State News

Legislation increasing access to, and the affordability of, health insurance for New Mexico families passed both the state House and Senate, reports the Los Alamos Daily Post. The bill codifies Affordable Care Act requirements for state-based health insurance exchanges and authorizes BeWellNM to continue moving toward becoming a fully state-based exchange.  

The California Health Care Foundation released its second annual California Health Policy Survey, identifying mental health, the provider workforce, and lowering prescription drug prices as top priority issues for Californians, reports State of Reform. Healthcare affordability continues to be a primary concern, with more people reporting that they are worried about unexpected medical bills, out-of-pocket costs for health services and prescription drug costs compared to last year. There is also an increase in the number of people who skipped or postponed care due to cost.

Idaho legislators have established the Idaho Behavioral Health Council, a new three-branch approach to improve care for Idahoans with mental health and substance use disorders, reports the Office of the Governor. State legislators will work collaboratively with local government, educators, and community partners to develop a statewide strategic plan with action-oriented, time-bound recommendations that improve access to behavioral healthcare.

Implementation of a Virginia Medicaid program responding to the opioid crisis by expanding treatment coverage and reforming delivery systems decreased the likelihood of having an emergency department visit by 9.4 percent, according to Health Affairs. Virginia combined a Section 1115 waiver with a comprehensive reform to its Medicaid substance use disorder treatment services to implement the Addiction Recovery and Treatment Services program focused on increasing access to evidence-based addiction treatment services for Medicaid beneficiaries. 

The Federal Communications Commission authorized more than $6.7 million in funding over 10 years to expand broadband access in rural Oklahoma, reports Tulsa World. The investment will reduce barriers to healthcare by supporting telehealth, as well as increase educational and economic opportunities, for over 2,400 unserved homes and businesses within the state. 

Pennsylvania state legislators submitted a 1332 State Innovation Waiver application to the Center for Medicare and Medicaid Services to create a state reinsurance program, according to GANT News. By reimbursing carriers for a portion of their higher-cost claims and spreading that risk across the broader marketplace, a reinsurance program could lower the premiums for individual health insurance plans. Lower premiums would be especially beneficial for Pennsylvanians who are not eligible for financial assistance.  

Just 10 treatment categories of drugs, including anti-asthmatic, cardiovascular and antiviral, accounted for over 70 percent of Massachusetts pharmacy claims from 2015 to 2017, according to MassLive. These statistics are available in a report on prescription drug use and spending from the Center for Health Information and Analysis (CHIA), an independent state agency that monitors the performance of Massachusetts’ healthcare system. The report found that anti-inflammatory tumor necrosis factor inhibiting agents, like Humira and Enbrel, which are used to treat difficult-to-manage diseases like rheumatoid arthritis, accounted for the largest portion of spending.

National surveys consistently rank Hawaii as one of the healthiest states in the nation, but commonly used metrics fail to recognize the stark inequities between Native Hawaiians and other groups, reports the Milwaukee Journal Sentinel. As the high cost of nutritious food has contributed to higher rates of preventable diseases, community leaders are emphasizing cultural traditions like indigenous farming practices and hula dancing as a means of improving health.

Colorado hospitals can operate effectively with commercial insurance rates that are at a drastically smaller percentage of the Medicare reimbursement rate  than what many are bringing in now under the state’s current healthcare system, according to State of Reform. The Colorado Department of Health Care Policy and Financing released an analysis showing that Colorado hospitals, on average, can cover their costs if reimbursed at 143 percent of Medicare rates. The conclusion is based on 2018 payment to cost ratio for Medicare payments and how much was needed to raise Medicare rates to ensure hospitals were paid their costs for seeing patients. The study also concluded that hospital across the nation, on average, cover the cost of providing care to patients at 115 percent. A RAND Corp. study found that Colorado hospitals charge privately insured patients for inpatient and outpatient, combined, on average, 269 percent of the Medicare rate, while inpatient services were billed at, on average, 221 percent of the Medicare price, indicating that commercial rates may be higher than they need to be.