State News

Washington | Apr 27, 2023 | News Story | Health Costs

Washington Passes Law Prohibiting Cost-Sharing for Abortion Services

Washington has passed a law eliminating cost-sharing for abortions for state-regulated health plans, reports The Seattle Times. However, this does not apply to private, employer-sponsored health insurance plans, on which a majority of residents rely on for coverage.

Delaware | Apr 24, 2023 | Report | Health Costs

Office of Value-Based Health Care Delivery Issues Annual Progress Report

Delaware's Office of Value-Based Health Care Delivery has issued the annual progress report, available on the Insurance Commissioner of the State of Delaware’s website. The report concentrates on the implementation of value-based care in the state, which aims to shift the focus from the quantity of care to the quality of care provided, ultimately reducing costs for patients.

Colorado | Apr 21, 2023 | Report | Health Costs

Colorado Eliminates Co-Pays for Medicaid

Colorado Governor Jared Polis signed legislation eliminating co-pays for pharmacy and other health care services for Colorado’s Medicaid program, reports State of Reform. Colorado residents with Medicaid coverage will have services such as hospital services, physician services, and prescription drugs covered without any cost-sharing, beginning in July. Additionally, the legislation will enable the state to pay providers more and access additional federal funding to make up the difference from the lost co-pay revenue.

North Dakota | Apr 17, 2023 | Report | Drug Costs

North Dakota Passes Insulin Cost Cap for State Employees

North Dakota has passed a new law capping the cost of insulin for state employees, reports AARP. The law caps the out-of-pocket cost for a 30-day supply of insulin, as well as copayments for diabetic supplies, at $25 per month for employees covered by the state’s Public Employees Retirement System. The high cost of insulin has been a significant financial burden for many diabetes patients in the state, where the average price of insulin tripled between 2002 and 2013.

New Mexico | Apr 8, 2023 | News Story | Drug Costs

New Mexico Limits Cost Sharing Contributions for Prescription Drugs

New Mexico has passed a law to reduce consumer prescription drug costs, according to the Los Alamos Daily Post. Senate Bill 51 stipulates that insurers must apply any discounts enrollees
receive to their cost-sharing obligation for prescription drugs, ensuring that pharmacies pass on discounts to consumers.

Colorado | Apr 6, 2023 | Blog | APCD Equity

Health Equity Analysis Shows Social Factors Strongly Related to Emergency Department Visits

A health equity analysis of data from Colorado’s APCD found that social factors such as income, housing, race, and education are strongly associated with potentially preventable visits to the emergency department, according to the Center for Improving Value in Health Care. In urban areas, all five social factors evaluated (income, education, employment, housing/transportation, and race/ethnicity/language) were all strongly correlated to greater preventable emergency department visits and adults not receiving preventive care. However, in rural areas, only income and education levels impacted potentially preventable emergency visits and only income levels influenced adults not getting preventive care. Statewide, the social factors analyzed did not show an impact on children and adolescents receiving preventive health care.

South Carolina | Apr 5, 2023 | News Story | Health Costs

South Carolina Repeals Tax on Women’s Health Products

South Carolina policymakers passed legislation exempting feminine hygiene products from sales tax, reports The Hill. Approximately 200,000 women in South Carolina are impacted by period poverty, and the repeal of the tax aims to improve health care affordability and access for women across the state by reducing the financial burden of menstrual products.

Connecticut | Apr 3, 2023 | News Story | Health Costs

Connecticut Health Care Spending Outpaces Economic Growth, Exceeds Cost Growth Benchmark

Health care spending in Connecticut has eclipsed economic growth in recent years, according to Connecticut Public Radio. Spending increased 6 percent between 2020 and 2021, which exceeded the state benchmark target of 3.4 percent, and was driven primarily by increases in commercial health insurance spending.

New York | Apr 1, 2023 | Report | Affordability

The Basic Health Program: Considerations for States and Lessons from New York and Minnesota

The basic health program (BHP) in New York and Minnesota succeeded in helping low-income consumers access affordable care and reducing administrative complexity, but those results may not be replicable in other states, based on state-specific factors such as regulation and provider reimbursement, according to a report from the Urban Institute. While only two states implemented a BHP after the ACA was enacted, several states have recently begun considering their own programs: Oregon, Kentucky, Illinois, and West Virginia. However, the fiscal impact of a BHP can vary based on the coverage provided, Marketplace premiums, and provider reimbursement rates. One factor in New York’s success has been the state’s ban on age rating in the individual market. New York and Minnesota both reported stable markets with many insurers participating in their BHP, but it is difficult to predict how insurers in other states will react.

Oregon | Mar 27, 2023 | Report | Health Costs

Oregon Saves Millions Using Reference-Based Pricing

Oregon established Medicare reference-based pricing for hospitals for its state employee health plans in 2017, and a 2021 audit found over $112 million in savings, reports NASHP. Payments for in-network and out-of-network services are not to exceed 200 and 185 percent of Medicare reimbursements, respectively; average reimbursements went from 215 percent of Medicare reimbursement amounts prior to the legislation’s enactment in 2017, to 163 percent in 2021.