State News

Indiana’s Department of Insurance has launched the state’s public facing All-Payer Claims
Database (APCD), reports WIMS Radio. The interactive tool allows consumers to shop for
health care services by comparing price and quality of care across the state, with average out-
of-pocket price available by insurance plan, procedure, and specific provider. The APCD is also
intended to provide valuable insight into health care costs, quality, and utilization patterns
available to employers, researchers, and policy makers. Employers can use this data to
strengthen their decision making about benefit design and network optimization for employees.

High health care costs continue to hit Coloradans hard, with two in three respondents to a new
survey saying they delayed or went without health care due to cost in the last 12 months,
reports CPR News. The issue is even more pressing for low-income respondents and those with
disabilities, who reported even higher rates of delays and foregone care. Across the board, a
large majority, 83 percent, reported being worried about their ability to afford health care costs in
the future. According to the survey, more than nine out of ten respondents backed more reforms, like requiring hospitals, doctors and insurers to provide consumers with upfront cost estimates, and, if an insurer drops your doctor, to make it easy to switch to another health plan.

Colorado’s cap on insulin costs was associated with significant reductions in out-of-pocket
spending for insulin prescriptions, with the mean out-of-pocket payment per thirty day supply
decreasing by almost half, according to a study in Health Affairs. Colorado was the first state to
cap out-of-pocket spending for insulin prescriptions in 2020, requiring fully insured health plans
to cap out-of-pocket spending at $100 for a thirty-day supply. Average out-of-pocket spending
per prescription fell by roughly 40 percent, and patients filling insulin prescriptions saved an
average of $184 per year. At the same time, prescription volume and days’ supply increased,
suggesting that insulin use may have been rationed by some patients prior to the cap’s
implementation.

A survey found that many Washington State residents struggle with health care costs, according
to the Economic Opportunity Institute. The survey shows that 57 percent of respondents
avoided seeking medical care in the last year due to cost, one in three lived in a household with
medical debt, and 88 percent are concerns about the cost of health care in the future. It also
found that 63 percent could not pay or would struggle to pay an unexpected $500 medical bill.

Pennsylvania has passed legislation limiting the use of noncompete clauses for health care
practitioners, reports The National Law Review. Effective January 1, 2025, the Fair Contracting
for Health Care Practitioners Act deems noncompete covenants as contrary to the public
interest and void and unenforceable. Exceptions include noncompete clauses of less than a
year if the practitioner was not dismissed by the employer, in some cases of the sale of the
practitioners ownership, and recovery of certain expenses from the practitioner.

A report from the St. Louis Area Business Health Coalition reveals that most St. Louis hospitals
charge prices exceeding what is considered fair by national standards, reports the St. Louis
Post-Dispatch. These findings highlight the growing financial burden on businesses and
consumers, with BJC HealthCare identified as the most expensive provider in the region. They
also call attention to the ongoing challenges of controlling health care costs in St. Louis.

Missouri has enacted a law ensuring that patients can access essential medications through
local pharmacies, countering restrictive measures imposed by pharmaceutical companies
during COVID-19, reports KZRG. This legislation aims to reduce the travel burden on patients,
particularly in underserved areas, by enabling them to obtain necessary prescriptions closer to
home.

Dental care is now a reality for more Missourians, reports KSHB 41. As of July 1, Missouri's
Medicaid program now includes coverage for routine dental exams for adults, marking a
significant expansion in dental care access. Nearly 40 percent of adults on Medicaid previously
lacked access to dental services due to cost. This coverage is pending final approval by CMS,
but once approved, it will align adult dental benefits with those available to children and other
specific groups under Medicaid.

Florida adults can’t afford to see a doctor when need to, reports Florida Phoenix. Florida has
some of the highest rates of people skipped medical visits due to cost; Florida also has one of
the highest rates of uninsured persons.