Our American States | An NCSL Podcast

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The “Our American States” podcast—produced by the National Conference of State Legislatures—is where you can hear compelling conversations that tell the story of America’s state legislatures, the people in them, the politics that compel them, and the important work of democracy.

You can listen to the podcast on this page, you can subscribe through iTunes, Google Play, Spotify or Stitcher, or you can use the RSS icon at the right to copy a feed URL for your podcatcher. 

Health

07

There is an increasing focus at the state and federal level on policies to require greater cost transparency in health care. While there’s debate about how effective these policies are, the goal is to allow comparison shopping on the part of consumers and employers with the aim of controlling the increasing cost of health care.

The guest on the podcast is an expert in the area of health data and analytics. Niall Brennan is the president and CEO of the Health Care Cost Institute, a nonprofit that focuses on data to analyze key issues affecting the U.S. health care system. Brennan previously was chief data officer for the Centers for Medicare and Medicaid Services.

Brennan discusses the pros and cons of price transparency, examples of where it’s been effective and his skepticism about the individual consumer’s use of the information. He also shares some surprising examples of price variation for the same medical procedure in the same area—even in the same hospital group. 

Niall Brennan, Health Care Cost Institute

 

 

 

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08

HIV/AIDS has killed about 700,000 people in the U.S. since it first emerged more than 40 years ago. But deaths have dropped dramatically since the mid-‘90s as new treatments have beome available. The U.S. Department of Health and Human Services in 2019 launched the Ending the HIV Epidemic Initiative that aims to eliminate the disease in this country.

On this podcast, we talk with Dr. Jonathan Mermin, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at the Centers for Disease Control and Prevention. He discusses the range of treatments available to fight HIV/AIDS, strategies to prevent spread of the disease and the role state policymakers can play in helping eradicate the disease.

Our other guest if Charlie Severance-Medaris, a policy expert at NCSL. Charlie explains the steps states are taking to help people to get access to critical medications, changes in laws that have criminalized some behaviors for people with HIV/AIDS, and other efforts at the state level to end the epidemic.

Dr Jonathan Mermin, CDCCharlie Severance-Medaris, NCSL

 

 

 

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18

Every state in the country is involved in distributing and administering the two COVID-19 vaccines now approved for use by the US. Food and Drug Administration. Each state is working with a plan that it created in consultation with the federal government.

On this podcast we discuss how those plans were created, how they’ve had to change as the pandemic has progressed and what lies ahead.

Our guests are Hemi Tewarson, an expert in state plans to distribute the COVID-19 vaccines. She is a visiting senior policy fellow at the Margolis Center for Health policy at Duke University. As a health policy expert, she has studied the state vaccine plans and discusses how those are working, changes in federal guidance and when everyone will have access to the vaccine.

Our other guest is Tahra Johnson, a policy expert at NCSL. Tahra discusses state legislative action related to vaccine plans and how legislators can get involved in the planning process.

Hemi TewarsonTahra Johnson

 

 

 

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11

A new category of gene therapies is offering life-changing treatments to people with some forms of cancer and other rare disorders. These revolutionary treatments, however, come with a large price tag, sometimes exceeding millions of dollars for a single patient. Often, these costs fall on state Medicaid systems.

On this podcast we discuss how states are dealing with this challenge. One of our guests is Anne Winter, a Medicaid strategist with the national research and consulting firm Health Management Associates. Winter, who has particular expertise in pharmacy benefit management, discusses some of the strategies state are employing.

Our other guest is Colleen Becker, a policy expert at NCSL, who lays out the scope of the challenge facing states.

Colleen Becker, NCSLAnne Winter, Health Management Associates

 

 

 

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07

An estimated 700 women will die  from pregnancy-related complications in the U.S. this year, and most of those deaths are preventable. In addition, Black and Indigenous women are two to three times more likely to die of pregnancy related issues than White women.

On this podcast, the focus is on maternal mortality. I talk with Dr. Wanda Barfield, the director of the Division of Reproductive Health at the Centers for Disease Control and Prevention. She  discusses efforts by the CDC to reduce the number of deaths, including sharing strategies with state legislators as they try to craft solutions that work best in their states.

