July 9, 2019

Welcome to the 8^th edition of State Policy Hub. The past two weeks have featured several states taking action to reform their state Medicaid programs, with Georgia proposing to partially expand benefits and New Hampshire walking back their Medicaid work requirements until 2021. Additionally, the Centers for Medicare and Medicaid Services (CMS) approved Louisiana’s “Netflix Model” drug pricing program and Maine enacted a drug pricing reform package that includes requirements for pharmacy benefit managers (PBMs).

 

MEDICAID

Georgia Looks to Expand Medicaid

Tuesday, May 25

Georgia state officials are preparing a Medicaid waiver that would expand Medicaid benefits to low-income individuals below the federal poverty line. Georgia is one of the remaining eight states that has not expanded Medicaid since the Affordable Care Act (ACA) was passed. This expansion is supported by Republican governors who do not want to accept full ACA Medicaid expansion.

 

New York Governor Proposes Budget Cuts to Medicaid Program

Wednesday, May 26

Gov. Andrew Cuomo (D) is proposing to cut funds for the state’s Consumer Directed Personal Assistance Program, which serves as an intermediary between older Americans and their personal aides. Gov. Cuomo’s proposed cuts would authorize 60 intermediaries, a 90 percent reduction in the number of current intermediaries. Legislators are urging Gov. Cuomo to delay the cuts to explore the full effects.

 

Alaska Governor Makes Cuts to Medicaid Budget

Monday, July 1

Gov. Mike Dunleavy (R) vetoed approximately $58 million from the proposed Medicaid budget, which includes adult preventive dental services.  Gov. Dunleavy cited a need to balance the budget and additionally made cuts to higher education and the state’s senior benefit program.

 

New Hampshire Rolls Back Medicaid Work Requirements

Monday, July 8

Gov. Chris Sununu (R) signed legislation that would allow state officials to waive the state’s Medicaid work requirements until July 2021. New Hampshire becomes the first Republican-led state to walk back the implementation of work requirements for fear of disenrolling many residents who are unaware of the requirement.

 

INSURANCE REFORM

Georgia Considers Filing Section 1332 Waiver

Tuesday, May 25

Lt. Gov. Geoff Duncan (R) stated that the state is preparing a section 1332 waiver that would include a premium stabilization program and allow patients to enter into direct primary care arrangements. The waiver would create an “invisible” high-risk pool to subsidize high-cost individuals in the state’s insurance marketplace by spreading the cost of the sick. The direct primary care program would allow marketplace customers to enter into contracts with primary care providers.

 

North Carolina Hospital Pricing Effort Faces Pushback

Wednesday, July 3

The North Carolina state Treasurer, Dale Folwell, proposed requiring all providers participating in the state employee health plan to accept Medicare payment rates next year. Many physicians have agreed to the proposal, but no major hospital system has signed on due to the lower reimbursement rate.

 

DRUG PRICING

CMS Approves Louisiana ‘Netflix Model’ Arrangement with Gilead

Wednesday, May 26

The Centers for Medicare and Medicaid (CMS) approved Louisiana’s state plan amendment that will allow the state to negotiate supplemental drug rebate agreements with manufacturers. Gov. John Bel Edwards (D) announced that the Louisiana Health Department has reached an agreement with Gilead Sciences to pay a fixed amount to the company for an unlimited supply of Hepatitis C medication.

 

Maine Enacts Comprehensive Drug Pricing Package

Tuesday, July 2

Gov. Janet Mills (D) signed that package into law that includes four laws aimed at curbing drug prices. The package includes stricter requirements for pharmacy benefit managers (PBMs), updates to the drug price transparency program, the development of drug affordability review board, and the pursuit of drug importation.

 

OPIOID EPIDEMIC

New Jersey Becomes First State to Treat Addiction at the Scene of an Overdose

Wednesday, June 26

The New Jersey Health Commissioner authorized paramedics to administer buprenorphine almost immediately following treating an individual with naloxone for an overdose. Buprenorphine is commonly used in medication assisted treatment, and health officials states that this model can serve as an immediate transition to longer-term treatment.