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Health

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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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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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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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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19

Our American States

podcastOur focus on this podcast is the prescription drug market and the role of pharmacy benefit managers or PBMs. PBMs play a major role in the drug supply chain. They are third-party administrators of prescription drug benefits for health plans, large employers and other payers, including state Medicaid programs. They process claims, review drug utilization, develop pharmacy networks, and create lists of covered drugs called formularies. They also negotiate rebates from manufacturers for placement on those formularies.

To reduce the costs for prescription drugs in their states, some legislators are considering strategies related to pharmacy benefit management. Legislatures have pursued a number of strategies, including reverse auctions.

We invited two legislators on who have worked on legislation related to PBMs to discuss the experience in their states. Our guests are Rep. Susan Lontine, a Democrat from Colorado, and Sen. Fred Mills, a Republican of Louisiana. Both states have passed legislation authorizing a reverse auction for their PBM contracts and they discuss why they pursued that avenue and other efforts to control prescription drug costs.

Rep. Susan Lontine, ColoradoSen. Fred Mills, Louisiana

 

 

 

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15

Our American States

podcastPeople having a mental health crisis in this country are more likely to encounter law enforcement than to receive treatment. And because of a lack of other resources, police sometimes spend a fifth of their time dealing with people with a mental illness. Studies indicate that more than 80% of people in jails with mental illness do not receive adequate treatment.

States are following a number of paths to deal with the problem and the guests on this podcast discuss the work they’ve done.

Jac Charlier is a former law enforcement officer in Illinois who is a pioneer in the area of deflection, a set of preventive measures aimed at reducing reliance on law enforcement as we respond to the mental health crisis in this country. He discussed how deflection programs work and offered some advice for legislators.

Also, guests on the program are Rep. Leslie Herod, a Democrat from Colorado, and Rep. Dwight Tosh, a Republican from Arkansas. Both have worked on legislation in their states to better address the issue.

If you’d like to learn more about this issue, don’t miss “5 Big Ideas: Collaborative Approaches to the Mental Health Crisis” at NCSL’s Legislative Summit in Denver Aug. 1-3. The session will be Aug. 2 and will feature lawmakers discussing what worked in their states.

This project is supported by the John D. and Catherine T. MacArthur Foundation and the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services. The CDC support is part of a financial assistance award totaling $200,000 with 50% funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS or the U.S. government.

Jac CharlierRep Leslie Herod, ColoradoRep Dwight Tosh, Arkansas

 

 

 

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13

Our American States

podcast Diabetes is a major health challenge in the U.S. About 30 million Americans are diagnosed with diabetes, and the American Diabetes Association estimates several million more are undiagnosed. Millions of people with diabetes use insulin to control their condition, and the cost of insulin has been rising dramatically.

In response, 18 states have implemented laws limiting the amount a health plan can charge a patient for insulin. Other states have created patient assistance programs or ensured payments made on behalf of a patient are applied solely to the patient’s out-of-pocket costs.

The guests on this podcast—Delegate Matthew Rohrbach(R) of West Virginia and Rep. Michael Howard of Minnesota(DFL)—both carried legislation in their states to help patients afford their medication. They discussed the details of their legislation and the challenges in passing it. They also shared advice for other legislators who are working on the issue.

Delegate Matthew Rohrbach (R), West VirginiaRep. Michael Howard (DFL), Minnesota

 

 

 

 

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Category: Health
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19

Our American States

podcast

The U.S. population is aging. In a little more than a decade, people 65 and older will outnumber children. Those older adults face economic, social and other challenges including the need for an array of long-term services.

Policymakers in a number of states are considering comprehensive approaches to support older adults. A few states have created what are termed master plans for aging that outline how the state can take on challenges in housing, transportation, health care, and other sectors.

Th guests on this podcast are Holly Riley, the aging services coordination director for Texas Health and Human Services, and Jarett Hughes, a senior policy advisor on aging for the governor of Colorado.

My guests discuss how their states are planning for this aging population, how they’ve tried to get key groups to work together on the effort and some of the lessons learned over years of developing their state plans.

Holly Riley, TexasJarett Hughes, Colorado

 

 

 

 

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05

Our American States

podcastNewborn screening in the U.S. is the practice of testing every child in the country for a number of disorders, many of which can be addressed if caught early. States are in charge of newborn screening and receive advice from federal agencies.

On this podcast, Peter Kyriacopoulos, the director for public policy at the Association of Public Health Laboratories, discusses how the screening works, how it differs from state to state, the role public health laboratories play and the challenges they face. He also explains how the recommended uniform screening panel, or the RUSP, helps guide states in deciding which screenings to include.

A second guest is Kelsie George from NCSL, who tracks legislation related to newborn screening. She fills us in on the legislative landscape on the topic.

Peter Kyriacopoulus, APHLKelsie George, NCSL

 

 

 

 

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15

The crushing strain of caring for patients the last year and half of pandemic has taken a toll on health care workers. Legislatures play an important role in this area by creating laws for licensure and regulation.

On the podcast to discuss the workforce and how to help health care workers cope with the current challenges is Dr. Luis Padilla, the associate administrator for health workforce at the Health Resources and Services Administration (HRSA). Padilla also serves as director of the National Health Service Corps.

Padilla discusses how HRSA supports states in strengthening the workforce. He also talked about the growing role of telehealth and the important role states have in regulating scope of practice rules.

The other guest is Sydne Enlund from NCSL. Enlund tracks of scope of practice laws across the country and maintains a website on the topic with interactive maps dealing with nurse practitioners, physician assistants, pharmacists and more. She discusses the role legislatures have played in modifying regulations for workers during the pandemic.

Dr Luis Padilla, HRSASydne Enlund, NCSL

 

 

 

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