Health and Human Services Newsletter | May/June 2019









From Congress

June 26, 2019—The Senate Committee on Health, Education, Labor and Pensions (HELP) passed out of committee (20-3) a bipartisan package on lowering health care costs. The Lower Health Care Costs Act, addresses ways to reduce surprise medical bills, improves the exchange of health information, increases transparency in health care practices and costs, reduces the price of prescription drugs and improves public health programs. Senate HELP Chairman Lamar Alexander (R-Tenn.) is working with Senate Finance Chair Chuck Grassley (R-Iowa) to pair the health care costs bill with a bipartisan drug-pricing deal Grassley has been working on and is expected to introduce after the July 4 recess. Alexander has signaled confidence in getting both bills to the Senate floor for a vote in the next few months.

June 26, 2019—The House Ways and Means Subcommittee on Health marked up several pieces of health care legislation. The bills looked at improving access to care including telehealth services, providing additional resources to workforce providers in the opioid and substance use disorder (SUD) space and extending certain provisions of Medicare. Two of the five bills passed out of subcommittee with bipartisan support.

June 27, 2019—Senator Debbie Stabenow (D-Mich.) and Senator Susan Collins (R-Maine) introduced bipartisan legislation, the Quality Care for Moms and Babies Act, that would establish maternal and infant health quality measures for Medicaid and the Children’s Health Insurance Program. The bill would also provide funding for regional partnerships between states, providers and other stakeholders working to improve maternal care. A bipartisan companion bill was also introduced in the House by Representative Eliot Engel (D-N.Y.) and Representative Steve Stivers (R-Ohio).

From the Administration

May 17, 2019—A report was released from the Government Accountability Office on 1115 waivers. The report highlighted that the Centers for Medicare and Medicaid Services (CMS) should work to provide more transparency when states requests 1115 waivers. Changes in procedure for the 1115 waiver program were put in place in 2012 under the Affordable Care Act (ACA) ensuring the public could comment and learn more about 1115 waiver applications in their states. The report found this to be a continuing weakness in the program and said that CMS transparency requirements needed to be stronger for states looking to change previously approved 1115 waivers. CMS had responded to the report and agreed to some of its recommendations and would review its processes as well.

June 27, 2019—The administration announced $1 million in Ryan White HIV/AIDS Program Part A grants to 10 metro areas that will provide technical assistance for ending the HIV epidemic. The Part A program operates in 52 metropolitan areas and provides medical and support services to people with HIV with a focus on areas with the highest number of people living with HIV and AIDS and places experiencing increases in HIV and AIDS cases. These grants are also focused on the most vulnerable populations living with HIV/AIDS in the United States.

June 27, 2019— President Donald Trump signed an executive order (EO) addressing different measures on healthcare transparency and pricing. Under the EO, within the next 60 days, the U.S. Department of Health and Human Services (HHS) will propose a regulation requiring hospitals to publicly post billing information based on negotiated rates for common health items and services. Additionally, HHS, and the Departments of Treasury and Labor, will issue a proposed rule asking for comments on other billing aspects. HHS will work with the U.S. attorney general and the Federal Trade Commission to issue a report on current private sector practices on health care pricing and transparency. There will also be a report developed by HHS, and the Departments of Defense and Veterans Affairs called the Health Quality Roadmap, which will evaluate data and quality measures across Medicare, Medicaid, the Children's Health Insurance Program, the Health Insurance Marketplace, the Military Health System and the Veterans Affairs Health System.

From the States

May 6, 2019—California passed legislation that will make it the first state to provide health benefits to some of its unauthorized immigrants. The legislation would allow low-income adults between the ages of 19 and 25 residing in the state, regardless of immigration status, to enroll in the state Medicaid program, if their income qualifies them for the program. The estimated cost would be for 138,000 people costing $98 million the first year. To offset part of the costs the state will tax uninsured California residents. The legislation was part of a larger budget plan.

