State News

In fiscal year 2022, Indian Health Service programs deferred or denied nearly $552 million for
120,000 care requests, reports the Daily Montanan. In turn, many indigenous patients have
been forced to forgo necessary care, increasing the risk of death or serious illness for people
with preventable or treatable medical conditions. Eligibility limitations tied to tribal lands restrict
access to care.
 

Thirteen percent of working-age households in Connecticut were unable to afford health care
costs in 2022, reports The Hartford Business Journal. The recently updated Connecticut
Health Affordability Index shows that 13.8% of employer-insured households and 27.8% of
those with individual market plans faced affordability issues that year, with nearly 70% of
Medicaid-eligible households unable to cover basic needs. Premium tax credits from the ARPA
had eased costs, but rising expenses and the credit's upcoming expiration date may contribute
to future cost burdens.

A new Missouri Senate committee is reviewing ways to lower health care costs,
reports Missourinet. The committee will cover a variety of health care issues related to
hospitals, pharmacies, insurance companies, drug makers and other healthcare providers.
Additionally, the committee aims to address coverage challenges for rural farmers and other
populations navigating excessive health care costs and is required to issue a report on findings
and recommendations by the end of the year.

Ohio Capital Journal highlights research from the Health Policy Institute of Ohio which finds
that rural and Appalachian Ohioans are challenged when it comes to accessing health care
services, including a lack of broadband to a lack of access to transportation. The report finds
that nearly one-fifth of households in rural Appalachia had no access to the internet from 2018-
2022, and that these residents were more likely to live in zero-vehicle households.
 

“Kentucky’s health insurance marketplace has been effective at providing affordable coverage
options on a consistent basis” according to an analysis at KyPolicy, Kentucky Center for
Economic Policy. Premium amounts have stayed relatively stable over the last ten years,
individual marketplace signups have remained stable, and the recent improved federal
subsidies have further lowered coverage costs. However, this analysis argues it remains very
expensive to use the coverage, with the out-of-pocket costs contributing to making using
health coverage unaffordable.

Massachusetts passed a new maternal health law aiming to improve birthing outcomes, reports
WPRI. The law provides pathways to doula and lactation consultant certification, increases
access to postpartum depression screening, and removes barriers to opening birthing centers.
Despite 98 percent of Massachusetts residents having health insurance, and despite the state
recently being named the best state in the country for women, the rate of severe maternal
morbidity almost doubled over the last decade. This is especially true for women of color, as
black women have astronomically higher rates of complications. This law looks to address this
inequity by providing access to services more often used by people of color, such as doula and
midwife care.

A new report finds the ConnectorCare pilot expansion enabled access to lower-cost health
insurance to over 51,000 Massachusetts residents and many new participants benefit from the
program’s financial protections, according to the Massachusetts Health Connector. The pilot
expansion is available to residents for calendar years 2024 and 2025 and lifted income eligibility
limits to the program from 300 percent to 500 percent of the federal poverty level. The report
details an increase in member cost savings and member utilization of their coverage.

Connecticut is expanding a program that subsidizes health care costs for paraeducators, reports
WSHU. The program was signed into law last year and initially funded with $5 million as part of
the 2023-2024 budget. With an additional $10 million allocated, the program aims to support
more educators, addressing the financial burden of health care costs and helping to mitigate the
state's paraeducator shortage. This expansion is part of broader efforts to attract and retain
essential educational staff.

An Oregon policy capping maximum hospital payments appeared to reduce patients’ out-of-
pocket spending, though its state health plan’s savings were fettered by a resulting increase in
utilization, reports Fierce Healthcare. Starting in October 2019, a state law applying to 24 of
Oregon’s largest hospitals and members of the Oregon State Employee plan began restricting
in-network hospital prices to 200 percent of Medicare and out-of-network prices at 185 percent.
Researchers found that plan members’ average out-of-pocket spending per outpatient
procedure dropped by 9.5 percent compared to control during the 27-month post-
implementation study period, and a 4.8 percent increase in outpatient procedures per enrollee
per year. the researchers estimated $1.8 million in out-of-pocket savings for the plan members
associated with 27 months of the price cap policy (or about $800,000 annually). The increase in
utilization led to lost plan savings of $10.3 million over 27 months ($4.6 million annually)—
though, even with the service use increases, the price cap generated tens of millions in annual
plan savings.