State News

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.

Colorado’s Prescription Drug Affordability Board (PDAB) has appointed 15 people to the
Prescription Drug Affordability Advisory Council, hosted a five-part learning series, adopted
rules and policies to guide their work, and selected five drugs for affordability review, according
to NASHP. The board has created opportunities for stakeholders to engage and provide
feedback to incorporate consumer voices in its decision-making. In the upcoming year, the
board will continue to review affordability review summary reports and, if a drug is deemed
unaffordable, consider setting an upper payment limit.

Missouri has launched a statewide prescription drug monitoring program, reports the Columbia
Missourian. The program requires pharmacies to document when they dispense prescribed
Schedule II, III, or IV controlled substances to patients and make dispensation information for
such substances available to prescribers, dispensers, and healthcare providers. Prescription
drug monitoring programs are recognized as an effective way to improve patient safety, reduce
low-value care and decrease health care costs related to inappropriate prescribing and drug
related injuries.

Affordable health insurance is a significant concern among South Carolinians, reports ABC 15
News. The 2023 Health Assessment report composed by the South Carolina Department of
Health and Environmental Control and the Alliance for a Healthier South Carolina describes the
top health issues facing South Carolinians, including: access to care; obesity, nutrition, and
physical activity; substance use; and mental health.

New dental insurance regulations are slated to take effect in Massachusetts at the start of the
new year, 14 months after the measure was approved by voters, reports WCVB. The
regulations require insurers to provide refunds to members if the insurer spends less than 83
percent of premiums on members’ expenses. Insurers will also be required to file base rates
and rating factors, which will be subject to approval by the insurance commissioner.

A study shows that Black women in Mississippi were four times more likely to die of pregnancy-
related causes than white women in 2020, reports WLBT3. Published by the State Department
of Health's Maternal Mortality Review Committee, the report found that the rate of pregnancy-
related deaths among Black non-Hispanic women was 63 percent, compared to 15 percent for
white non-Hispanic women. The overall state mortality rate was 35.2 deaths per 1,000 live
births, 80 percent of which were preventable. The report noted that a substantial portion of care
is provided by smaller hospitals with limited resources, many facing closures and limiting or
discontinuing obstetrical services, further increasing burdens for these communities.

Starting in 2024, Illinois hospitals will be required to screen uninsured and underinsured patients
for public health insurance coverage and hospital financial assistance eligibility before pursuing
any collection action, according to JD Supra. The Protect Illinoisans from Unfair Medical Debt
bill is intended to protect patients against medical debt and reduce hospital debt as well. The bill
also requires that hospitals document when and why uninsured patients decline screening.

A preliminary report to Washington State legislators outlines the current state of Washington’s
health care system, including recent market consolidation and a process for evaluating changes
that could improve affordability, published by the Office of the Insurance Commissioner. The
report highlights that the cost of care is driven by both rates of utilization and the price of
services, and efforts by private employers and the state to reduce health care costs.

Ambulance passengers in Washington face high costs for ambulance rides despite having no
choice about the service, reports The Columbian. The federal No Surprises Act, which prohibits
balance billing for services in other areas of the health care sector including air ambulances,
does not protect against surprise bills for ground ambulances. The report from the Office of the
Insurance Commissioner states that, on average, patients are responsible for more than $500 in
payment for emergency visits and more than $1,000 for non-emergency visits. The report
examines protections enacted by other states and issues policy recommendations for future
legislation to address the issue.