When a health consumer receives care outside of an insurer’s network of providers, he or she may receive a surprisingly high medical bill, and face the prospects of paying unexpectedly high out-of-pocket costs.
These situations are not uncommon, and often not the fault of the health consumer — for example, he or she requires immediate emergency care, or an out-of-network provider is part of a larger team of physicians providing complex medical treatment.
As evidenced in recent polling data and new state laws, “surprise billing” has become a widespread concern among health care consumers and policymakers alike. In a poll conducted last year by the Kaiser Family Foundation, two-thirds of Americans said they were either “very worried” or “somewhat worried” about being able to afford their own or a family member’s unexpected medical bills.
The Commonwealth Fund, meanwhile, has been tracking the spread of laws to protect individuals from certain types of “surprise billing.” By the end of 2018, the number of states with such laws had reached 25: nine with comprehensive laws (including Illinois in the Midwest) and 16 with “partial protections” (including Indiana, Iowa and Minnesota).
Iowa legislators have created a first-of-its-kind system to better meet the mental health needs of children. As part of HF 690, signed into law in May, an appointed state board will be created to oversee this new comprehensive, coordinated system.
Members of the board will include a mix of state executive branch leaders (in health and education), experts in child welfare and mental health, local school leaders, pediatricians and law enforcement. Legislators will serve on the board as non-voting members. Iowa’s new law also spells out the types of “core services” that the system must deliver to children. That list of services includes: early intervention, medication management, outpatient therapy, access to a 24-hour crisis helpline, mobile response teams, and the availability of community-based and residential services to stabilize behavioral health crises in children.
A U.S. Army Corps of Engineers plan to keep Asian carp from reaching the Great Lakes has an important new supporter — J.B. Pritzker, the recently elected governor of Illinois. In an April letter to the Corps, Pritzker said the state was “willing to move forward to preconstruction, engineering and design” on the Brandon Road Lock and Dam Project. But he also expressed concern about the estimated price tag: $778 million.
Turnout rates among younger voters jumped in 2018, though they still lag other age cohorts. States, meanwhile, have a mix of new laws and programs to encourage voting among young people and to remove potential obstacles.
Starting in 2021, North Dakota and Wisconsin will be the only two Midwestern states with chief state school officers elected by voters. Indiana legislators accelerated their state’s switch in governance structure with this year’s HB 1005, which replaces the position of school superintendent in two years with a governor-appointed secretary of education. (The change had been scheduled to take effect in 2025.)
Every state in this region funds a loan forgiveness program to assist certain individuals with their college debts. These programs most commonly target help for graduates entering a specific profession such as education or health care.
A nine-year-old constitutional dispute in Kansas over how, and how much, the state spends on its schools may finally be coming to an end. In early April, Gov. Laura Kelly signed SB 16, which provides Kansas public schools with an additional $90 million a year.
This year, Nebraska Sen. Julie Slama took a lead role in updating her state’s 70-year-old law on civics education. She had some experience from the not-so-distant past to guide that work — the time she spent as a student herself. The 23-year-old senator (one of the youngest people ever to serve in the Unicameral Legislature) still fondly recalls those civics classes and how her teachers approached lessons on government and citizenship.
“It wasn’t about memorization of dates and [historical] figures,” Slama says. “It was about the role of being a citizen, about discussing the issues of the day. From that, you learn that people can come to different conclusions about those issues, that disagreement is part of the process. And you learn to engage respectfully.”
But are most young people being exposed to a rich, meaningful civics curriculum?
Slama worries that many are not, based on her more recent experiences working with students as a track coach and as a counselor for the American Legion Auxiliary’s Girls State. Too many young people, she says, don’t know basic facts, such as the three branches of government, and aren’t equipped with the skills to be informed, active citizens.
She’s hoping this year’s passage of LB 399 will strengthen the curriculum offered in Nebraska schools. Her work on the bill reflects a national trend; across the country, state legislators have been exploring ways to put a greater emphasis on civics in schools, and to perhaps teach it in a different way.
In April, Indiana submitted to the federal government its list of subject areas in education that have a statewide shortage of teachers. The list was long (close to 15 subject areas) and varied, from a dearth of music and arts teachers, to the need for more people to teach special education, math and science, and English.
“Sadly, ‘Indiana’ and ‘teacher shortage’ have become synonymous terms,” State Superintendent of Public Instruction Jennifer McCormick said in releasing the state’s most recent analysis of shortages.
Legislators are hoping a series of recently signed bills will help fix the problem, by addressing two oft-cited causes: high turnover and low pay.
Starting in August, North Dakota stores will have the option of being open for business on Sunday mornings, the result of a legislative change this year that repealed the state’s longstanding “blue” laws. HB 1097 was signed in March by Gov. Doug Burgum. He hailed the measure as supporting “freedom, fairness and local control,” as well as a way to help the state’s Main Street businesses compete with online retailers.