Last month, the Washington, D.C.- and Minneapolis-based nonprofit… United States of Care (USofCare) He launched his State Legislature Final Report for 2024USofCare’s analysis of the 2024 legislative sessions revealed three trends aimed at addressing the health care affordability crisis: advancing policies that promote hospital accountability, protecting and expanding access to health coverage, and opportunities to innovate and improve health care affordability.
The report said lawmakers view rising hospital prices as the primary driver of the affordability crisis. “State legislatures sought bipartisan solutions to increase hospital accountability by limiting the ability of health systems and hospitals to consolidate, protecting people from the negative impacts of already consolidated systems, and enforcing requirements that certain hospitals give back to the communities they serve.” Both Republican and purple state legislatures were successful with proposals to control hospital prices.
“Oregon’s Health Care Marketplace Oversight program and the Massachusetts Health Policy Commission’s transaction review initiative served as models for other states to follow,” the report states. Oversight of health care transactions allows for review and approval conditions that examine the effect of transactions on consumers.
New York and Tennessee focused on solutions to protect people from consolidated health systems through contractual clauses between health systems and insurance companies.
Sixteen states looked at laws regulating facility fees. According to the report, “A recent poll shows that 74% of voters support limiting or restricting facility fees, while 81% support requiring that facility fees be disclosed to patients in advance before they are served.”
Twenty-six states considered legislation relating to medical debt, including proposals to restrict wage garnishment, limit payment plans and ban medical debt from credit reports.
The report noted that state legislatures expanded eligibility for current health coverage programs to reduce coverage gaps and protect critical health care coverage.
According to the report, “To address the challenges facing undocumented immigrants, several states considered state-funded public insurance.”
Many states also sought to improve maternal health, reduce disparities and enhance coverage for pregnant women by extending postpartum Medicaid coverage. The report highlighted Arkansas as the only state that did not authorize this extension.
The report notes that health care spending in the United States is projected to reach $4.9 trillion by 2024. “Several state legislatures have implemented policies to develop new, low-cost health insurance coverage options to provide individuals and their families with reliable coverage. In addition, state policymakers have explored reforms to make health care more affordable for their residents through solutions that protect individuals from unexpected medical bills and medical debt, set cost-increase targets, and increase prescription drug affordability.”
Some states created their own affordable coverage options. In Colorado, for example, 80,655 people enrolled in the Colorado Public Health Insurance Option. Other states explored flexible policies, such as Medicaid buy-in, to meet the needs of their residents.
According to the report, “Early results from Medicaid redetermination processes have sparked interest among policymakers in finding effective approaches to preserve access to health care for the millions of people who are losing their Medicaid coverage while also addressing the needs of the remaining uninsured and underinsured populations.”
The report cited Vermont as an example of lawmakers considering a proposal for a public option for small businesses. Since small businesses are less likely to offer insurance coverage, a state-backed public option could help reduce coverage gaps and allow businesses to expand their benefits packages.
The report found that one in three adults reported being unable to afford prescription drugs. Many state lawmakers have implemented strategies to reduce costs. Some have created prescription drug affordability boards, set price caps or reformed pharmacy benefit manager (PBM) practices.
USofCare found that voters across all parties overwhelmingly support policies to lower hospital prices and implement transparency in health care billing. The nonprofit hopes policymakers will continue to push for policies focused on equity.
