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1. Our American States

02

Our American States

podcastMedicaid agencies and enrollees around the country will face big changes in the new year.

The current federal public health emergency for COVID-19 has resulted in about a 25% increase in people enrolled in Medicaid. Under the emergency declaration, Medicaid agencies have not reviewed the eligibility of people in the program since early 2020. Once that emergency declaration expires, probably in early 2023, experts expect millions of current enrollees will no longer be eligible.

To help understand what’s coming, we sat down with Andrea Maresca and Jane Longo of Health Management Associates. Both have deep expertise in Medicaid policy at the federal and state level.

Maresca discussed the details of the changes at the federal level, the increase in the number of enrollee and how it affected care for people in the Medicaid program.

Longo explained how state Medicaid agencies responded to the increase in clients, how state legislatures are helping to manage the coming changes and the scale of the challenge facing Medicaid agencies around the nation.

Andrea Maresca, Health Management AssociatesJane Longo, Health Management Associates

 

 

 

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25

Our American States

podcastTraffic fatalities have been on a disturbing upward trend for a couple of years, largely coinciding with the pandemic. In 2021, the National Highway Traffic Safety Administration (NHTSA) estimated that 42,915 people died in motor vehicle traffic crashes. That was the largest number of fatalities since 2005 and the largest year-over-year percentage increase since NHTSA instituted its present system for recording fatalities in 1975.

Ron Thaniel, the director of Governmental and External Affairs for NHTSA, is the guest on this podcast. He talked about what NHTSA is doing to combat this surge of traffic fatalities, including working with states and legislatures, which are responsible for traffic laws. In 2020, legislatures saw the introduction of more than 1,400 bills related to traffic safety.

Thaniel also said human behavior— impaired driving, speeding, not wearing a seatbelt—was the greatest factor in the increased number of fatalities in recent years. Thaniel also talked about efforts to protect vulnerable road users, such as pedestrians and bicyclists. Overall, he said, states will see increased spending from NHTSA with money for traffic safety included in the Infrastructure Investment and Jobs Act.

Ron Thaniel, NHTSA

 

 

 

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04

Our American States

podcastOur focus on this podcast is the resilience of our electrical grid and systems in the face of extreme weather events and cyber threats. Just this summer, there’s been major flooding in Kentucky and Texas, extreme heat across the country and in Europe, and growing concern about wildfires in the western U.S.

State legislatures play a key role in shaping state policies that improve the security and resilience of energy systems. States also partner with federal agencies to identify risks, mitigate threats, and respond to disruptions.

To learn more about the state-federal partnership, we talked with two officials from the Office Of Cybersecurity, Energy Security, and Emergency Response, or CESER, at the U.S. Department of Energy. Ken Buell is the deputy director and Brandi Martin manages the State, Local, Tribal and Territorial Program.

Buell and Martin discussed how CESER responds to natural and man-made threats, how the office works with legislatures and other state entities, and the value of teaming up with state and local partners both during an emergency and at other times. They also highlighted efforts states are making to make their electrical systems more resilient.

Brandi Martin, CESERKen Buell, CESER

 

 

 

 

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28

Our American States

podcastWhen it comes to prescription drug policy, many lawmakers have focused efforts on reducing the cost of drugs to their constituents, such as limiting the copayment on insulin, or to their state budgets, as in the case of a reverse auction for a pharmacy benefit management contract.

Although these policies may lower costs, they do not alter a drug’s list price. Additionally, these laws only apply to people with health insurance. For uninsured or underinsured patients, they may be responsible for the full price of the drug. When it comes to drug pricing, legislators are considering a wide array of strategies to address this concern.

Our two guests on this podcast offer perspective on the route their state took. Delegate Joseline Pena-Melnyk is a Democrat from Maryland and Representative Tom Oliverson is a Republican from Texas. Both have backed legislation intended to make the price of prescription drugs more transparent.

Texas, along with nearly a dozen other states, is requiring reporting from manufacturers on price increases or initial launch prices, with some also requiring pricing and cost data from health plans, PBMs and wholesalers. Oliverson said that approach in Texas is already revealing useful information about rebates and other issues affecting the cost to consumers.

Maryland pioneered the idea of prescription drug affordability boards, or PDABs, to study drug prices, particularly for drugs that pose affordability issues for state, public and private programs. Pena-Melnyk explained how this sort of nongovernmental agency can examine drug pricing and costs in the state and how the system has worked in Maryland since it passed in 2019. Six other states have adopted similar legislation.

Maryland Delegate Joseline Pena-Melnyk (D)Texas Rep. Tom Oliverson (R)

 

 

 

 

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21

Our American States

podcastThe focus of this podcast is the transportation portion of the Infrastructure Investment and Jobs Act, or IIJA, signed by President Biden in November 2021. Overall, it provided $1.2 trillion for roads, bridges, highways, broadband, water projects and more. It’s the largest investment in transportation infrastructure since the Eisenhower administration.

