Health and Human Services Newsletter | April 2018


From Congress

04/19/2018 – The House Committee on Agriculture held a hearing to mark up H.R. 2, the Agriculture and Nutrition Act of 2018, also known as the Farm Bill. One of the most debated sections of the bill concerned reforming the Supplemental Nutrition Assistance Program (SNAP). Among other changes the legislation proposed expanding the SNAP population that would be subject to work requirements and establishing tighter time frames for participants to find work or a job training program. Senate agricultural committee members have signaled they will not be prioritizing significant changes to SNAP requirements, and want to focus on passing the bill in a bipartisan manner.

04/20/2018 – Senator Chuck Schumer released one of several proposals to decriminalize marijuana at the federal level, leaving regulation up to states. Although the bill would still allow federal law enforcement for movement of the drug between states, it would remove marijuana from its place on the controlled substances list. Check out NCSL’s page on State Medical Marijuana Laws, including a state-by-state breakdown, for more information.

From the Administration

04/09/2018 – The Congressional Budget Office (CBO) released its 2018 Budget and Economic Outlook Report. The report looks at the economic forecast for the next decade. In terms of health care spending, CBO predicts Medicare spending to grow by 3 percent this year and increase each year by an average of 7 percent. Medicaid spending is predicted to increase by 2 percent in 2018 with an average yearly increase of 5.5 percent for the next nine years, and health insurance premiums would increase by 21 percent this year and then drop to a growth rate of 5 percent each year until 2028.

04/10/2018 – The White House released an executive order (EO) outlining proposals promoting economic mobility for those enrolled in government assistance programs. Within the EO is a request to several agencies to review public assistance programs they run to determine if the programs include work requirements as part of enrollment, and if enforcing work requirements is consistent with federal law. The EO asks these agencies to report their findings within 90 days to the director of the Office of Management and Budget and the assistant to the president for Domestic Policy Council for any recommended regulatory or policy changes.

04/2018 – The HHS Office of Adolescent Health has released an updated Think Grow Act Playbook. This initiative was started in the office four years ago to improve adolescent health in the U.S. The playbook provides resources to organizations and individuals to support the healthy development of America’s adolescents.

04/17/2018 – Attorney General Jeff Sessions released a new proposed rule that sets limits on how many painkillers a company can manufacture in a year. Under the rule, the Drug Enforcement Administration (DEA) would be required to consider the possible diversion of opioids for misuse and would set limits with input from agencies and state governments. The rule comes in response to a suit out of West Virginia about the DEA’s opioid quotas.

04/22/2018 – Tribal leaders are challenging several states and the Centers for Medicare and Medicaid Services on proposed work requirements for Medicaid recipients. Although historically exempt from penalties under the Affordable Care Act (ACA) and other federal health laws, the administration is now arguing that Native Americans are a race not separate from this government and should not be exempt from Medicaid work laws. Some states, including Utah and Arizona, have changed their work requirement plans to provide an exemption for Native Americans.

From The States

04/09/2018 – Maryland passed legislation to set up a reinsurance program, joining several other states looking into this funding mechanism that helps cover high-risk pool patients. Reinsurance programs can be financed by taxing insurers and receive federal funding to share costs through a 1332 waiver. More states are considering reinsurance programs to make sure insurers don’t leave their markets, while strengthening provider networks, while simultaneously drawing in new insurance providers. The initial challenge for some states considering reinsurance are the up-front costs they would need to pay for the program.

04/17/2018 – The Virginia House of Delegates passed a two-year budget in its current special session. Within the budget is a proposal to accept federal dollars for Medicaid expansion, covering around 300,000 Virginians under ACA. Medicaid expansion was proposed in the previous budget but this version has new language, including: the requirement that able-bodied Medicaid recipients are removed from the program if they fail to look for a job or job training for three consecutive months, setting aside funds to help those complying with the work requirement and the creation of a high-risk insurance pool.

From The Courts

04/20/2018 – A U.S. Court of Claims judge rejected the Justice Department’s attempt to block class action status in a lawsuit regarding cutting off cost-sharing reduction payments by the administration last fall. The judge certified that the case can move forward as a class action case, and the government is required to provide the plaintiff, Common Ground Health Cooperative, with a list of potential class members by May 18.

04/29/2018 – The 7th Circuit affirmed a lower court ruling striking down an Indiana law prohibiting abortions if the mother is seeking the abortion solely based on race, sex, or diagnosis of a disability. The 2016 law also included provisions specifying the manner of dealing with fetal remains. Several other states have similar laws banning abortion based on race, sex, or disability diagnosis, but this ruling is the first declaring the provisions unconstitutional.  

Spotlight On:

The Health Resources and Services Administration (HRSA) will award 75 grants to rural communities to facilitate opioid response planning. The Centers for Disease Control and Prevention previously identified 220 counties as being at risk of opioid epidemics, and HRSA aims to help high risk rural communities develop plans for opioid use disorder prevention, treatment, and recovery programs. Read more here.  

Read here to learn more about the Center’s for Medicare and Medicaid Services (CMS) changes for state run insurance marketplaces.

NCSL’s DC Office is currently hosting a Bill Emerson National Hunger Fellow for NCSL’s Hunger Partnership, you can read her recent blog on college hunger here.


2018 NCSL Legislative Summit

Registration is Open for the 2018 NCSL Legislative Summit

NCSL’s 2018 Legislative Summit will take place in Los Angeles, July 30-Aug. 2. Connect with legislative peers and policy innovators and explore the constantly changing work of state legislatures. From skills training to policy deep dives, you'll take home ideas you can put into action in your state.

The NCSL Legislative Summit business meeting, Setting the States’ Agenda, is where NCSL adopts the policy directives and resolutions that guide NCSL’s advocacy before Congress, the White House and federal agencies.

Visit the Summit Registration webpage or for more information.

For more information on NCSL’s Health and Human Services Standing Committee State-Federal Affairs activities, please visit our website, or email Haley Nicholson or Abbie Gruwell

NCSL's Advocacy in Washington

NCSL's Washington staff advocate Congress, the White House, and federal agencies on behalf of state legislatures in accord with the policy directives and resolutions that are recommended by the NCSL Standing Committees and adopted by the full conference at the annual NCSL Legislative Summit Business Meeting. As a result of the advocacy that is guided by these policies positions, NCSL is recognized as a formidable lobbying force in state-federal relations.

NCSL Staff in Washington, D.C.

  • Neal Osten | 202-624-8660 | Molly Ramsdell | 202-624-3584 | Directors
  • Max Behlke | 202-624-3586 | Budgets and Revenue
  • Danielle Dean | 202-624-8698 | Communications, Financial Services
  • Susan Frederick | 202-624-3566 | Law, Criminal Justice, and Public Safety
  • Abbie Gruwell | 202-624-3569 | Human Services
  • Ben Husch | 202-624-7779 | Natural Resources and Infrastructure 
  • Jon Jukuri  | 202-624-8663 | Labor, Economic Development and International Trade
  • Haley Nicholson | 202-624-8662 | Health
  • Ethan Wilson | 202-624-8686 | Commerce and Financial Services
  • Joan Wodiska | 202-624-3558 | Education