State News

The California Health Care Foundation released its 2021 Health Policy Survey detailing California residents’ experiences with the healthcare system in the past year and the health policy agenda they believe state policymakers should support. Top priorities included making sure state and county public health departments have the resources they need to control the spread of COVID-19 and making sure there are enough healthcare providers across the state. Fifty one percent of respondents said they delayed, skipped or cut back on care because of cost in the last 12 months. Of those individuals, 41 percent said that rationing their care worsened their health condition. Additionally, nearly half of Californians said that it is harder for Black and Latino people to get the care they need compared to white people. Of those who believe it is harder, at least three in four think the federal government, health insurance plans, state government and individual healthcare providers are doing too little to address racial and ethnic inequality in the healthcare system.

The D.C. Council created the Council Office of Racial Equity (CORE), which will assess proposed legislation for its impact on racial equity, reports DCist. CORE will primarily use Racial Equity Impact Statements to evaluate how a piece of legislation could hurt or benefit groups of people who have traditionally been underserved and discriminated against and provide a list of possible effects or racial and social inequities.

Rhode Island’s strategy to implement a cost growth benchmark, in tandem with engaging healthcare leaders and stakeholders, is a model for other states, according to a report from the Milbank Memorial Fund. Rhode Island implemented measures to work alongside the cost growth benchmark in order to address not only cost growth, but cost drivers, to control rising healthcare costs in the state. The state’s private-public partnership emphasizes the shared commitment to reducing healthcare costs and can be used as a model in other states exploring cost-containment strategies.

Tennessee is set to become the first state to implement a Medicaid block-grant program after the Centers for Medicare and Medicaid Services (CMS) approved the state's waiver last week, according to Healthcare Finance. The block grant, called an “aggregate cap,” will create a fixed spending target based on historical enrollment and Medicaid cost data that increases at a “reasonable growth rate” over time. It will also give the state the option to exclude certain pharmaceutical drugs from the formulary. Numerous advocacy organizations, payers and providers oppose Medicaid block grants because they fear that underserved populations will lose access to healthcare by putting a cap on federal funds.

Colorado is now soliciting vendors to implement the state’s Canadian Drug Importation Program, reports CBS Denver, and anticipates awarding vendor contracts later this year. The program is designed to give Coloradans access to Canada’s lower-prices drugs and was made possible through a change in federal policy enacted in November 2020, which allows FDA-authorized programs to import certain prescription drugs from Canada. A recent report from the Colorado Department of Health Care Policy & Financing posits that the average savings on importable drugs could be more than 60 percent, but savings for some drugs was greater than 90 percent.

A majority of Virginians are unaware of the State Corporation Commission's Bureau of Insurance and believe the bureau does not provide consumers with enough information about how to contest health insurance coverage decisions, according to a survey by Mason-Dixon polling. Additionally, 92 percent indicated that they want easy-to-access information about insurance industry profits, medical expenditures, administrative costs and other metrics, reports State of Reform. A recent Altarum analysis found that though healthcare expenditures in Virginia are below the national average, private personal insurance healthcare spending is up 42.7 percent since 2008.

"The Birthday Rule" can generate large, unexpected medical expenses for emergency infant healthcare, according to a bill investigation by Kaiser Health News. When a baby is born covered by employer-based insurance from both parents, the child's primary coverage must be with the parent whose birthday falls earlier in the calendar year. If the early-birthday parent's coverage has a high deductible or is out of network for the infant intensive care services provided, parents may be charged thousands of dollars. Most states have adopted this regulation, and parents have no choice in which coverage their baby has apart from removing the child from the inferior coverage or dropping it altogether.

A new report from the Colorado Department of Health Care Policy & Financing found that specialty drugs represented less than two percent of drugs prescribed to patients in Colorado but accounted for almost 50 percent of total prescription drug expenditures, reports State Network. Additionally, the report on reducing prescription drug costs found that rebates paid to middlemen such as PBMs and insurance carriers are often retained as profits. Proposed solutions include creating an affordability board to study prescription drug prices, passing along rebates and savings to employers and consumers and increasing transparency in prices, profits and rebates.

D.C. Health announced changes to its COVID-19 vaccination distribution plan to ensure equitable distribution throughout the district, reports WJLA. Additional vaccination appointments will be made available to residents in wards that have a high proportion of BIPOC members and have been disproportionately impacted by the coronavirus. The plan to ensure equitable distribution comes after data from D.C. Health revealed that very few residents in wards that have had the most deaths from COVID-19 have been able to get a vaccine appointment, while residents in areas with the least deaths have been able to obtain the most appointments.