NASHP’s 2015 Health Policy Year in Review

NASHP has long been a key health policy go-to for states, and 2015 was no different. It’s hard to believe it’s only been a year since I rejoined the organization. We began 2015 hearing from governors across the country calling for progress in reducing health care cost growth, discussing state based exchanges, improving behavioral health services, and proposing changes to Medicaid programs, investments in prevention, and drug treatment.

Adding to our robust work with children’s coverage, we worked with states as Congress deliberated the future of CHIP, documenting when states would run out of money and the long process required to close down the program had they not acted to extend the program for two more years. We also released a survey of CHIP directors. The current extension stimulates continued work to assure appropriate coverage for children in a volatile policy landscape.

Once again this year the fate of some key state health policy outcomes rested in the hands of the courts. We spent the first half of the year carefully watching the Supreme Court for an outcome on King v. Burwell. NASHP worked with states and reported what they might do in the event that a decision ended subsidies through the federally facilitated marketplace. Following the Court’s decision, NASHP quickly convened state leaders and national experts to examine and discuss implications for states even as that decision upheld the validity of the subsidies in the federally facilitated marketplace. As we end the year, the U.S. Supreme Court is deliberating over Gobeille v. Liberty Mutual, a case that could have a chilling effect on all payer claims data systems and the critical analysis regarding the costs and quality that they enable- if the court rules that self-insured employers need not provide data to those programs.

Working together with the State-based Marketplaces, as well as federally facilitated marketplace states, we have closely followed the open enrollment process, and monitored actions brought about by states. Through our State Refor(u)m work we developed our Medicaid Expansion map and continued to host a forum where state health policymakers can share and learn from one another as they continue ACA implementation. We have closely monitored and reported on state policy deliberations and emerging waiver proposals to extend Medicaid coverage. This year we also explored how states are using creative outreach strategies to connect people to coverage, such as enrolling justice-involved individuals in coverage. Additionally, we examined DSRIP programs as one state strategy to move toward value-based payments.

In October, nearly 800 state health policy leaders from all 50 states and the District of Columbia made the 28th Annual State Health Policy Conference the largest in our history, and, by their reports, one of the best. There we launched new work on the changing health care delivery system, the efforts to control health care costs and how states are incorporating efforts to support holistic policies that cut across health and social supports into their payment and delivery reform. Through learning collaboratives, our work addressed behavioral health needs including telehealth and privacy concerns. We have been contemplating with state leaders, the potential of 1332 waivers to make changes to certain ACA coverage programs and examined newly proposed regulations that appear to narrow the options some states had been brainstorming.

We look forward to working with all of you in 2016 to track and address the issues most important to states. We will continue to develop timely and informative pieces and will continue to rely on you to guide us in our policy and strategy so we can meet the needs of state health policymakers. I would value your thoughts and ideas about how NASHP can provide the most value to assist busy state leaders develop and achieve your health policy goals.

Happy New Year! We look forward to our work together in 2016!