New Issue Brief Details How States Are Tackling the Healthcare Affordability Crisis
State Futures and State Health and Value Strategies at Princeton University release new brief documenting state strategies to reduce costs, strengthen financial protections, and close revenue gaps as federal cuts take hold
Washington, DC — June 15 – Even as gas prices soar, healthcare still leads as the top affordability concern for Americans and tops the list of voter priorities heading into this year’s midterm elections. As the congressional budget reconciliation bill turns one year old, states are grappling with new Medicaid work requirements and federal funding cuts projected to strip coverage from 10 million people.
Today, State Futures, in partnership with State Health and Value Strategies at Princeton University, released a new issue brief documenting how state legislators are responding — deploying a range of strategies to reduce healthcare costs, strengthen hospital financial assistance policies, and generate new revenue to offset massive losses in federal funding.
"One-third of adults are delaying or skipping care because they can't afford it, and federal policy changes are about to make that number worse," said Gaby Goldstein, President of State Futures. "State legislators have real tools to drive down costs — from capping what patients pay out of pocket to reining in hospital pricing to building state-funded subsidy programs. This brief lays out what's working and what other states can learn from."
Key state strategies highlighted in the brief include:
Capping out-of-pocket costs: Massachusetts requires insurers to eliminate cost-sharing for one generic drug and cap co-payments at $25 per 30-day supply for one brand-name drug for diabetes, asthma, and certain heart conditions.
Protecting against surprise medical bills: Illinois, New Hampshire, North Dakota, Oregon, and Utah regulate billing for emergency and ambulatory services to protect patients from surprise costs.
Reining in private equity: Oregon restricted management service organizations from owning healthcare entities. California, Massachusetts, and New Mexico have enacted transaction review and disclosure requirements.
Banning outpatient facility fees: Eight states including Connecticut, New York, and Washington have prohibited the hidden fees that hospitals add on top of the cost of care — charges that disproportionately hit uninsured and underinsured patients.
Building state marketplace subsidy programs: Following the expiration of federal enhanced premium tax credits — which resulted in more than 20 million Americans seeing large premium increases — California, Colorado, Connecticut, Maryland, Massachusetts, and New Mexico have created or expanded state-funded subsidy programs to keep coverage affordable.
Generating new revenue to fund state health programs: States are pursuing health insurer fees, individual mandate penalty revenue, and employer assessments. Colorado, Maryland, New Jersey, and New Mexico all use health insurer fees to fund their marketplace subsidy programs; Massachusetts has an employer payroll contribution, and others are exploring “fair share” employer taxes.
A companion brief on state legislative actions to address medical debt was released in May.
Journalists covering healthcare policy, economics, or federal-state dynamics are encouraged to read the brief and reach out for interviews. State Futures can connect press with Princeton collaborators and state policymakers actively pursuing these strategies.
Read the full issue brief: State Legislative Actions to Address Healthcare Affordability
About State Futures: State Futures is a national nonprofit that supports a network of 850+ values-aligned state policymakers, including legislators and State Financial Officers. Through working groups, policy research, and strategic support, State Futures empowers state policymakers to learn from each other, innovate together, and take coordinated action across states.
Media Contact:
Kristen Wilder, Communications
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