Since 2022, state-level abortion policy has been extremely diverse. Stark policy differences exist between Democratic and Republican controlled states. In liberal states, legislatures have maintained or even expanded access to abortion care. Meanwhile, conservative states have imposed various restrictions, from outright bans to gestational limits. 

The History of Abortion Policy

Roe v. Wade protected abortion access as a constitutional right. It curtailed states’ ability to regulate or limit access to the procedure. In Roe, the justices argued that abortion was a personal, medical decision protected by the constitutional right to privacy. Any regulations on abortion access had to be justified by a compelling state interest until the fetus reached viability. After viability, states could prohibit abortion except when necessary to protect life or health. 

Yet, despite the protections ensured by Roe, many state legislatures continued to pass abortion restrictions in an effort to test the decision’s boundaries in federal courts. Conservatives, particularly the Christian Right, remained strongly opposed to abortion and wished to see Roe overturned. With the Dobbs decision, the anti-choice lobby achieved a decades-long project. 

The case that ended Roe originated in Mississippi. In 2018, the Mississippi legislature passed a law that effectively banned abortion after 15 weeks of gestation. The law was an intentional challenge to the Supreme Court’s precedent. Mississippi legislators knew it would result in litigation. 

Mississippi’s sole abortion provider, the Jackson Women’s Health Organization, challenged the ban in court. This case, known as Dobbs v. Jackson Women’s Health Clinic, traveled through the lower and appellate court system before reaching the Supreme Court in 2022. There, the Justices voted 5-4 in favor of the State of Mississippi. The decision allowed the 15-week ban to take effect, reversing the Roe decision.  

The Court’s decision in Dobbs is all but unprecedented. It’s arguably the first time in U.S. history that the Court reversed a previously guaranteed constitutional right. As such, it raised the possibility of other contested or controversial Supreme Court decisions being overturned. Many Americans share concerns that precedent protecting other reproductive rights, including contraception, could be next.

Current Abortion Laws in the United States

Dobbs was a major turning point in American history. As mentioned, it has unleashed a flurry of abortion policy changes at the state level. A few states have enacted new policies protecting abortion access and reproductive rights. However, most policy change has occurred in conservative states to restrict abortion access. Overall, abortion access has been severely curtailed.

Protecting Abortion Access at the State Level 

Since Dobbs, there have been several state-level policy victories for abortion rights advocates. First, in a 2022 special election, Kansas voters rejected a ballot measure that would have paved the way for a total abortion ban. Over 59% of voters voted against the measure. The initiative drove increased turnout in an off-cycle election in a right-leaning state.  

Backlash continued in the 2022 midterm elections. Across party lines, Americans voted in favor of abortion rights in statewide ballot measures. Voters in California, Michigan, and Vermont supported measures that explicitly preserved abortion access. In conservative Kentucky, voters rejected a constitutional amendment that would remove abortion protections from the state constitution. Ohio voters followed suit in 2023, approving a ballot measure that explicitly protected reproductive rights.

Overall, a trend is clear. Not one state has passed an abortion restriction via ballot measure since Dobbs. Most Americans are in favor of abortion access, even in conservative-leaning states.

Total Abortion Bans 

Since the Dobbs decision, fourteen states have enacted total abortion bans. These laws offer no exceptions, or incredibly narrow exceptions, in the case of rape, incest, extreme fetal abnormalities, and so on. Many of these states have also enacted criminal penalties for women that seek abortions, or for doctors that perform them. 

Three states have passed a six-week gestational limit on abortion. In practice, six-week abortion bans function as total bans, because so few women even know that they are pregnant at the six-week mark. 

In states with total abortion bans, pregnancy is increasingly dangerous. Women seeking reproductive healthcare for medical emergencies, including ectopic pregnancy or miscarriage, are being denied care. Healthcare providers fear facing criminal penalties for defying abortion bans.

Limiting, But Not Banning, Abortions 

While most states have passed measures that are explicitly in favor of or against reproductive rights, few currently operate in the gray area between legality and illegality. Arizona and Utah have passed “moderate” gestational limits since Dobbs. Those seeking or needing abortions in these states are subject to fifteen and eighteen week bans, respectively. While these measures are less restrictive than outright or six-week bans, advocacy groups such as Planned Parenthood still claim that these limits are needlessly burdensome and restrictive.