The first guest on the podcast is Charles Small, the deputy assistant secretary for Intergovernmental Affairs at U.S. Department of Transportation. He explained what’s in the bill for transportation projects and discussed new programs related to bridges and electric vehicle charging, the investment in transit and how legislatures can make the most of the federal funds available.

The second guest is Joung Lee, deputy director-chief policy officer of The American Association of State Highway and Transportation Officials (AASHTO). He discussed the perspective of state directors of transportation, how they see the rollout of the bill so far and how the mix of formula and competitive grants affects states.

Charles Small, U.S. DOTJoung Lee, AASHTO

 

 

 

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14

Our American States

podcastTwo years of the COVID-19 pandemic have put a spotlight on the many challenges faced by public health professionals. A key one is the collection and analysis of public health data information that can then be used to determine strategies to control a disease outbreak.

Joining the podcast is Janet Hamilton, the executive director of the Council of State and Territorial Epidemiologists. She discussed what was learned about health care data and analysis during the pandemic, why anemic funding of public health in many areas created problems, and how legislators can work with their state epidemiologists to ensure they have the information they need in the next public health crisis.

Our other guest is Shannon Kolman from NCSL, who discussed how legislatures have responded to the public health data challenges laid bare during the pandemic.

Janet Hamilton, CSTEShannon Kolman, NCSL

 

 

 

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31

Our American States

podcastRobyn Benincasa learned her leadership lessons the hard way--taking part in extreme endurance races, including several seasons on the reality TV show called the “Eco-Challenge,” a grueling 10-day team race. She’s written a book – “How Winning Works: 8 Essential Lessons from the Toughest Teams on Earth.”

She’ll be sharing stories of the races and the lessons they taught as a featured speaker at NCSL’s Legislative Summit in Denver Aug. 1. She says the lessons are particularly pertinent to legislators and their staffs.

Robyn Benincasa

 

 

 

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24

Our American States

podcastOur focus in this podcast is state securities administrators. These are the agencies in every state that oversee investor protection and efficient capital formation. Their key focus is protecting consumers who purchase investment advice or securities.

Guests on the podcast are Melanie Senter Lubin, the Maryland securities commissioner and president of the North American Securities Administrators Association, and Faith Anderson, the chief of Registration and Regulatory Affairs of the Securities Division of the Washington state Department of Financial Institutions.

They discussed the various roles state securities regulators play, the assistance they can offer state legislators and legislative staff, and how state regulators work with their federal counterparts. They also sketched out their perspective on a variety of policy topics, including licensing and digital currency. Both Lubin and Anderson also wanted legislators to know that the securities regulars in your state are always available to answer questions for you or your constituents.

Faith Anderson, Washington stateMelanie Senter Lubin, Maryland

 

 

 

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20

Our American States

podcastWhat can lawmakers and legislative staff learn from entrepreneurs?

Plenty, says Kevin O’Leary, an investor best known as a host of “Shark Tank,” the Emmy Award winning venture capital reality program. He’s the guest on this podcast.

O’Leary also is a keynote speaker at NCSL’s Legislative Summit. He will appear on Aug. 3 at 3 p.m. at the Colorado Convention Center in Denver.

O’Leary explained why he believes sound public policy is the foundation of a dynamic economy, what lawmakers can learn from the entrepreneurs on “Shark Tank” and why it’s critical to have people who are successful in business get involved in government.

Kevin O'Leary

 

 

 

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17

Our American States

podcastWhile cannabis remains illegal under federal law, states have regulated cannabis for nearly 30 years. But policymakers have had few evidence-based policy tools to inform them. More than two-thirds of the states and territories regulate cannabis for medical use and more than 20 states and territories allow for nonmedical adult use.

Michael Sofis, Ph.D., director of research for the Cannabis Public Policy Consulting, is one of the few researchers looking at the policy issues of concern to lawmakers. His firm does extensive surveying around public policy affecting cannabis.

On this podcast, he discusses some of the surprises from his findings, the questions states are trying to answer and explains why the cannabis black market still does a brisk business even in places where it’s legal.

 You can learn more about the policy issues surrounding cannabis during the session “Growing Fields of Data: Public Health and Cannabis Policy” at NCSL’s Legislative Summit Aug. 3 from 1:30-2:45 p.m. at the Colorado Convention Center in Denver.

NCSL tracks and assists legislators with their questions about many policy topics, including state regulation of cannabis. NCSL takes no position on individual state cannabis policies. The federal Controlled Substances Act lists cannabis in Schedule I, with heroin, LSD, ecstasy and other products considered to have the highest potential for abuse with no currently accepted medical use in treatment in the United States

This podcast is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $563,000 with 100% funded by CDC/HHS. The contents were created by NCSL and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

Michael Sofis

 

 

 

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