State News Roundup - November-December 2022

Arizona

Arizona Passes Medical Debt Protections
By Stephanie Innes | AZ Central | Nov. 8, 2022

Arizona voters approved a proposition to lower the maximum interest rates on medical debt to 3 percent, reports AZ Central. The measure also limits wage garnishment and asset seizure by debt collectors for medical debt. This is the first time a statewide ballot measure has addressed medical debt.

California

California Keeps Uninsured Penalties Rather than Lowering Costs
By Angela Hart l Kaiser Health News l Nov. 29, 2022

The state of California has kept funds collected from fines levied against residents who do not have health insurance, rather than using the funds to lower costs, according to Kaiser Health News. Revenues collected from the state’s individual mandate were supposed to fund state-based subsidies for low- and middle-income residents who purchase coverage through Covered California, but following a boost in federal subsidies during the pandemic, the Newsom administration claimed the state subsidies were no longer necessary. Penalties collected total $1.3 billion from 2020 through 2022 and are now being held in a special fund for future use in health affordability programs when the federal subsidies expire.

California Health Survey Reveals Health Equity Gaps
By Soraya Marashi l State of Reform l Dec. 15, 2022

The 2021 California Health Interview Survey results (released in 2022) show that Black or African American adults and American Indian and Alaska Native adults had disproportionately high rates of adverse childhood experience, according to State of Reform. In addition, 27 percent of Californians stated that they did not receive medical care due to cost or lack of insurance.

Connecticut

Connecticut Receives Federal Funding to Support Covered Connecticut Health Program
Office of Governor Ned Lamont l Dec. 21, 2022

Connecticut has received federal approval for a Section 1115 demonstration waiver that will support the Covered Connecticut program, reports the Connecticut Office of Governor Ned Lamont. The approval provides federal matching funds to sustain the existing program, which offers federal premium subsidies, cost-sharing reductions and eliminates out-of-pocket costs for enrollees.

Kansas

Kansas Scores Low on Healthcare Affordability
Kansas Public Radio | Nov. 30, 2022

The Healthcare Value Hub’s Healthcare Affordability State Policy Scorecard ranked Kansas 49 out of 50 states and the District of Columbia in healthcare affordability, reports Kansas Public Radio. Poor healthcare affordability may stem from private payers in Kansas paying more than double Medicare rates for the same services and could be improved through the creation of healthcare price transparency tools and spending oversight committees to curb excess prices.

Louisiana

Report finds Louisiana the Second Most Expensive State for Healthcare
By Jenny Peterson | New Orleans City Business | Nov. 2, 2022

Healthcare in Louisiana averaged $9,796 per person in 2020 in Louisiana, the second most expensive in the country, reports New Orleans City Business. The report details how Louisiana residents with employer-sponsored insurance have some of the highest premiums in the country, with single employees paying $1,740 per year. Louisiana had the fifth highest increase in overall healthcare spending per person between 2016 and 2020—with about a 23 percent increase.

Massachusetts

Report Details Telehealth Digital Divide in Massachusetts
By David Raths l Healthcare Innovation l Nov. 18, 2022

There exist large disparities in telehealth usage in Massachusetts, specifically by age, internet accessibility and rurality, reports Healthcare Innovation. These revelations come from a report
by the Harvard Pilgrim Health Care Institute, which found that seniors, children and people who live in rural areas were less likely to use telehealth during the pandemic. Telehealth use was also lower in communities where fewer households had home internet access. The report also found that telehealth greatly enabled access to primary, chronic disease and behavioral healthcare during the pandemic, making the uneven uptake more alarming. Furthermore, lower quality experiences with telehealth were associated with gaps in broadband infrastructure, digital affordability and in the usability of technological platforms.

Missouri

The High Price of Healthcare in Missouri: Confronting Crushing Costs
By Sami Schrage Bunk l Missouri Foundation for Health l Dec. 15, 2022

Even with insurance many Missourians face challenges affording healthcare, reports the Missouri Foundation for Health. Nine percent of Missourians remain uninsured and three-in-five Missouri adults struggle to afford healthcare due to high costs. These challenges are disproportionately shouldered by households that include a person with a disability.

New Mexico

State Healthcare Affordability Fund Set to Deliver Major Savings on Health Insurance
By Carol A. Clark l Los Alamos Daily Post l Dec. 5, 2022

Most of those who qualify for health coverage on New Mexico’s healthcare exchange, beWellnm, will be receiving large healthcare savings, reports Los Alamos Daily Post. These savings in premiums, deductibles, co-pays and other out-of-pocket costs are due to the federal Inflation Reduction Act of 2022, as well as New Mexico’s Health Insurance Marketplace Affordability Program. This state program reduces premiums and out-of-pocket costs not just for New Mexicans who qualify for coverage on the marketplace, but also for small businesses and their employees. It also provides resources for planning, design and implementation of healthcare coverage initiatives for uninsured New Mexicans.

