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Health Issues Overview
NCSL's health programs are divided into three broad categories for web design purposes:
1) Health Care;
2) Health Finance, Insurance, and Managed Care;
3) Public Health.
NCSL's Denver office is the base for the NCSL Health Program. NCSL's Washington, D.C. office is home to The Forum for State Health Policy Leadership; D.C. also is where federal health policy lobbying activities take place and NCSL staff represent states' voices in the federal system. The two offices jointly run the NCSL Standing Committee on Health, which consists of legislators and legislative staff from across the country, appointed by state leadership. Below, you will find descriptions of and live links to NCSL's many health topics and programs.
NCSL tracks health care issues in the broad areas of access to health care and the uninsured, children, women, and reproductive health, genetics, long-term care, mental health and substance abuse, oral health, pharmaceuticals, and rural health. Health care costs are taking up an increasing percentage of state budgets and health access concerns are driving constituent needs; these links provide policymakers the information they need to tackle the most pressing issues.
Access to Health Care and the Uninsured With 46 million Americans uninsured, states are looking at a number of options to provide better access to health care. We have information on Dependency, Disease Management, Employer Reporting, ERISA/Pay or Play Legislation, Health Centers, Health Disparities, and Universal Health Care.
Children, Women, and Reproductive Health encompasses a broad range of issues for policymakers. All of these groups have specific health care needs and issues. Here, you will find information on Adolescent & School Health, Birth Defects, Breastfeeding, Childhood Injury Prevention, Emergency Contraception, Emergency Medical Services, Insurance Coverage: Contraceptives or Infertility Treatments, Maternal & Child Health, Newborn Screening, OsteoporosisOsteoporosis, Poison Control, SCHIP, and SIDS.
Genetics continue to interest state policymakers and is quickly growing into one of the most technical and challenging policy areas. Genetics needs to be described in a manner that limits scientific jargon and puts policy issues at the forefront. Areas covered include Genetics Laws & Legislative Activity, Human Cloning, Newborn Screening, Reproductive Technologies, Genetics Briefs, Publications and Other Genetic Issues.
Long-Term Care accounts for more than 35 percent of Medicaid budgets. States are reforming their long-term care systems and seeking higher quality, cost efficiency and consumer satisfaction. The webpage Long-Term Care Reform HCBS & Olmstead includes information on state efforts to reform this area of health care.
Mental Health and Substance Abuse services have been a significant part of medical care for a number of years. The costs, insurance coverage and availability of such services have been the object of policy discussions and a variety of state legislation. This site contains several articles, charts and briefs on Federal Legislation/Regulation, Mental Health, Substance Abuse and Tobacco Use & Prevention.
Oral Health and Rural Health encompasses many topics including public health and prevention efforts, provider issues and Medicaid. In addition, America's rural areas are struggling to maintain a "healthy" health care system. Among the challenges: provider shortages; provider recruitment and retention; implications of managed care; adjustments to the Medicare payment system; and demographic shifts that include a proportionately older population with higher numbers of uninsured. Oral Health and Rural Health.
Pharmaceuticals state legislation is one of the most active health policy issues. A recent count showed total pharmaceutical spending in the United States topped $177 billion in 2005. This Web site includes State Pharmaceutical Assistance Programs, States and Medicare Part D, Prescription Drug State Legislation, Medicaid Prescription Drug Laws, Direct-to-Consumer Advertising, 340B Drug Pricing Program, Pharmacy Plus - Medicaid Waivers, Prescription Drug Bulk Purchasing.
NCSL's work on health finance and insurance includes five broad areas: 1) health cost containment, 2) health finance, 3) health insurance and managed care, 4) Medicaid and 5) SCHIP, the State Children's Health Insurance Program. With 180 million Americans who rely on commercial health insurance, another 50 million enrolled in Medicaid-related programs, and about 44 million people who lack health coverage, state legislatures play an active role in providing coverage, regulating health plans, and examining costs and funds for health programs.
Health Cost Containment is a growing focus for state policymakers, as well as for employers and consumers. Medical inflation is at four times the overall inflation rate, and the cost of running many public programs rose about 15 percent in 2003. Legislators have especially focused on Medicaid cost containment, balancing health priorities, pharmaceuticals, and a menu of creative solutions.
