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States force drugmakers to keep selling cheaper meds under federal program
In their ongoing quest to lower prescription drug prices, some states are forcing drugmakers to continue to sell cheaper medications to thousands of pharmacies through a federal drug-discount program. Under the 32-year-old 340B program, pharmaceutical companies that participate in Medicaid must sell outpatient drugs at discounted prices to clinics, community health centers and hospitals that […]
To lower prescription drug costs, states head to the courthouse
Last month, the Federal Trade Commission released a scathing report suggesting that pharmacy benefit managers, the middlemen in the drug supply chain known as PBMs, are “profiting by inflating drug costs and squeezing Main Street pharmacies.” The FTC found that because of consolidation in the industry, the three largest PBMs now manage nearly 80% of […]
States want to lower drug prices. A federal law stands in their way.
Oliver Lackey opened a pharmacy in his hometown of Fairview, Oklahoma, so he could “provide the best patient care.” He set up shop a decade ago in the local grocery store with “zero prescriptions.” Before long, business took off — yet he was still struggling. “I was getting more patients and was filling more prescriptions,” […]
In the 10 states that didn’t expand Medicaid, 1.6M can’t afford health insurance
Nearly 1 of every 5 uninsured working-age adults across the 10 states that have not expanded Medicaid under the Affordable Care Act are, according to a new analysis, stuck in a health care limbo known as a “coverage gap.” That means they earn too much money to receive Medicaid but not enough to qualify for […]
As public health becomes political, state surgeons general play delicate role
When Louisiana Republican state Rep. Brach Myers stood on the House floor this past April to advocate for his bill to create a state surgeon general position, the questions were sparse, and the debate lasted only a few minutes. Democratic Rep. Matthew Willard asked whether the new role “could create chaos or maybe even division” […]
Cooler states now forced to grapple with extreme heat fueled by climate change
NEW YORK — As temperatures soared into the 90s, the heat and humidity hit the concrete in Astoria, Queens, and bounced into the air. People moved along the scorched sidewalk slowly, their clothes drenched with sweat. Elianne Alvarado, 44, who was raised in New York City and has lived here for most of her life, […]
States struggle to help patients navigate insurance hurdle known as ‘step therapy’
Cassidy Yermal, 32, began experiencing debilitating migraines when she was 17 years old. As a teenager growing up in northeastern Pennsylvania, she saw numerous neurologists and tried a variety of medications before finding one that provided relief. In 2022, her new insurer asked her to prove it. Yermal now lives in Marlboro, Maryland, where she’s […]
Amid mental health crisis, new compact allows social workers to practice across state lines
Stefani Goerlich, a certified sex therapist and social worker with a private practice in Detroit, sees several dozen clients a month, most of them from underserved and minority backgrounds. She speaks to them about sensitive matters such as gender-affirming care, and building trust takes time. Those hard-won relationships often are upended when clients move away […]
As states loosen childhood vaccine requirements, health experts’ worries grow
Louisiana Republican state Rep. Kathy Edmonston believes no one ought to be required to vaccinate their children. So, she wants schools to proactively tell parents that it’s their right under Louisiana law to seek an exemption. “It’s not the vaccine itself, it is the mandate,” Edmonston told Stateline. “The law is the law. And it […]
Montana could be a model as more GOP states weigh Medicaid work requirements
Two decades ago, Jeff Beisecker and his family returned to Great Falls, Montana, from a religious mission to the Philippines. Beisecker had no health insurance and no steady source of income, and neither did his wife. Fearful of being without coverage, Beisecker enrolled himself, his wife and their four children in Medicaid for nearly a […]
Holdout states consider expanding Medicaid — with work requirements
In Humphreys County, Mississippi — about 70 miles north of the state capital, in the heart of the fertile Delta region — a third of the residents live in poverty. In Belzoni, the county seat, there are just a handful of health care clinics. The town’s only major hospital closed more than a decade ago, […]
States want to make it harder for health insurers to deny care, but firms might evade enforcement
For decades, Amina Tollin struggled with mysterious, debilitating pain that radiated throughout her body. A few years ago, when a doctor finally diagnosed her with polyneuropathy, a chronic nerve condition, she had begun to use a wheelchair. The doctor prescribed a blood infusion therapy that allowed Tollin, 40, to live her life normally. That is, […]