Study Shows Uninsured New Mexicans are Charged More for Medical Treatment
By Natalie Wadas l KRQE l Nov. 29, 2022

Uninsured patients in New Mexico are often charged up to ten times more for medical treatments than insured patients, reports KRQE. These statistics, taken from a study prepared for the New Mexico Center on Law and Poverty, have dire implications for uninsured New Mexicans, namely, that they will likely incur medical debt. The study looked at the prices of 17 different medical services across 43 New Mexico hospitals and revealed that prices varied widely between those with and without health insurance. For instance, for a certain coronary artery stent, the average list price was around $85,000 but the average insurance payments totaled only around $44,000, meaning that the uninsured patient was stuck with a bill almost double what an insured patient would receive. New Mexico passed the Patients Debt Collection Act in 2021, which bans hospitals from suing low-income patients or sending them to collections, but advocates claim that more protections may be required, given the disparities in hospital charges.

New York

New York Passes Legislation to Protect Patients with Medical Debt
By Natalie Wadas l Office of the Governor of New York l Nov. 23, 2022

Recent legislation passed in New York aims to protect patients who have accumulated medical debt, reports the Office of Governor Hochul. The legislation amends the civil practice law and rules to prohibit healthcare providers from placing home liens on an individual’s primary residence or garnishing their wages to collect medical debt. This issue is particularly important to consumers, as more than 50,000 New Yorkers have been sued for medical debt over the past five years.

New York Lawmakers Request Data to Reduce Health Insurance Overpayments
By Kate Lisa l Spectrum News 1 l Nov. 1, 2022

Advocates estimate that New York state could be overpaying by $1 billion for healthcare amid an increasing disparity in hospital costs, depending on where a person receives treatment, reports Spectrum News 1. As a result, some state lawmakers are working to find out just how much the state may be overpaying, due to the wildly fluctuating costs between hospitals and insurance plans. Specifically, lawmakers are asking for data to evaluate the cost of 1.2 million state workers enrolled in the New York State Health Insurance Program. The lawmakers addressed the Civil Service Department, trying to determine which hospital systems are overcharging for standard procedures.

North Carolina

Employee Healthcare Costs are Impacting Dozens of Small Businesses
By Estephany Escobar l Spectrum News 1 l Nov. 15, 2022

North Carolina small businesses are facing increasing health insurance costs that are hindering their growth, reports Spectrum News 1. These revelations come from a Small Business for America’s Future survey of 109 small business owners in North Carolina. Each of the business owners had up to 500 employees, although the majority had 10 or fewer employees. According to the survey, 72 percent of respondents reported that they don’t provide employee health insurance because it is too expensive. Furthermore, 86 percent of small business owner respondents feel strongly that healthcare affordability for small business owners is an issue that lawmakers must address. According to survey authors, the key issue for these business owners is urgency around the issue – they want quick action from lawmakers.

Medical Debt Weighs on 1 in 5 North Carolinians
By Virginia Annable l St. Louis Post-Dispatch l Nov. 11, 2022

About 20 percent of North Carolina residents have medical debt in collections, reports the St. Louis Post-Dispatch, making it the state with the fourth-highest level of unpaid medical debt. According to data from the Urban Institute, the levels of medical debt correspond to poverty levels, with many of the most impoverished counties experiencing the highest levels of medical debt. Advocates hope that by expanding Medicaid in the state, they can reduce the incidence of debt, while others point to additional legislation targeted at shielding consumers from the worst aspects of having their debt in collections.

Ohio

Local Ohio Governments Purchase Residents’ Medical Debt and Provide Relief
By The Blade Editorial Board | The Blade | Nov. 11, 2022

The city of Toledo and Lucas County, Ohio, used $1.6 million in federal funds to forgive $200 million in medical debt for their residents, reports The Blade. The Toledo City Council and Lucas County Board of Commissioners partnered with RIP Medical Debt, a charity that buys and forgives medical debt across the country, to provide relief in the community where over 41,000 residents have medical debt. RIP Medical Debt has traditionally relied upon private donations; this is the first such time that city and county resources have been devoted to relieving medical debt through the nonprofit—providing a model for other communities.

Oregon

Oregon Voters Approve Measure to Make Healthcare a Right
By Nick Budnick | The Lund Report | Nov. 15, 2022

Oregon voters approved Measure 111, making healthcare a right under the Oregon Constitution, reports The Lund Report. The measure enshrines every Oregonian’s right to affordable and clinically appropriate healthcare and that the state balance healthcare with other needs in the state’s budget. How this affects state residents in reality will likely be determined by the Legislature and the courts.

