State News

In Colorado, the averae deductible in 2017 was nearly $5,800 for a bronze-level plan, and according to an analysis by the Colorado Center on Law & Policy, 1 in 4 Coloradans wouldn't be able to afford to pay the deductible over the course of a year, according to Kaiser Health News. Rural and lower-income Coloradans are increasingly likely to be unable to afford a high deductible. As such, rural residents who are transferred from smaller, rural hospitals to larger hospitals with a higher level of care may never end up paying their bills at the first hospital. While Colordo has avoided the rural hospital closures that have plagued other states, 22 rural Colorado hospitals have operated in the red in 2019. 

The U.S. Supreme Court will hear a case that could decide the validity of at least 38 states’ laws regulating how companies like Express Scripts and CVS Health make money off prescription drugs, reports Bloomberg Law. The justices agreed January 10 to take a case asking whether an Arkansas law regulating pharmacy benefit managers is preempted by the federal Employee Retirement Income Security Act. The Pharmaceutical Care Management Association, a trade group representing PBMs, successfully challenged the law on ERISA preemption grounds in the Eighth Circuit. The court’s decision to hear the case came at the urging of U.S. Solicitor General, who argued that the Arkansas law doesn’t reference ERISA plans or have an impermissible connection with them.

Two of New Hampshire's largest healthcare providers say they need to merge to gain access to more patients, protect the state's only academic medical center and support the state's struggling rural hospitals, according to U.S. News. Dartmouth-Hitchcock Health is seeking to combine with Manchester's Catholic Medical Center. However, concerns over consolidation in the state have been raised. 

Americans frequently get slapped with costs for out-of-network services in situations where they weren’t able to shop for an in-network option, but research suggests Kansans may be especially vulnerable, according to KCUR. A Kaiser Family Foundation study put Kansas in the five worst states for how often patients received services from out-of-network providers during emergencies or inpatient care at an in-network hospital in 2017. Half of states — red and blue alike — have passed some level of consumer protections against surprise bills, but Kansas has not. While these protections don’t apply to all patients, they are a first step towards reducing avoidable, and potentially devastating, financial harm. 

Many rural Montanans struggle with medical access, reports the Missoulian, with 15 Montana counties having no practicing physicians in 2014. More than a third of Montana's physicians are over the age of 60. As such, the Family Medicine Residency of Western Montana was eastablished to tackle this lack of providers in rural areas of the state, hoping to anchor physicians in Montana and get new doctors into the medical care pipeline as older ones retire. 

A certificate of need (CON) is a permit that healthcare organizations in Tennessee must obtain from the state before building, operating or offering one of 26 regulated facilities, technologies and services. Legislators are discussing whether small tweaks or a sweeping overhaul could help or harm a fragile health care system in which 12 rural hospitals have closed since 2013, according to Chattanooga Times Free Press. Proponents of the programs argue they're needed to ensure orderly growth and limit health care spending, because health care is unlike other goods and services. However, opponents believe removing the cumbersome regulation will free the healthcare industry, bringing more providers into the market to drive competition and lower costs. A legislator working group has relied on data, stakeholder input, expert testimonies and their past experience wrestling with the law as they weigh options for changes.

A Texas law that aims to protect patients from surprise medical bills has taken effect, according to The Texas Tribune. The legislation aims to remove patients from billing disputes between health insurance plans and healthcare providers. The protections apply to Texans with state-regulated health plans, which includes most state employees and public school teachers, people who purchase insurance through the ACA marketplace and some people who receive health insurance through their private employers. The new law bans balance billing for emergency care. In nonemergency situations, there is an exception that allows providers to charge balance bills to patients who intentionally seek out-of-network providers.  

Mental health centers in Kansas are forced to rely on out-of-state doctors willing to work remotely due to a shortage of mental health providers in certain areas of the state, according to KCUR. Like many states, Kansas is seeing an increase in patients seeking mental health treatment, but there aren’t enough doctors, nurses and therapists to treat them. Providers say the problem is worse in the state’s least-populated rural areas, where clinic jobs can stay open for years at a time. Only nine of 105 Kansas counties have enough psychiatrists and they are mostly in urban areas.

To be launched in 2020, the New York Governor's Office announced the creation of a consumer-friendly healthcare price comparions website, reports Becker's Hospital Review. The website, NYHealthcareCompare, will provide cost, quality and volume data, broken down by hospital, as well as educational information about financial assistance options and surprise billing.