Debra Miller

Author Articles

In the face of the devastating opioid crisis, states are confronted with financing and regulating complex -- and often disconnected -- systems of services to treat opioid use disorder. A comprehensive, sustainable service system must include a robust mix of high-quality treatment for acute needs linked to long-term supports for care maintenance with wraparound supports. This session provided an opportunity to hear from state leaders about the keys to creating and financing a high-functioning system to serve people with this disorder and their communities.  

This session was presented in partnership with the Pew Charitable Trusts and their Substance Use Prevention and Treatment Initiative.

Those in attendance at the "Growing Green: Marijuana Policy Impacts on State Budgets"  session at the CSG National Conference heard that states have collected what they characterized as significant but not game changing revenues. Friednash and Todd, both from Colorado, the first state to legalize sales of recreational marijuana, reinforced that marijuana revenues are but a sliver of overall state revenues. In his presentation, economist Beau Whitney presented estimates of other economic impacts of marijuana legalization...

The Council of State Governments hosted its 2018 National Conference from Dec. 5th - Dec. 8th in Northern Kentucky/Greater Cincinnati.

The meeting provided state leaders with a full agenda structured to tackle some of the most pressing issues facing state governments. If you would like to review the agendas and speakers, or get copies of the presentations and related materials, please

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The midterm elections moved more states into the legalized marijuana category. Voters in Michigan approved a ballot measure to make marijuana legal and to regulate businesses involved in selling it. That vote brought to ten the number of states with legalized recreational marijuana.
Medical marijuana laws exist in 33 states now, with Missouri and Utah added after voter referenda were approved in the November elections.

During the 2018 CSG National Conference in Northern Kentucky - Greater Cincinnati, attendees will have the opportunity to participate in a day-long policy academy on Wednesday, Dec. 5, 8 a.m.- 5 p.m. to consider state options to implement gaming in their states following the recent Murphy decision by the U.S. Supreme Court. 

Over twenty speakers will provide real-life exampes of programs and policies that make a difference for persons with opioid use disorders during a day-long Dec. 5 policy academy at the 2018 CSG National Conference in Northern Kentucky/Greater Cincinnati. The day will culminate with an audience particpation exercise for attendees to select among 19 different strategies for treatment, harm reduction, reducing demand, and limiting supply by designating theoretical spending of $10 million to $100 million on those strategies.

Ballot measures to expand Medicaid eligibility in Idaho, Nebraska and Utah passed in the mid-term elections. Montana voters rejected a measure to continue the expansion in their state.

On Oct. 22, the federal government issued new draft regulations concerning 1332 waivers. In a call to CSG from the Centers for Medicare and Medicaid Services (CMS), officials explained the new regulations would provide more flexibility to states, revising the “guardrails” set in the 2012 regulations. Plans previously considered non-ACA compliant could be sold on the marketplaces and could qualify for federal subsidies. 

Yesterday, the U.S. Census Bureau released a report with 2017 data on health insurance status in each state. In 2017, 28.5 million people (or 8.8 percent) did not have health insurance at any point during the year. The uninsured rate and number were not statistically different from 2016. In some states the uninsured rate change between 2016 and 2017 was statistically significant. In three states – California, Louisiana, and New York—the percentage of people without insurance decreased, but in 14 states the percentage increased. The states where the uninsured rates increased are Connecticut, Florida, Georgia, Illinois, Iowa, Massachusetts, Minnesota, Ohio, Oregon, South Carolina, Tennessee, Texas, Vermont and West Virginia.

For three days in September 2018, state legislative leaders in the health arena will meet at the CSG Medicaid Leadership Academy to hear from federal government representatives and officials from health policy organizations and state Medicaid programs about innovative programs in states that are improving health outcomes and reducing health care costs.

Presentation topics will include dementia-competent care in Virginia, a telehealth diabetes monitoring program in Mississippi, a proposal in Oklahoma to move to value-based...

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