by Jane Anderson
Going into 2020, state
lawmakers likely will continue to target prescription drug prices with
proposals largely aimed at PBMs, but they may also tackle bills on a wide range
of topics, including reinsurance, the opioid epidemic and maternal mortality.
More than 260 bills to
rein in the cost of prescription drugs — many of which specifically banned
common PBM business practices — cropped up in the U.S. this past spring, and
Gerard (Jerry) Vitti, founder and CEO of Healthcare Financial, Inc., says he
anticipates more of the same going forward.
"The debate will be
around drug pricing — around half of the [2019] bills are PBM-related,"
Vitti tells AIS Health.
While pharmacy and drug
pricing measures are likely to heat up again in states through the fall and into
2020, other issues of interest to insurers also are likely to get some
attention.
For example, lawmakers in
additional states are likely to approve proposals asking CMS to grant them
Affordable Care Act Section 1332 waivers to implement reinsurance programs
designed to lower premiums in their individual marketplaces, says Alex
Shekhdar, founder of Sycamore Creek Healthcare Advisors.
State lawmakers also are
likely to continue tackling the opioid crisis, using federal funding to finance
various prevention and treatment programs, he says.
Going forward, "we
continue to see more red states attempt to expand Medicaid under flexible
arrangements," Vitti notes. These arrangements might include work
requirements, even though courts struck down Medicaid work requirements in
Arkansas and Kentucky.
Vitti notes that some
conservative-leaning states also may consider Medicaid beneficiary
cost-sharing, adding, "there really is an appetite in state legislatures
for these types of conservative policies."
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