State Policy Hub (1st ed.)
April 2, 2019
Welcome to State Policy Hub, the Wynne Health Group’s biweekly brief of state policy developments for federal affairs professionals. Every two weeks, WHG will provide updates on policy developments in six core states and others that reflect national trends of interest to Washington.
For this edition, the past two weeks have seen significant activity relating to Medicaid expansion, drug pricing, abortion, opioids, and medical marijuana. Tennessee is trying to become the first state to fund Medicaid through a block grant and Mississippi passed the nation’s first “heartbeat bill” prohibiting abortions once a fetal heart beat is detectable, which will likely encounter legal challenges.
San Francisco Proposes First Ban on the Sale of E-Cigarette Products
Wednesday, March 20
The two-part ban would prohibit the sale of all e-cigarette products that have not undergone the FDA approval process and prevents manufacturers from renting city property. Currently no e-cigarette products on the market have FDA approval. Advocates worry that these products, ostensibly intended for adults seeking to quit smoking, have been marketed for youth-use through the use of flavors.
Senate Committee Approves Bill to Import Drugs from Canada
Tuesday, March 19
The legislation would require the state’s Department of Health Care Policy and Financing to identify a list of drugs that will generate cost savings from importation and sort out operational issues, such as identification of a wholesaler to manage the supply chain. Governor Jared Polis (D) supports the measure. Importation of drugs from foreign markets requires Federal approval, however, and no state has secured such approval yet.
Governor Polis Signs Hospital Transparency Bill
Thursday, March 28
The new law requires hospitals to make more of their financial and pricing information available to the public. Its intent is to allow policymakers to differentiate among hospitals in different parts of the states, initiate new strategies to control costs, and track whether savings generated by system reform are passed on to consumers.
Florida Launches Pilot Program to Expand Medicaid to the Homeless
Monday, April 1
CMS has granted $750,000 to central Florida agencies like the Central Florida Commission on the Homeless to help families and individuals find stable housing and address primary and behavioral health needs. The program intends to help the homeless get access to primary care providers, rather than relying on emergency services, and will serve 300 individuals in central Florida.
Governor Cuomo Drops Proposed Legalized Marijuana Revenue from State Budget
Wednesday, March 20
Governor Cuomo had proposed legalizing marijuana in order to generate tax revenue to offset the current budget deficit of $3 billion but he was unable to reach a resolution with lawmakers. He has replaced the proposal with a pied-á-terre tax and revenue will be dedicated to improving the Metropolitan Transportation Authority.
Medicaid Block Grant Proposed in New Health Care Finance Bill
Thursday, March 28
Tennessee lawmakers proposed major changes to the way in which the state finances its Medicaid program, TennCare, which provides health insurance to twenty percent of state residents. TennCare also funds subsidies for hospitals, nursing homes, neonatal intensive care units, and the Department of Children’s Services.
Lawmakers Debate ‘Heartbeat’ Abortion Bill
Saturday, March 23
Tennessee lawmakers have been considering a ‘heartbeat bill,’ similar to one recently adopted by Mississippi, that would prohibit abortions once a fetal heartbeat is detected. Lt. Gov. Randy McNally is concerned such a law would be struck down by the Supreme Court and favors a straight abortion ban if the Court overturns Roe v. Wade. The ‘heartbeat bill’ has currently passed through the House but has not been taken up in committee in the Senate.
Texas Advocates Seek to Renew Section 1115 Waiver for Safety Net Services for the Uninsured
Friday, March 15
Physicians, hospitals and patient advocates are urging Texas lawmakers to renew the state’s Section 1115 waiver before funding expires in 2021. The current funding goes toward reimbursing uncompensated care at hospitals and to “innovative health care projects” that serve the uninsured in Texas. Advocates hope that lawmakers begin the renewal of the waiver immediately to ensure that safety net services do not lapse.
Texas Lt. Gov. Opposes Expansion of Medical Cannabis
Tuesday, March 19
Sale of medical cannabis with low levels of THC is currently permitted under compassionate use policies for patients with severe epilepsy. A variety of bills, which many legislators support, have been introduced to expand access, including by raising the cap on THC levels and the eligible patient population. State Lieutenant Governor Dan Patrick (R), who presides over the state Senate, is skeptical of such measures and intends to block them.
Georgia Moves to Expand Medicaid
Wednesday, March 27
The bill authorizes a waiver under section 1115 and 1332 to expand coverage to approximately 240,000 residents within the state with incomes up to the federal poverty line. Republican Governor Brian Kemp strongly advocated for the expansion.
Utah Medicaid Expansion Approved by CMS
Friday, March 29
By expanding coverage to those up to 100 percent of the Federal Poverty Level, the state’s section 1115 waiver reflects a “partial expansion” of what was initially contemplated by the ACA. The waiver also includes a work requirement. The Utah waiver deviates from the broader expansion initially approved by Utah residents via referendum.
Louisiana Cuts Deal with Gilead for “Subscription” to Hep-C Drug
Tuesday, March 26
Per an agreement signed by the company with the state’s departments of Health and Corrections, Louisiana will have unrestricted access to the antiviral medication for five years in exchange for a fixed fee.
Mississippi Governor Signs ‘Heartbeat Bill’ in to Law
Friday, March 22
The new law would prohibit women from obtaining an abortion once the fetus has a detectable heartbeat, which typically occurs at about six weeks. Opponents of the bill argue that a heartbeat is often present before women know that they are pregnant and plan to file a lawsuit against the measure. 11 other states have introduced similar ‘heartbeat bills’ this year aimed at challenging Roe v. Wade.
Delaware Department of Public Health Launches App with Directions to Reverse Opioid Overdose
Wednesday, March 13
The new smartphone app, OpiRescue, provides instructions on how to administer naloxone in the event of an opioid overdose. The Delaware state funded app also provides information on signs of an overdose as well as prevention, treatment, and recovery resources.
Minnesota House Passes Bill to Levy Fee on Manufacturers to Address Opioid Epidemic
Monday, March 18
The state’s Democrat-controlled House approved a measure to raise $20 million annually for an array of programs from public education to treatment and recovery support. The fee would be levied on manufacturers and wholesalers that sell or distribute opioids in the state.
New Jersey Moving Towards State-Based Health Care Exchange
Monday, March 25
Governor Phil Murphy announced that New Jersey will transition from the federal government online marketplace, Healthcare.gov, to their own state-based exchange for the fall 2020 enrollment period. Governor Murphy has also signed a state mandate and reinsurance program in to law to further strengthen the force of the Affordable Care Act in New Jersey.