June 17, 2019—The governor of Maine signed a budget deal that included funding for Medicaid expansion in the state. The two-year budget includes an $8 billion-dollar proposal and will become effective July 2019. The agreement will provide expansion funds for Maine’s Medicaid program and provisions like making it easier for those with a SUD to get access to medication assisted treatment.

From the Courts

June 5, 2019—The 9th U.S. Circuit Court of Appeals has ruled on a lawsuit that was brought by California Attorney General Xavier Becerra, 13 states and the District of Columbia challenging the administration’s rules that would allow any employer to seek a religious or moral exemption to not provide birth control. The ACA requires that most private insurance cover birth control without a copay. The court issued a permanent injunction against ACA’s contraceptive requirements and found the previous accommodations under the Obama administration violated the Religious Freedom Restoration Act.

June 25, 2019—A U.S. district judge issued an order stopping U.S. Stem Cell Clinic, LLC, of Weston, Fla., and U.S. Stem Cell, Inc, of Sunrise, Fla. along with the manufacturing or distribution of all their stem cell products to be banned until they come into compliance with the law. The Department of Justice worked with the Food and Drug Administration (FDA) to initiate this legal action against the companies in May 2018, seeking a permanent injunction after the company failed to comply with the law, including FDA regulations designed to protection patients from clinics’ harmful practices. It was determined by the court that the clinics were adulterating and misbranding their stem cell products. This comes on the heels of issues with hundreds of stem cell clinics providing improper information and harmful services to patients. 

Funding Announcements

June 2019—The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced several funding opportunities including for:

Mental Health and Substance Use Disorder Practitioner Data: will provide comprehensive data and analysis on individuals working in prevention and treatment fields to address mental and substance use disorders and will help them provide data on existing practitioners and viable information to SAMHSA to make policy and planning decisions. Applications are due: Aug. 12, 2019.

Expansion of Practitioner Education: This program will expand the integration of SUD education in the standard curriculum of relevant healthcare and health services education. Applications are due: Aug. 2, 2019.

Tribal Opioid Response Grants: This program aims to address the opioid crisis in tribal communities by increasing access to culturally appropriate and evidence-based treatment. Applications are due Aug. 6, 2019.

Spotlight On

Spotlight On:

June 2019—The Opioid Policy Fellows kicked off their second meeting of the year in Denver. The meeting included a session on successful examples of collaboration between health and justice system actors to improve outcomes for individuals. Legislators heard from experts highlighting strategies for deflection, diversion and integration of medication-assisted treatment into various parts of the justice system.

June 2019—The Maternal and Child Health Fellows also kicked off their second meeting of the year in Denver. The meeting included a session on “Improving Maternity Care in Rural Areas.”

June 2019—During the second convening for the two fellows programs—the Maternal and Child Health Fellows and the Opioid Policy Fellows—both programs came together for a lunch session to hear from a leading expert in maternal and child health and substance use disorder, Dr. Rahul Gupta with the March of Dimes. Gupta gave a short presentation on the rising rates of maternal mortality and morbidity in the U.S. and discussed his work in West Virginia as the former state health official to propose opportunities for prevention.

Photo of Dr. Rahul Gupta with the March of Dimes presenting for the two fellows programs.



In this photo, Assemblywoman Brittney Miller (Nev.) discusses improving maternity care in rural areas with Representative Morrison (Minn.), Representative Dempsey (Ga.) and Assemblywoman Bilbray Axelrod (Nev.). This discussion took place after Gunnison Valley Health CEO Rob Santilli shared the successes and challenges of delivering healthy babies in an isolated rural setting.

Read here for NCSL’s recent blog on the “Supreme Court to Decide ACA Risk Corridor Case.”

Listen here for NCSL’s recent podcast on Measles, Vaccinations and the Role of Government.

Read NCSL’s recent report on: “Increasing Access to Health Care Through Telehealth.”

Catch up on health trends with NCSL’s recent blog on “Public Options for Health Care-Buying Into Government-Sponsored Health Plans.

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 Margaret Wile,

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.