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...

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.

On Tuesday, the Legislative Council, which handles budget and business when the full legislature is not in session, voted 10-1 to file a lawsuit against Gov. Bill Walker over his unilateral executive action to expand Medicaid eligibility, according to the Alaska Dispatch News.

Gov. Walker, after unsuccessfully trying to get the legislature to approve his budget proposal to expand Medicaid eligibility during the 2015 session, followed the lead of governors in Kentucky and West Virginia and took action without the legislature’s approval.

The new Medicaid rules are to go into effect on September 1 and would made Alaska the 30th state to expand Medicaid as allowed under the Affordable Care Act.

Long-term care for the elderly and disabled is driving up Medicaid costs, and states should take notice. That was the message of speakers at the 2015 CSG Medicaid Policy Academy held June 17-19 in Washington, D.C. “In nine states, at least 30 percent of Medicaid enrollees are elderly or disabled,” explained Matt McKillop, an officer for the State Health Care Spending division of The Pew Charitable Trusts. The main source of funding to provide long-term care and support for these individuals streams from Medicaid through state budgets. McKillop highlighted national data from the Centers for Medicare and Medicaid Services that showed the elderly and disabled individuals comprised 24 percent of Medicaid enrollees in 2010, but accounted for 64 percent of total Medicaid expenditures in the states.

State legislators attending the fourth annual CSG Medicaid Policy Academy June 17-19, in Washington, D.C., learned how critical Medicaid funding can be to services for vulnerable persons. Dr. Jeffery Brenner, a 2013 winner of a MacArthur Foundation genius award, challenged the group to rationalize the health care system. He described how his project in Camden, N.J. has reduced costs and improved care for patients suffering from a complex set of chronic diseases. Health care workers visit patients in their residences and seek to evaluate not just medical needs but social and emotional needs as well.