State News

Rhode Island policymakers have introduced an initiative to enhance health care access and
affordability across the state, reports WPRI. The HEALTH Initiative consists of over two dozen
legislative proposals across four target areas: consumer protection, provider availability and
care quality, cost containment, and health system financial stability. Measures include
eliminating medical debt through ARPA funding, prohibiting medical debt reporting to credit
bureaus, capping interest rates on medical debt, and preventing liens on patients' homes due to
medical debt. Other proposals involve enhancing training for health care professionals,
establishing scholarship programs, expanding Medicaid reimbursement for mental health
services, and adopting various interstate compacts to improve access to care. Additionally, the
initiative includes measures to promote price transparency, establish drug affordability
commissions, and review primary care rates.

A new report finds Colorado's standardized health-insurance plan, known as the Colorado
Option, is changing how consumers interact with insurance, reports Public News Service. In
2024, more than 93,000 Coloradans enrolled in Colorado Option plans, more than doubling
enrollment in 2023 and representing more than a third of all enrollments through Connect for
Health Colorado. More insurers are also offering plans, providing much-needed competition in
12 counties. Primary goals for the Colorado Option were to make insurance easier to
understand and more affordable, and to improve health outcomes for historically disadvantaged
communities.

Oregon’s state employee health insurance plan instituted a cap on hospital payments, resulting
in over $100 million in savings during the first two years, according to a study in Health Affairs.
The cap, which limited hospital facility prices to 200 percent of Medicare payments for in-
network services and 185 percent of Medicare payments for out-of-network services, was
implemented in October 2019 and January 2020 for members of Oregon’s state employee
health insurance plan. The cap was associated with a 25.4 percent reduction in outpatient price
levels. Inpatient facility prices per admission did not change significantly in the first year, but
declined in the second year of the policy. Price variation also declined as hospitals’ relative
prices moved closer to the cap.

In 2022, Georgia implemented a reinsurance program as part of its Section 1332 waiver of the
Affordable Care Act, but an analysis shows it may have reverse effects, according to a study in
Health Affairs. An analysis shows that the minimum cost of enrolling in subsidized coverage
increased 30 percent and overall enrollment numbers are down by one-third. This outcome
suggests that reinsurance programs may show unintended consequences for residents looking
for affordable health care coverage.

New Mexico will require hospitals to notify the state of mergers and acquisitions and grant the
state government oversight over such transactions, reports the Santa Fe New Mexican. Under
the Health Care Consolidation Oversight Act, the Office of the Superintendent of Insurance’s
review of proposed transactions can include the potential reduction or elimination in access to
essential services, along with the availability, accessibility, and quality of health care services to
affected communities, including patient costs and potential for the transaction to affect health
outcomes for residents. The legislation follows a failed $11 billion health care merger in the
state and aims to address concerns over the trend of hospital acquisitions by out-of-state and
private equity firms.

Arizona is partnering with non-profit RIP Medical Debt to forgive medical debt for up to one
million Arizonans, according to the Office of the Governor. The state will make up to $30 million
dollars in funds available to RIP Medical Debt to purchase debt from providers for pennies on
the dollar, and cancel the balance. Debt owed by Arizonans earning less than 400 percent of
the Federal Poverty Line or who owe more than five percent of their annual income will be
eligible for forgiveness.

Connecticut will be raising the cost growth benchmark target to four percent due to high inflation,
reports the state Office of Health Strategy. In consultation with health system stakeholders and
experts, OHS had previously established Connecticut's benchmarks at 3.4 percent for 2021, 3.2
percent for 2022, and 2.9 percent for 2023, 2024, and 2025. Notably, the statewide per-person
spending for 2020-2021 exceeded the 3.4 percent benchmark, with a 6 percent increase in
overall per-person spending statewide.

New Jersey residents will benefit from a new law designed to speed up the prior authorization
process, reports WHYY. Once it takes effect next year, health insurance companies must
decide on prior authorization requests within three days. In cases of urgent medication needs, a
response from the insurance company is required within 24 hours of the doctor's request.
Notably, New Jersey is the second state, after Washington, to pass such legislation, with over
20 other states currently considering similar bills.

Connecticut will become the first state to use American Rescue Plan Funding to forgive medical
debt among residents, reports New Hampshire Public Radio. Last year, state policymakers
allocated $6.5 million in the state budget towards erasing eligible residents' medical debt and
over the next several months, Connecticut will collaborate with a nonprofit that purchases
medical debt at a reduced rate to begin the process. Eligibility for relief extends to state
residents whose medical debt exceeds five percent of their income or who earn up to four times
the federal poverty line. Notification for eligible individuals could occur as early as this summer,
according to the governor’s office.