The Controversy Over Abortion Policy & Its Impact on Elections

Since Roe v. Wade was overturned, political controversy over abortion policy has escalated. Abortion access has driven polarization and drastically influenced voter behavior. Elections have become referendums on the future of abortion policy in America. The issue has profoundly impacted campaigns and elections across all levels of government. With abortion rights no longer federally protected, the issue has become a focal point in state and local campaigns.

Generally speaking, conservatives prioritize abortion opposition. They’ve made a “pro-life” position and identity a litmus test for candidates seeking party support. This has resulted in the rise of anti-abortion politicians. Restrictive abortion measures have become intrinsically integrated into Republican Party platforms. Conversely, liberals view reproductive rights as fundamental to gender equality and bodily autonomy. Democrats have campaigned on restoring abortion access in recent elections. 

Over the past two years, candidates have made reproductive rights a central campaign issue. On the whole, pro-choice candidates are winning those races. Despite heightened polarization, a majority of Americans support abortion access and oppose the Dobbs decision. Many Republicans, particularly those in toss-up states, have subsequently de-emphasized abortion rights as a campaign issue. With Roe gone, abortion is largely losing issue for Republicans. Conservatives must move towards the middle or risk alienating moderate voters and women.  

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• Access superior public policy data 
• Be the first to know about new bills and changes in bill status
• Streamline your day with seamless organization features
• Harness the power of time-saving AI tools to gain insights into individual bills and the entire legislative landscape
• Keep everyone on the same page with internal collaboration and external reporting all in one place

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In this blog, we’ll discuss the various areas of legislation that impact medical associations. We’ll also discuss how Plural helps medical associations maximize their policy impact.

The Policy Environment

Various areas of legislation impact medical associations. This includes healthcare reform, drug pricing, and research funding, among others. Learn more below.

Healthcare Reform

Medical associations are at the forefront of healthcare reform discussions. They advocate for policies that ensure equitable access to healthcare and improve quality of care. Any new developments can have profound impacts on how healthcare services are delivered and financed. This includes changes to healthcare coverage, payment models, and new patient care protocols. Medical associations must stay informed about legislative developments in these areas. This awareness allows them to effectively represent their members and help shape policies that foster a sustainable healthcare system.

Regulatory Compliance

The healthcare sector is subject to a myriad of frequently-updated regulations. They cover everything from patient privacy and data security to clinical practices and facility standards. Medical associations must help their members understand and navigate these regulations. Compliance is not just adherence to laws, but also ensuring that the highest standards of patient care and safety are met.

Drug Pricing

The cost of medications remains a critical issue in healthcare policy. Medical associations are actively involved in the dialogue surrounding drug pricing. They advocate for legislation that makes medications affordable. At the same time, they also encourage the innovation necessary to develop new treatments. Understanding the complexities of pharmaceutical pricing, including the roles of manufacturers, insurers, and government programs, is essential for effective advocacy.

Medical Research Funding

Advocating for research funding is another key area of focus for medical associations. Medical research is the backbone of advancement. Securing funding is crucial. This involves engaging with legislative bodies to ensure that government grants and subsidies are allocated to support vital research projects. Effective stakeholder management is key to this process. Medical associations must also monitor and influence the budgetary allocations at federal and state levels. They must make the case for the importance of continued investment in medical research.

Plural’s Strategic Advantage

Top medical associations trust Plural for their legislative tracking and stakeholder engagement needs. Plural’s suite of tools is designed to empower medical associations to manage the legislative complexities of the healthcare sector more effectively. Learn more about how Plural meets the challenge below.

Best-in-Class Data

Access to comprehensive and up-to-date legislative information is crucial for staying informed about changes that impact healthcare policy and regulations. Plural enables medical associations to stay up-to-date on legislative trends and developments. This includes:

• Tools to discover everything there is to know about a bill
• Legislator and staffer information
• Historical data
• AI-powered insights
• And more!

