2024 State Legislative Preview

Conclusions

This state legislative session seems different than the previous ones I have been a part of at the ACR. There is a lot of opportunity for wins on our issues, but it lacks the clear themes of previous sessions. Even legislation that is generally popular, such as copay accumulator bans, can get caught up in the trappings of election-year politics. Although that makes writing articles like this one particularly challenging, it does make the session even more exciting. Usually, we have a good sense of what is likely to happen prior to the start of the legislative calendar. 2024 may hold more surprises than usual, even if it lacks a clear theme.

Joseph Cantrell, JD, is the director of state affairs and community relations for the ACR.

With 2023 state legislative sessions underway, early prevailing themes may forecast areas where we will see gains this year. Key issues include utilization management, copay accumulator bans, white bagging and pharmacy benefit manager reform.

As the medications for rheumatology become more expensive, the need for patient financial assistance becomes paramount. Unfortunately, commercially insured patients are finding it difficult to afford the exorbitant copays required by their plans, and the latest strategy of pharmacy benefit managers (PBMs) threatens to derail rheumatologic treatment goals. High deductible plans combined with copay accumulator…

If passed, the ACR-authored resolution will direct the AMA to advocate for copay accumulator bans at state and federal levels. Several other specialties and state medical associations have joined the resolution as cosponsors.

This legislative season has seen key pharmacy benefit manager reforms but slow movement on other issues, such as copay accumulators and utilization management. The ACR is also monitoring emerging topics, such as biomarker testing and post-public health emergency telehealth reforms.

Conclusions

What to Expect in Healthcare Policy from the 2023 State Legislative Sessions

Copay Accumulator Programs Can Derail Rheumatologic Treatment Plans

ACR Leads Resolution to Address Copay Accumulator Policies at AMA House of Delegates Meeting

Slow but Steady: 2023 State Legislative Progress

Conclusions

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