermont residents have health insurance, they often don’t have the means to pay out-of-pocket costs. Vermont hospitals have consistently reported between $62 million and $85 million annually in unforgiven medical debt, which can hurt Vermonters finances and credit scores. Through story gathering, Vermont officials have found that fear of worsening medical debt pushes people to forego care, causing health conditions to worsen and ultimately increase the overall cost of care in Vermont.

For many people, basic dental care is out of reach, even for those who have health insurance, reports Foster’s Daily Democrat. Special insurance riders are needed before dentist visits will be covered by Medicaid, which only carries a dental benefit for children. Even people with dental coverage through their jobs can’t afford to pay their out-of-pocket costs. As a result, adults can be left with no access to a dentist and suffer through severe tooth pain, gum disease and worse, as well as develop serious oral diseases and other health problems. Because good dental care contributes to overall health, experts and physicians argue it should be covered by insurance. There have been efforts in New Hampshire to add adult dental benefits to Medicaid, and there are hopes a new bill will be reintroduced in 2022, after a previous version was vetoed by the governor in 2020.

Lori Dingwell of Waterbury, Connecticut, tested positive for COVID-19 in February 2021 and, though she has seen numerous specialists, has yet to fully recover, reports Connecticut Health I-Team. Suffering from long-haul COVID, Dingwell has racked up nearly $10,000 in medical debt and is paying out-of-pocket for her mental healthcare, as well as a large share of her medical treatment, though she has health insurance through the state's exchange. Dingwell does not qualify for Medicaid, though she is low-income, and Connecticut ranks among the highest in the country for per capita spending on healthcare, yet medical debt remains an issue for consumers. When Dingwell was referred to a COVID clinic, the staff informed her that she would have to pay for the majority of her treatment out-of-pocket; Dingwell gave up. 

A report from the Shriver Center, in partnership with Altarum, conducted five focus groups, comprised of primarily Black Indigenous People of Color (BIPOC) individuals, to learn about Illinois residents' views on healthcare coverage. The focus groups, which consisted of 30 participants and one group held solely in Spanish, revealed that two major barriers participants experience were the cost of healthcare coverage and the complexity of choosing and enrolling into healthcare coverage. Participants expressed that what they pay out-of-pocket can sometimes be enough to cause them to choose between healthcare and basic necessities. Participants also felt that eligibility and enrollment for both Medicaid and the Marketplace were complex and confusing. They also noted the stigma attached to Medicaid and suggested that Medicaid be rebranded with different names and marketing to encourage people to enroll.