With Plural, medical associations turn potential policy threats into manageable challenges.

Advanced Search Tools

With Plural, it’s easy for medical associations to filter through the noise to find relevant bills. Advanced search capabilities allow users to pinpoint specific legislation affecting healthcare. Search by keyword, legislature, session, bill status, and more. This precision helps associations focus their efforts on the most impactful issues, saving time and enhancing the effectiveness of their advocacy.

Real-Time Updates

The healthcare policy landscape can change rapidly. Plural’s real-time updates ensure that medical associations receive immediate notifications about legislative developments. These insights allowing them to respond swiftly and keep their members informed.

Global Bill Search

Thousands of bills are introduced in each jurisdiction throughout each legislative session. For medical associations, finding the exact bills that matter can feel like searching for a needle in a haystack. The ability to quickly and efficiently find the bills that matter is the key to staying ahead. Plural’s Global Bill Search streamlines the discovery process and brings relevant legislation to the forefront. Global Bill Search helps medical associations discover the national landscape of legislation impacting their goals and objectives.

Momentum Indicator

Identifying which bills are gaining traction is crucial for medical associations. These insights guide strategic planning and advocacy. Yet, without the right tools, policy teams must rely on manual tracking and intuition. This often leads to missed opportunities and misallocated resources. Plural’s Momentum Indicator offers a novel way to assess a bill’s traction and potential for progress. With the Momentum Indicator, discovering which bills are likely to become law is quick and simple.

Why Plural Is Indispensable for Medical Associations

Medical associations are committed to advancing healthcare standards and best practices. Plural offers a robust solution for navigating the complex world of healthcare policy. With Plural, medical associations can not only keep up with, but also actively influence this dynamic policy field. By adopting a proactive approach, medical associations ensure that they can efficiently represent the interests of both healthcare providers and patients, promoting a healthier future for all.

Are you ready to enhance your legislative tracking and advocacy efforts? Sign up for a demo today and empower your medical association to lead in healthcare policy.

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Want to be able to explain the benefits of artificial intelligence for lobbying and advocacy? Everyone is talking about AI. And we get it, it’s not simple to understand. But as an AI-powered organization, Plural is here to help you get the most out of advancements in AI to make your job as a policy […]

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Staying on top of key deadlines is manageable in one state, but if you’re tracking bills across multiple states, or nationwide, it quickly becomes overwhelming. That’s why we created the 2025 Legislative Committee Deadlines Calendar. Stay ahead of important dates and download our calendar today. Get started with Plural. Plural helps top public policy teams get […]

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The 2024 Florida legislative session saw significant activity in the realm of insurance and financial services, reflecting key themes of consumer protection, market stability, and regulatory modernization.

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Identifying a problem doesn’t necessarily lead to consensus on a solution. Regardless, bipartisan attention on prescription drug costs has shifted focus toward the drug supply chain over the past decade.

Recently, many states have introduced proposals to reign in prescription drug prices. These proposals have included:

• Establishing prescription drug affordability boards
• Allowing for the import of drugs from Canada
• Requiring greater transparency from drug manufacturers

At the federal level, the Biden Administration has also taken action. President Biden has enacted laws that:

• Allow Medicare to negotiate pricing on a limited number of prescription drugs
• Require drug companies to pay rebates when they increase prices on certain drugs too quickly

Amidst varying proposals and laws, common themes emerge. One common area of focus is the role of Pharmacy Benefit Managers (PBMs) in the drug supply chain. PBMs have become a key subject of debate in both state houses and Congress. Below, we dive into what PBMs do and how legislators are seeking to regulate their behavior.

What is a Pharmacy Benefit Manager?

If you have never heard of PBMs or don’t know what they do, you are not alone. PBMs work largely behind the scenes with health plans, drug manufacturers, and pharmacies. A PBM is a company that negotiates with drug manufacturers, generally on behalf of health insurers. They interact with each party in the process of buying and provisioning prescription drugs.

Because of their behind-the-scenes role, the part PBMs play in determining how much patients pay for drugs and what drugs they’re able to access isn’t always obvious. Despite this, PBMs have a massive impact on the availability and affordability of drugs.