My second guest is Khanh Nguyen, a policy expert at NCSL who tracks legislation related to maternal mortality. She shares examples of specific legislation and approaches employed by states, including a focus on helping Black and Indigenous women.

Dr. Wanda Barfield, CDCKhanh Nguyen, NCSL

 

 

 

 

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14

Today’s podcast focuses on childhood vaccinations and a troubling drop in the rate of routine immunizations for children in the early months of the COVID-19 pandemic.

Our first guest is Dr. Melinda Wharton, the director of the Immunization Services Division at the Centers for Disease Control and Prevention. Dr. Wharton, one of the nation’s preeminent experts on vaccine policy, discusses the reasons behind the drop, the steps the CDC is taking to help states bolster the immunization rate, the importance of keeping children on a vaccine schedule and what state lawmakers can do to help. She also reminds us that adults need vaccines as well as we enter flu season.

My other guest is Erik Skinner, an NCSL policy associate who tracks legislation related to vaccines. He offers a perspective on how state legislatures acted on vaccine policy.

Dr. Melinda Wharton, CDCErik Skinner, NCSL

 

 

 

 

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12

For the first time, around 2040, there will be more older adults than children. By 2060, the U.S. Census Bureau says, nearly 1 in 4 Americans will be 65 years and older. And in that same year, the number of people 85 years and older will triple and the country will add a half million centenarians. We decided to explore what “Living to 100” means for state policymakers across the country.

Later in the program, we’ll talk with Karen Brown, who is an original and current member—and a former chair—of the Colorado Strategic Action Planning Group on Aging. The group was formed by the Colorado General Assembly since the state has one of the fastest growing senior populations.

Our guests are:

  • James Firman, president and CEO of the National Council on Aging.
  • Karen Brown, a member and former chair of Colorado’s Strategic Action Planning Group on Aging and CEO of iAging.

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25

Medicaid is a state-federal health insurance program designed to provide relief for the less fortunate, including low-income people, the elderly and people with disabilities. The program is a significant part of state budgets. State expenditures on Medicaid exceeded $600 billion in 2018, with about 1 in 5 Americans receiving coverage. The federal government accounts for about 60 percent of this financing with the rest coming from state budgets.

All 50 states participate in the Medicaid program. But, as we learn in this episode, states have flexibility in how to determine spending, eligibility and covered services. We learn how some states are looking to reduce their Medicaid spending and how others are moving to expand their services. We’ll also explore the relationship with the program and the Affordable Care Act, as well how mental health, behavioral health and living conditions are influencing policymakers’ decisions on how to appropriate funding.

To walk us through the various issues is Emily Blanford, a program principal in NCSL’s health program, specializing in Medicaid policy. 

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20

Government and health officials from across the country have expressed concern in recent months as cases of measles have been reported in limited areas of the country—the most reported since 1992. The disease was declared all but eliminated in our borders in the year 2000. Maintaining that status is threatened by increased international travel and by the number of parents who are now hesitant to have their children vaccinated.

To get answers about current outbreaks, how the various levels of government have reacted, and how the nation is responding to parents who are hesitant to vaccination their children, we reached out to the nation’s foremost expert on the subject: Dr. Robert Redfield, director of the Centers for Disease Control and Prevention. He talks about the current cases, the need for vaccinations, how certain states have addressed populations hesitant to vaccinate and the role that state legislators play in addressing public concerns.

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25

At some point in 2016, 1 in 7 U.S. households was food insecure and more than 44 million people participated in the federal Supplemental Nutrition Assistance Program (SNAP). The nonprofit No Kid Hungry says more than 13 million U.S. children live in "food insecure" homes.

The National Conference of State Legislatures created a Hunger Partnership to address food insecurity. With more than 20 legislators and three legislative staff, the partnership works to address hunger in America. Corporate and nonprofit partners, including the Congressional Hunger Center, support the partnership.

We get unique perspectives on this issue from our two guests:

  • Hugh Acheson, who has won major awards including the James Beard Award for best chef and Food & Wine’s best new chef, has been featured on several TV cooking shows. He discusses his involvement in providing meals for school children.
  • Senator Renee Unterman (R-Ga.) is co-chair of NCSL’s Hunger Partnership. She discusses the work of the partnership and how it works with the federal government to address food insecurity.

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