State Policy Hub (2nd ed.)

April 16, 2019

CALIFORNIA, COLORADO, FLORIDA, NEW YORK, TENNESSEE, TEXAS, OTHER STATES

This is the 2nd edition of State Policy Hub, the Wynne Health Group’s biweekly brief of state policy developments for federal affairs professionals. Every two weeks, WHG provides topline analysis of policy developments in six core states as well as others that reflect national trends of interest to Washington.

These past two weeks have featured several states taking steps to ensure timely access to medication assisted treatment (MAT) for opioid addiction and considering bills to lower the price of prescription drugs. Additionally, Maryland could become the first state to halt participation in the Title X program and Washington and Colorado considered adding public options to their state Exchanges.

 

CALIFORNIA

California Republican Lawmaker Supports State-Based Drug Negotiator Agency

Friday, April 12

State Senator Jeff Stone suggested that California create a state agency to directly negotiate drug prices with manufacturers. The measure would replace private pharmacy benefit managers (PBMs), which have come under scrutiny during the drug pricing debate.

COLORADO

Colorado Lawmaker Pulls ‘Public Option’ Proposal 

Tuesday, April 2

The proposed pilot program would have allowed 100 residents to buy into the state employee health insurance plan to test the possibility of a state-wide public option. Ultimately, the pilot was killed due to concerns it would attract patients with heightened medical needs and present high premiums for those without subsidies. Colorado lawmakers are still interested in pursuing a state-wide public option but have not yet resolved the details.

Colorado Lawmakers Pass Amendment to Revise Funding for State Reinsurance Program 

Monday, April 8

The previous draft of the bill paid for the reinsurance program with savings generated by capping hospital reimbursement. The new version will hold hospitals responsible for fees of up to $150 million per year to fund the program. Bill sponsor, Rep. Julie McCluskie, favors the new funding approach because it is more likely to be approved by the Trump Administration. The change also neutralized hospital opposition to the bill.

FLORIDA

Florida Launches Task Force on Opioid Crisis 

Tuesday, April 2

Governor DeSantis announced the reinstatement of the Florida Office of Drug Control and a drug abuse task force intended to combat the state’s opioid crisis.  The Office of Drug Control will coordinate existing state and federal resources for the prevention and treatment of opioid addiction. Governor DeSantis also announced an additional $26 million in federal funding for the epidemic.

Florida House Approves Drug Importation Program

Tuesday, April 2

The bill would allow for the importation of high-cost drugs from Canada. Proponents of the bill have touted the fact that thirty Canadian drug manufacturers are registered with the FDA and that Canadian drug safety standards are comparable to those in the U.S.

NEW YORK

New York State Assembly Passes Bill Removing Prior Authorization for Opioid Treatments

Wednesday, April 10

 The bill would prohibit insurance companies from requiring prior authorization for buprenorphine, methadone, injectable naltrexone, and other drugs used to combat substance-use disorders.  Supporters say the measure will improve access to medication-assisted treatment for those with opioid addiction.

TENNESSEE

Tennessee Disenrolled 128,000 Children from State Medicaid Program Over Past Two Years

Tuesday, April 2

State officials said these reductions are due to children that no longer qualify or families not responding to mandatory renewal forms. Physicians worry that some families are unaware of the lapse in coverage. TennCare spokeswoman, Kelly Gunderson, said the changes in enrollment represent normal Medicaid churn.

TEXAS

Texas Considers Reducing Support for Rural Hospitals

Tuesday, April 9

Texas relies on property taxes to supplemental federal funding for rural hospital payments. Due to Texas opting out of the Medicaid expansion and expiration of a recent demonstration program, hospitals claim that their support for providing care to the uninsured has been sharply reduced. Texas lawmakers are considering property tax caps that would further reduce payments to hospitals, especially those in rural areas.

Texas Lawmakers Propose Nursing Home Reforms 

Monday, April 15

The proposals aim to improve the quality of nursing home care, an area where providers in Texas have lagged significantly in standardized metrics. They include specific strategies such as limiting antipsychotics and improving hiring practices. The reform efforts come after the Trump Administration has recently relaxed oversight of nursing homes.

OTHER STATES

Washington Close to Passing Public Option

Monday, April 15

The proposed public option would include plan benefits determined by the state and then offered through private companies. The state plan would be offered a discount for qualified residents and state officials plan to expand state subsidies for private insurance to the middle class. The bill has passed the House and the Senate has until Wednesday, April 17 to approve the House version.

 Idaho Expands Medicaid with Work Requirement

Tuesday, April 9

The law requires the Medicaid expansion population to participate in twenty hours per week of work, service, or study in order to retain their eligibility. Additionally, it would allow the Medicaid population that earns 100 to 138 percent of the federal poverty level to purchase subsidized health insurance from the individual market.

CMS Approves Utah Medicaid Work Requirements

Friday, April 12

Utah’s new Medicaid program would scale back the enrollment expansion approved by voters last November by 60,000 individuals and impose new work requirements. The program also allows for an enrollment cap if funding runs out.

Maryland Passes Prescription Drug Affordability Board Legislation 

Monday, April 15

The bill, which still awaits signature by the Governor, would create new body to review drugs whose prices have increased beyond a specified threshold. The board would make recommendations to state policymakers to address price increases deemed unreasonable, but would not have independent authority to set prices in the state.

New Jersey Medicaid Program Removes Prior Authorization for Medication-Assisted Treatment

Monday, April 8

The removal of the prior authorization barrier for Medicaid beneficiaries with opioid addiction would allow for more timely access to medication-assisted treatment (MAT). The step is part of Governor Phil Murphy’s plan to combat the opioid crisis in New Jersey through increased treatment options and prevention efforts.

Maryland Legislature Passes Bill to Become First State to Halt Participation in Title X

Wednesday, April 3

 Under the Trump Administration proposed rule, federal family planning funds, known as Title X, may be used for abortion referrals. The Maryland measure would prohibit the state’s health department from accepting the federal funds if it is conditioned on this “gag rule.” The bill has been sent to Governor Larry Hogan for signature.

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