Health Finance examines how and where the United States expends more than $1.5 trillion annually on health care. State budget figures highlight the ongoing dilemma of states, which expend up to 30 percent of their money on health care. State employee health programs affect more than 3.4 million workers at a cost of about $25 billion. National experts provide members with the latest thinking and trends on health costs.
Health Insurance and Managed Care policies affect most of the 180 million Americans with commercial health insurance. NCSL has tracked almost 1,000 laws affecting managed care enacted in the past decade, as well as state mandated coverage laws and policies. Our Web site also has resources on HSAs (Health Savings Accounts), ERISA (the Federal Employee Retirement Income Security Act) and HIPAA, the federal law that affects medical record privacy and provider transactions.
Medicaid looms as the single largest health financing source in the United States, providing health coverage to about 40 million Americans. Our site provides extensive studies and resources of the Medicaid program, with special materials on "HIFA" waivers, Home and Community Based Services, Medicaid Pharmaceuticals, "Pharmacy Plus" waivers, the "Ticket to Work" program and others.
SCHIP, the State Children's Health Insurance Program, was launched in 1997 as a state-federal partnership with $20 billion in federal funds and a broad mission to cover kids from birth through age 18. Our site features an SCHIP overview, charts and related documents, publications and extensive Web resources.
Public Health consists of organized community efforts aimed at the treatment and prevention of diseases, addressing the needs of the entire community. Environmental health, state laws on heart attacks & defibrillators, terrorism preparedness & response, Access to Healthy Food and disease prevention and control are all aspects of public health. State legislators play vital roles in public health, passing laws that define public health activities, initiating and funding public health programs, and holding health agencies accountable for their work.
Access to Healthy Food is an expansion of the NCSL Healthy Community Design Project that currently addresses how transportation, environment, land use, education and health policies can affect the ability of a person to be physically active. The obesity epidemic continues to be depicted in the media on a regular basis. Meanwhile some public health professionals are beginning to break the issue into two pieces: a physical inactivity epidemic and a unhealthy diet epidemic. The access to healthy food project addresses the factors that affect the availability, cost and quality of food in lower income communities, specifically those with a high percentage of minority households. Transportation policies can help low-income families, older adults and others with mobility challenges gain access to supermarkets. Land-use policies can increase accessibility to fruits and vegetables while preserving farmland and open space and slowing sprawl. Direct marketing programs can provide farmers an opportunity to develop new markets with often higher returns for their goods. Over the past few years state legislation has been discussed, and some laws have been passed, that address physical inactivity and access to healthy food through agriculture, transportation, land use and education policies.
Environmental Health concerns include indoor air quality, asbestos, lead hazards, asthma and radon. In addition, NCSL focuses on children's environmental health issues. The latter issue is of special concern because a growing body of evidence, including rising developmental disability and asthma rates, indicates that children are more sensitive than adults to environmental contaminants. The U.S. Environmental Protection Agency is revising pesticide residue limits to make sure they provide a margin of safety for children as well as adults. States may be required to update environmental standards to comply with federal regulations. Currently, most state and federal regulations are based on adults. Only within the last few years has state legislation been passed in California and Maryland, for example, to take children's special vulnerabilities into account. Legislation addressing environmental health issues can be tracked through NCSL's Environmental Health Legislation database.
The NCSL Health Program. NCSL staff include Group Director Martha King; Dick Cauchi; Megan (Feller) Foreman; Alise Garcia; Karmen Hanson; Jody Hatz; Joanne Stroud; Laura Tobler; Amy Winterfeld. Joy Johnson Wilson in the DC office handles state-federal issues. Martha King in the Denver office, along with Joy Johnson Wilson in the D.C. office provide support to the NCSL Standing Committee on Health.
The Forum for State Health Policy Leadership is a group of grant-funded projects based in the DC office that provide training and technical assistance and promote interstate networking for groups such as Health Committee Chairs (Health Chairs Project), relatively new state legislators who are potential future leaders in health policy (Critical Health Areas Project, "CHAP"), and legislative health staff. Contact: Group Director Donna Folkemer at donna.folkemer@ncsl.org.
reposted: June 2006 |