Pennsylvania

Six Pennsylvania Counties Marked as Maternal Health Deserts
By Cassie Miller l Pennsylvania Capital-Star l Nov. 1, 2022

Six of Pennsylvania’s 67 counties are now classified as “maternal health deserts,” which presents concerns about maternal mortality rates for Black women, reports the Pennsylvania Capital-Star. These insights come from a March of Dimes, Nowhere to Go: Maternity Care Deserts Across the U.S. 2022 Report, which found that six counties had no hospitals providing obstetric care, no birth centers, no OB/GYN and no certified nurse midwives, affecting more than 105,000 women age 18-44. Notably, the state’s overall maternal mortality rate is 82 deaths per 100,000 live births, but the rate for Black residents is 163 deaths per 100,000 live births.

Rhode Island

Rhode Island Looks to Auto-Enrollment to Ease Transitions from Medicaid to Marketplace
By Gia Gould and Maureen Hensley-Quinn | NASHP | Nov. 14, 2022

Rhode Island is launching a new program to automatically enroll consumers determined ineligible for Medicaid into a qualified health plan on the state’s health insurance marketplace when the Public Health Emergency ends, according to NASHP. When the Medicaid continuous coverage requirement expires with the Public Health Emergency, Rhode Island will automatically enroll those who have incomes at or below 200 percent of the federal poverty level in the qualified health plans at the silver level. For residents with incomes up to 250 percent who actively select marketplace coverage, Rhode Island will ease coverage transitions by paying for two months of premiums for medical and/or dental coverage. The state hopes this will reduce unnecessary coverage gaps along with higher costs associated with churn.

South Dakota

South Dakota Passes Medicaid Expansion
By Phil McCausland l NBC News l Nov. 9, 2022

South Dakota voters have passed Medicaid expansion, according to NBC News. The expansion allows those earning up to 138 percent of the Federal Poverty Level to receive Medicaid benefits under the Affordable Care Act, and will allow more than 40,000 people to gain access to the program, effective July 2024.

South Dakota Ranked Most Expensive for Healthcare
By Les Masterson and Amy Danise l Forbes l Nov. 8, 2022

South Dakota was rated the most expensive state for healthcare, according to Forbes. According to the report, per person South Dakota healthcare costs averaged $11,736 per year for services, such as hospital care, and the state had the sixth highest annual insurance premiums for those with individual plans on the marketplace, along with the third highest annual deductible for employer-provided insurance among those with single coverage.

Vermont

Insurance Plans in Vermont to Include Hearing Aids in 2024
Deerfield Valley News l Dec. 8, 2022

Beginning in 2024, individual and small group health plans across Vermont will be required to cover the cost of one prescription hearing aid every three years and annual auditory exams, reports the Deerfield Valley News. The addition of hearing aids in Vermont’s’ essential health benefits is anticipated to improve quality of life, decrease preventable injuries and improve access to affordable hearing aids across the state. The new essential health benefits are expected to lower the out-of-pocket costs for hearing aids by thousands of dollars.

Vermont Regulators Unanimously Approve Extension of All-Payer Health Reform Contract
By Kristen Fountain l Vermont Digger l Nov. 28, 2022

The Green Mountain Care Board unanimously approved an extension of the existing all-payer health reform contract, reports the Vermont Digger. The prevailing contract is an effort to move to value-based care in the state; it requires that the state engage in parallel payment reform agreements with Medicaid and commercial insurance providers, provides incentives for meeting program goals and allows participating providers to waive certain Medicare requirements for telehealth. The initial arrangement was originally slated to expire in 2022 but the extension will allow the state to continue the project through Dec. 31, 2023, with a transition period ending on Dec. 31, 2024. Language included in the extension agreement will also allow CMS evaluators to include the pandemic as an exogenous factor when assessing performance on financial and quality targets.

Wisconsin

Wisconsin Study Aims to Lower Healthcare Costs Through Price Transparency
By Anthony Dabruzzi l Spectrum News 1 l Nov. 21, 2022

Wisconsin’s hospital prices are the fourth highest in the nation, according to a study from the RAND Corporation, but a new study from the Wisconsin Institute for Law & Liberty has some recommendations to combat this, reports Spectrum News 1. Recommendations focus on price transparency reforms, including the creation of one state-run central website where healthcare providers and insurance companies list their prices, so that consumers can know their out-of-pocket cost before getting a procedure. The report notes that, because the cost of similar procedures varies widely around the state, shopping around is important for consumers. The study notes that low compliance with recent federal price transparency requirements has made this information difficult for consumers to find, making additional state action crucial to its success.

Multi-State

Healthcare Access in the Heartland
By Darren Chapman, et al. | Heartland Forward | Dec. 7, 2022

County health data, focus groups and expert interviews highlight rural healthcare access issues, according to new research from Heartland Forward. Some of the findings of the report include complexity of insurance and payment systems limiting access to care and the services provided, and many providers have adopted multiple modes of telehealth care to adapt to access strains. The authors recommend increasing price transparency, lowering barriers to telehealth usage and policy changes to increase medical workforce in rural areas.

 

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