State News

Michigan will allow pregnant women and children with green cards to access state-sponsored
insurance without a 5-year wait, reports CBS Detroit. Pregnant women and children with green
cards will now be able to access Medicaid as well as ACA Marketplace subsidies. The change
is slated to start October 1, 2023, and will impact roughly 3,000 people in Michigan.

The Massachusetts Health Connector approved a two-year pilot program expanding income
eligibility limits to 500 percent of the federal poverty level, up from 300 percent, according to the
Massachusetts Health Connector. This expansion is estimated to impact over 50,000 people.
This change comes after the 2024 state budget was signed, which included the income limit
expansion and requiring all Marketplace carriers to participate in the program.

Pennsylvania survey respondents support government interventions in prescription drug pricing,
according to Families USA. The survey found that 87 percent of respondents support the
Pennsylvania state government making prescription drugs more affordable, and 83 percent of
all respondents supporting the creation of a Prescription Drug Affordability Board, including 75
percent of Republicans. 94 percent of Democrats, and 70 percent of unaffiliated respondents.

Illinois has passed hospital antitrust legislation monitoring mergers and acquisitions, according
to Becker's ASC Review. Health care providers will now be required to notify the state attorney
general of proposed mergers acquisitions or contracting affiliations. Notification of such
transactions is one tool states can use to monitor and highlight mergers and acquisitions that
may result in increased prices for patients. Failing to provide proper notice will result in a penalty
of up to $500 per day.

Illinois will offer a discount program that will allow diabetics to buy insulin for $35 per month at a
post-rebate price, according to WAND. House Bills 2189 is intended to build on previous
legislation that capped insulin prices for only about 15 percent of the population through
insurance for state employees. Starting in 2025, program participants will be able to get official
cards from the state with information about how to request reimbursement from their health
insurance and how pharmacies will honor the discount. The state also passed House Bill 3639
which caps EpiPens at $60 per two-pack, however this is not a discount program and the cap
may only apply to state-regulated plans.

The 2020 Maternal Mortality in Missouri report revealed an increase in maternal mortality rates,
with 32 people dying per 100,000 live births, up from about 25 per 100,000 from 2017 to 2019,
according to St. Louis Public Radio. The leading causes of death in Missouri’s pregnant and
postpartum women were overdoses, suicides, and other mental health problems. Most new
mothers died between 43 days and one year after they gave birth, with the highest rate of
mortality was among women who had a Medicaid-covered pregnancy. The report examined
deaths between 2018 and 2020, prior to the state expanding postpartum Medicaid coverage – in
2023, the state legislature voted to extend Medicaid coverage for new mothers up to twelve
months following birth, a move providers hope will result in fewer postpartum deaths.

Illinois has passed a law prohibiting price gouging of certain prescription medications, reported by the Office of Senator Koehler. Effective January, 2024, House Bill 3957 prohibits manufacturers and distributors from engaging in price gouging of essential off-patent and generic medication, making Illinois the first state in the country to do so.

New York and Connecticut have recently enacted and expanded laws regulating facility fee
billing, reports Mintz. The regulations in New York, effective June 21, adopted patient notice
requirements and made New York the first state to place an outright ban on facility fees related
to preventative care. The Connecticut legislation, which goes into effect July 1, 2024, will
expand existing oversight of facility fee billing by prohibiting hospitals and health systems from
collecting facility fees for outpatient health care services provided on a hospital campus.

New Jersey Governor Phil Murphy signed three bills into law designed to lower prescription drug
costs in the state, reports New Jersey Business Magazine. The legislation includes establishes
a Drug Affordability Council to create prescription drug affordability policy reforms and requires
drug manufacturers to report pricing data to the state. Another bill, S3240, caps out-of-pocket
costs for insulin at $50 per month and requires insurers to cover certain diabetes medications. A
third bill, S3241, increases oversight of pharmacy benefit managers and requires them to
disclose certain pricing information.