PBMs provide value to pharmacies, insurers, and drug manufacturers. They take responsibility for the logistical morass that determines:

• What drugs are available to patients
• How they access them
• At what cost (to the patient, the plan, the pharmacy, and the manufacturer) said drugs can be accessed

In solving this puzzle, PBMs end up with significant leverage to negotiate with drug manufacturers. In theory, this leverage would allow them to lower costs for insurers and patients alike. 

But PBMs are also for-profit entities, and often very successful ones. PBMs make money by:

• Receiving rebates from drug manufacturers
• Receiving payments from insurers for drugs that are higher than what the PBM pays the pharmacy to dispense that drug. This is commonly called “spread pricing”
• Charging administrative fees to the insurers they work for. 

How are Lawmakers Attempting to Regulate Pharmacy Benefit Managers?

It’s clear that PBMs have a massive influence on drug distribution and affordability. Given this, it seems obvious that they would be a focus of legislative attempts to lower prescription drug costs. Hundreds of bills have been filed over the past two years with this intent. Proposals have primarily been aimed at increasing transparency into how PBMs make money. In April of 2024, two such proposals have passed. Learn more below.

Oregon HB 4149

Oregon HB 4149 became law on April 10, 2024. The new law requires PBMs to be licensed by the state. PBMs will also be subject to increased reporting requirements. The new law will also likely give state officials more latitude to investigate and penalize PBMs that violate the law.

Idaho H 596

Idaho H 596 became law on April 1, 2024. The new law ensures PBMs pass on rebates. It will also limit the use of “spread pricing” and require additional transparency from PBMs.

Many other state-level proposals have followed similar themes. Other bills seek to ban “spread pricing” or require that rebates are passed along to insurers and patients. On the federal level, legislative efforts have proposed similar reforms. Though they’ve received some bipartisan report, bills have not yet been moved forward by leadership.

The PBM industry has pushed back against these legislative proposals. They argue that rising drug prices are largely the fault of drug manufacturers. 

Looking Ahead: Efforts to Regulate Pharmacy Benefit Managers

Robust action on PBMs at the federal level is not imminent. Regardless, recent reforms by the Biden Administration show that prescription drug pricing is a policy area where coalition-building and legislative success are possible. Given this, it wouldn’t be surprising to see PBM reforms included in negotiations over “must pass” defense or budget legislation.

At the state level, states that have passed PBM legislation will serve as a model for future bills. Because the PBM industry is so nationalized, legislation passed in one state could have ramifications on others.

In a time when most policy areas are unlikely to be acted on due to political polarization, prescription drug policy represents a uniquely active space. You can discover, track, and influence the development and progress of this legislation using Plural today. Create an account or book a demo!

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Key Topics in the 2024 State of the Union Address

President Biden discussed several key topics central to his own and the Democratic party’s platform. These included: 

The State of Democracy 

The State of the Union address started out with a conversation on the current state of Democracy. President Biden was inaugurated immediately following the capital insurrection on January 6, 2021. Since then, he has made many significant speeches on the state of democracy in the United States. During the State of the Union, President Biden spoke directly to the current state of affairs. With regard to the upcoming 2024 election, President Biden declared that the U.S. is facing “the biggest threat to democracy since the Civil War.”

Reproductive Justice

President Biden often discusses his staunch pro-choice beliefs. This was no different throughout the State of the Union. President Biden called out his presidential predecessor for his role in Roe v. Wade being overturned. He also slammed the Republican Party’s interest in voting for a federal ban on abortion access, discussing the dangers of such a proposal. In response, President Biden called for increased federal protections for reproductive healthcare. He promised the American people that, if elected, he would protect the right to abortion and ensure abortion medications are available via the U.S. Postal Service.

Job Creation and the Inflation Reduction Act

President Biden entered office in the heat of the COVID-19 pandemic. The Administration’s successes in COVID-19 response and recovery were a key aspect of the State of the Union address. He boasted about recovery efforts and how the country has emerged from quarantine with full access to COVID-19 vaccines.

