On Sept. 21, news that Turing Pharmaceuticals raised the price of a 62-year-old drug by 4,000 percent overnight made headlines. The drug, Daraprim, is critical to the care of HIV and AIDS patients. The sharp rise in price from $18 to $750 per pill is part of the all-too-familiar trend of drug-price spiking in the United States and highlights concerns about the sustainability of health care.

Arizona is asking the federal government to allow it to add work requirements and lifetime eligibility limits for some adults enrolled in Medicaid, Stateline reported today. The request, which is in the form of a Section 1115 waiver request, is required under laws passed by the 2015 Arizona State Legislature. Senate Bill 1475 and Senate Bill 1092 require the governor to submit the waiver but do not link continuation of the current Medicaid expansion to the waiver’s approval. Former Gov. Jan Brewer vetoed nearly identical legislation the year before, the Arizona Daily Star reported in March 2015.

Twenty-two state legislators and one governor's health policy advisor from states gathered in Washington, D.C. on Sept. 21-23, 2015, for a CSG-led Medicaid Leadership Policy Academy. Almost 50 percent of the attendees were chairs or vice-chairs of health committees in their home states. A significant number...

CSG Midwest
New policies in three Midwestern states have the goals of boosting immunization rates among young people and preventing the spread of disease.

As classes resume across the country this fall, the University of Iowa will join nearly 1,100 colleges and universities that have declared their campuses tobacco free. The new policy adds smokeless tobacco, snuff, water pipes and electronic cigarettes—or e-cigarettes—to their list of banned substances on campus, joining cigarette and cigar smoke under the school’s previous policy.

This year’s HIV outbreak in Scott County, Indiana, refocused public attention on HIV and AIDS as an ongoing public health issue. Time magazine featured the Indiana story on its June 15, 2015, cover. About 1.2 million people in the U.S. currently live with HIV, and one in eight (12 percent) of those do not know that they have the virus. Each year 50,000 new cases are diagnosed, a number that has remained steady since the late 1990s, despite significant educational efforts at federal, state and community levels.

State uninsured rates in 2014 ranged from a low of 3.3 percent in Massachusetts to a high of 19.1 percent in Texas. From 2013 to 2014, the uninsured rate fell in all 50 states, with Kentucky seeing the biggest gains - a drop of 5.8 percentage points.

Vermont and at least 16 other states collect health care claims data. In Gobeille v. Liberty Mutual Insurance Company the Supreme Court will decide whether the Employee Retirement Income Security Act (ERISA) preempts Vermont’s all-payers claims database (APCD) law. The State and Local Legal Center (SLLC) filed an amicus brief arguing against ERISA preemption.

ERISA applies to most health insurance plans and requires them to report detailed financial and actuarial information to the Department of Labor (DOL). ERISA preempts state laws if they “relate to” the core functions of an ERISA plan. Vermont’s APCD law seeks the following medical claims data: services provided, charges and payments for services, and demographic information about those covered.  

Two sources of contemporaneous data available from reputable national research institutions provide evidence that the Affordable Care Act has realized its principal goal of increasing the rate of health insurance coverage in the United States. The rates of uninsured Americans between late 2013 and early 2015 have dropped from 18 percent to 11.9 percent, according to Gallup, and from 17.4 to 10.1 percent, according to the Urban Institute. Further, the Gallup data which also provide state-by-state statistics show that the states with the greatest uptake in health insurance were more likely to have increased Medicaid eligibility and to operate state-based health insurance exchanges

While the same-sex marriage and Affordable Care Act cases are the most significant of the U.S. Supreme Court’s 2014–15 term in general and specifically affecting states, other cases will significantly impact states too. The court will decide three tax cases, a Medicaid reimbursement case, two redistricting cases and a Fair Housing disparate impact case.