State News

A case study by Third Way finds that hospital consolidation has driven up the cost of care in
Maine, reports Bangor Daily News. Costs in Maine are the highest in New England and exceed
the national average by 25 percent. The study recommends that state and federal lawmakers
strengthen hospital price transparency, limit facility fees and restrict tactics that reduce
competition when negotiating insurance contracts.

New Mexico is capping cost-sharing for certain services in state-regulated plans, including
diabetes supplies, breast cancer screening exams, and sexually transmitted infection (STI)
treatment, reports Source NM. State-regulated plans will be required to provide basic diabetes
care and supplies alongside a $25 cap on a 30-day supply of insulin. In addition, cost-sharing is
eliminated for diagnostic breast exams and prevention and treatment for STIs. Cancer
biomarker testing must now also be covered by insurance, though cost-sharing is allowed.

A survey of people who lost Medicaid coverage in Utah last year found just over half made no
effort to renew their coverage, in many cases due to difficulties with paperwork requirements,
reports KFF Health News. While many found insurance elsewhere—39 percent through an
employer and 15 percent through the Marketplace—thirty percent became uninsured and many
reported obstacles in reapplying for Medicaid. Nineteen percent said they never received
renewal documents from the Utah Medicaid enrollment agency, the Department of Workforce
Services. Fourteen percent said they didn’t get around to the paperwork, 13 percent said it was
too difficult, and 7 percent said they didn’t have the necessary documents to prove their
eligibility.

A state-by-state report has found that Texans with mental health needs struggle to find and
afford treatment, reports KERA News. According to the report from insurance company
Milliman, 88 percent of Texans live in a county without enough mental health providers, and the
average cost of an out-of-pocket therapy session in the state was at least $160, or $68 even
with insurance if the provider is out-of-network.

Starting January 1, 2024, California will require certain insurers to cover more of the cost of
vasectomies and birth control, according to Cal Matters. The Contraceptive Equity Act requires
insurers regulated by the state to charge no copay for birth control products at in-network
pharmacies, and vasectomies will be subjected to reduced cost-sharing.

A report released by the Blue Cross Blue Shield of Massachusetts Foundation finds racism is
preventing people of color, and those who don’t speak English as their primary language, from
receiving the same quality of healthcare that white people get, reports Mass Live. While the
report notes the progress that has been made toward addressing the cause and effects of
racism, there is still more work to be done. Efforts need to be coordinated and bring
stakeholders together in new ways, according to the foundation.

As of January 1, 2024 all California residents, regardless of immigration status or age, will be
eligible for Medi-Cal—California’s Medicaid Program—reports ABC News. The program is
expected to provide full health care coverage for approximately 700,000 residents aged 26-49
who were not previously eligible.

A legislative report released by the Oklahoma Department of Human Services highlights health
care affordability challenges affecting the state's aging population, reports The Journal Record.
The report explains that seniors throughout the state are concerned about the cost of health
care and the lack of affordable transportation to services. Similarly, when asked about
recommendations to address other concerns, interview participants responded that the state
needs to examine opportunities address the deficit in affordable prescription drugs and medical
equipment.

Data from Connecticut, Rhode Island, and Oregon shows that even after accounting for rebates,
spending on prescription drugs has continued to grow at an unaffordable rate, according to
Health Affairs Forefront. Connecticut, Rhode Island, and Oregon collect aggregate spending
data from payers as part of their cost growth targets and found that accounting for prescription
drug rebates did not lower spending growth to an affordable level, relative to household income
level, in the commercial market. Between 2018 and 2021, average retail prescription drug
spending in these states grew between 6.0 percent and 9.2 percent; accounting for rebates
reduced spending growth to between 3.2 percent and 6.1 percent during this time period.