The President also discussed increased employment rates. Over the past four years, the U.S. has seen the highest rates of job creation in the country’s history. With fifteen million jobs created in just three years, President Biden has seen the highest job creation rate of any U.S. president.

Job growth is due in large part to the Inflation Reduction Act (IRA), a key success of Biden’s term as president. The IRA flooded state governments and the federal government with economic investments, clean energy programs, and job creation projects.

Support for Unions

Throughout his political career, President Biden has been a major supporter of Unions. In the State of the Union address, he boasted to the crowd that he was the first U.S. President to cross a picket line in support of a workers’ union. President Biden also spoke to the experiences of the middle class, including the difficulties they have faced as a result of the COVID-19 pandemic. The middle class has endured challenges from a reduction in policies protecting them. They’ve also had fewer opportunities to unionize. President Biden concluded this portion of his address by exclaiming: “the middle class built this country, and unions built the middle class.”

The Economy

President Biden discussed the state of the economy in the United States. Since taking office, the President has signed off on and implemented policies aiming to reduce inflation across the country. He’s also supported efforts to increase job availability. President Biden stated: “wages are on the up, and inflation is on the down.”

Healthcare and New Policy Proposals

President Biden touted his ability to secure a reduction in insulin prices to no more than $35 per month for seniors on Medicare. As President, Biden has secured the passage of this measure through Congress. He has also advocated for the application of this policy throughout the United States.

On the topic of healthcare, President Biden also encouraged Congress to work with him to pass a bill allowing Medicare to negotiate prices on more than 500 essential medications. These policy proposals and passages are key goals for the Administration, as they hope to build on the legacy of Obamacare.

Housing and New Policy Proposals

The President discussed the ongoing housing crisis faced by renters, owners, and buyers across the country. He proposed a policy that would give homeowners $400 per month over the next two years to apply towards their mortgages. For renters, President Biden pointed to provisions within the IRA to build affordable housing in neighborhoods in need. In laying the groundwork for these proposals, President Biden is also signaling to Americans what another term as President would look like.

The State of Education

President Biden is a staunch supporter of public education. His wife, First Lady Dr. Jill Biden, is a former public school educator and continues to advocate for education. In the State of the Union address, President Biden focused on many topics related to education.

The President signaled his support for early childhood education and universal access to preschool. He stating that students who finish preschool are more likely to finish high school and achieve a two to four year degree, no matter their background.

President Biden also mentioned his ongoing effort to decrease student loan debt, and already providing essential workers in the U.S. such as firefighters, teachers, and medics with student loan debt decreases. Last summer, the Supreme Court thwarted his efforts to cancel a significant portion of the student loan debt that plagues many Americans.

Next, President Biden informed viewers about measures to increase access to education for marginalized communities. The Administration has increased Pell Grants for low-income students. The President also announced investments in Historically Black Colleges and Hispanic Serving Institutions. 

Finally, President Biden called for increased support for public school teachers. He unequivocally announced: “Public school teachers need a raise.”

A Re-Framing of the State of Immigration 

President Biden reframed the issue of immigration from how Republicans typically discuss it. Republicans often frame immigration as a crisis of too many individuals crossing the border, seeking refugee status, asylum, or formal green cards. President Biden framed immigration as an issue of an underfunded legal and social immigration system within the United States.

The President outlined a proposal to hire hundreds more immigration case workers, lawyers, and judges. With increased staffing, the Administration hopes that court cases can go from a six-month wait to just six weeks.

The response to this proposal highlighted partisan divides on the issue of immigration. It was met with heckling from Republicans and cheers from Democrats. As such, it’s likely that this will be a highly contested policy.

Foreign Affairs

In the last portion of the Address, President Biden spoke about the ongoing conflicts internationally. Addressing his continued support for Ukraine and speaking to the aggression occurring in Gaza. Israel’s response to attacks by Hamas in October of 2023 has dominated public debate in the United States. The President began his speech by stating that Israel has the right to “go after” Hamas. He also voiced support for the return of hostages within Gaza.

Afterwards, President Biden declared that Israel has the responsibility to protect innocent civilians within Gaza. These statements come after more than one hundred days of ongoing conflict within Gaza. More than 35,000 men, women, and children have been killed, and thousands more have been injured.

President Biden urged Israel to stop blocking humanitarian assistance from entering Gaza. He also shared that the U.S. plans to create a temporary dock on the coast of Gaza to aid in the distribution of humanitarian aid. The President concluded his discussion of the topic by encouraging a six-week ceasefire in Gaza and exclaiming the necessity of a two-state solution.

The President’s remarks on Israel and Gaza were met with a variety of reactions, both from viewers at home and legislators in the crowd. The conflict between Israel and Palestinians is a hotly contested topic within the United States. Many Americans believe Israel is defending itself against Hamas. Many others view what is happening in Gaza as a genocide, especially following the International Court of Justice’s interim decision. A few Democratic legislators in the crowd held signs asking the President to call for a lasting ceasefire.

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Plural is the legislative tracking tool of choice for policy teams looking to track key public policy topics on both the state and federal levels. Interested in getting started? Create a free account or book a demo today!

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The post The State of the Union 2024: Context and Key Topics appeared first on Plural Policy.

In our highly partisan times, debate over a single state’s actions is often nationalized. It can be easy to forget this virtue of our federal system espoused by Justice Brandeis. However, this context can be helpful as we consider the progression of Oregon’s drug laws in recent years. What does the soon-to-be-enacted Oregon HB 4002 mean for drug policy in the state?

How Did We Get Here?

In November 2020, Oregon voters made history in their overwhelming passage of Ballot Measure 110. The Ballot Measure effectively decriminalized the possession of small amounts of illicit drugs. It also sought to increase funding for recovery resources such as rehab facilities. At the time, studies showed that Oregon had high rates of addiction, and ranked poorly for providing access to treatment. Advocates for Measure 110 believed that increased funding for recovery, combined with a transition away from punitive responses to addiction, could improve the situation in Oregon.

Measure 110 took effect in 2021. Law enforcement entities began issuing citations and treatment referrals rather than arrests. Since then, opioid overdoses increased, both nationally and within Oregon. This spike was driven in part by an increased prevalence of fentanyl in the state. At the same time, treatment funding mechanisms established by Measure 110 were slow to get off the ground. Many programs are only just starting to feel their impact. 

Last fall, business leaders and opponents of Measure 110 began organizing opposition to the new rules. This included gathering signatures for a referendum to roll back aspects of the Measure. Prior to the 2024 legislative session, both Democrat and Republican leaders signaled their support to revise Measure 110.

What Is Oregon HB 4002?

Bipartisan interest in rethinking Measure 110 resulted in HB 4002. The bill passed through the legislature, and Governor Kotek will soon sign it into law. Oregon HB 4002 directs additional resources towards the addiction recovery continuum of care, including measures:

• Increasing funding for community-based treatment
• Establishing additional treatment options
• Prohibiting insurers from requiring prior authorization of medication for substance use disorder

Most notably, HB 4002 will also recriminalize possession of illicit drugs in some circumstances. Under the bill, those found in possession of small amounts of drugs can be charged with a crime. However, they may have the opportunity to avoid conviction by seeking addiction treatment. Repeat offenders or those who break probation may serve up to six months in jail. 

While HB 4002 provides ample opportunity for diversion from the criminal justice system, opponents are concerned that it marks a return to the criminalization of addiction. Oregon’s overburdened and under-resourced addiction healthcare system may prevent those caught with drugs from choosing treatment. Further, the Oregon Criminal Justice Commission noted that the bill may disproportionately impact communities of color.

What Will Oregon HB 4002’s Impact on Drug Policy Be?

The politics surrounding Measure 110 have remained impactful. Returning to Justice Brandeis’s thinking, one might argue that other states may resist decriminalization efforts based on Oregon’s experience.

At the same time, it is worth noting that HB 4002 does not represent a full reversal of thinking by Oregon’s leaders. The bill continues to increase investment in treatment. Further, the re-criminalization of drug possession still includes pathways out of the justice system. Even after HB 4002 goes into effect, Oregon’s drug laws will be among the most progressive in the country.

It’s expected that HB 4002 will make decriminalization efforts (beyond marijuana) difficult. In recent years, New York, Massachusetts, and Washington have introduced bills proposing expansive decriminalization of drug possession. Opponents of those efforts will point to Oregon’s experience with Measure 110 as evidence of failure.

Get Started With Plural

Plural is the legislative tracking and analysis tool of choice for policy professionals looking to gain greater insights into impactful bills. With Plural, you’ll:

• Access superior public policy data 
• Be the first to know about new bills and changes in bill status
• Streamline your day with seamless organization features
• Harness the power of time-saving AI tools to gain insights into individual bills and the entire legislative landscape
• Keep everyone on the same page with internal collaboration and external reporting all in one place

Interested in getting started? Book a demo or create a free account today!

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In the United States, the landscape of healthcare policies is complex and marked by many ongoing challenges. Healthcare services remain a critical concern at both the state and federal levels. Access to care, mental health, and prescription drugs are at the forefront of the issue. The COVID-19 pandemic intensified these issues, underscoring disparities and exorbitant costs. The federal government plays a pivotal role in healthcare policy. In particular, the federal government manages enrollment assistance and addresses health-related social needs. On the state level, priorities and objectives vary. For instance, some states prioritize advancing health equity. In other states, health equity is not yet a significant concern. Navigating these varied policies is critical for many Americans, particularly those living at or below the poverty level.

State-Level Healthcare Policy Priorities

Individual states significantly impact healthcare policy. They wield considerable influence in the shaping of healthcare services, coverage, and costs. States play a vital role in tailoring policies to address specific regional needs. They impact underrepresented communities, influence prescription drug costs, and determine access to medical care. Recognizing states’ role is essential for a nuanced understanding of the healthcare landscape.

Improving Eligibility and Enrollment Processes

With the ongoing implementation of the ACA, eligibility and enrollment to healthcare policies is an ongoing struggle. The ACA grants states the option whether to enroll in its provisions. As such, access to healthcare is unequally distributed across the United States. 

Case Study: Access to Healthcare in Texas

Texas currently has the largest population of uninsured residents in the United States. Nearly five million people do not have access to health insurance in the Lone Star state. There has been an ongoing conversation and effort to reduce this statistic.

Texas lawmakers have demonstrated interest in reducing the number of uninsured Texans. In the past year, there has been a 37% increase in enrollment to the Affordable Care Act, also known as Obamacare. This is due in large part to the implementation of the federal Inflation Reduction Act (IRA). In 2024, advocates within Texas are hoping to continue this trend. They are pushing the state to expand access to Medicaid beyond children and adults with disabilities. Should the advocates succeed, an additional 800,000 Texans would receive access to healthcare. 

Expanding Medicaid

Medicaid expansion requires a coalition of legislators and advocates on both the federal and state levels. This is due to certain provisions of the Affordable Care Act (ACA). As of 2024, the most effective way to expand access to Medicaid is through state-level action. The Governor must sign on to expanding Medicaid to nonelderly people with incomes up to 138% of the federal poverty level. The states that have not yet done so include: Alabama, Florida, Georgia, Kansas, Mississippi, Tennessee, Texas, Wisconsin, and Wyoming. These states remain the emphasis of policy advocacy to ensure increased access. 

Consumer Protection 

Consumer protection from inflated healthcare prices and price-gouging practices has been a hot topic of conversation. Ongoing litigation and negotiations with pharmaceutical companies aim to prevent pricing people out of necessary healthcare. Many of these efforts are taking place at the federal level. At the state level, many governors are taking initiative in consumer protection efforts.

Case Study: Consumer Protection Efforts in New York

In New York, Governor Kathy Hochul hopes to enact the most expansive prohibition against insulin cost-sharing in the nation. The proposal would completely eliminate insulin cost-sharing through legislation. It would provide financial relief and improve adherence to these life-saving medications. With 1.58 million New Yorkers diagnosed with diabetes, this is poised to make a significant impact if passed. 

Governor Hochul is also championing legislation that would prevent hospitals from suing patients earning less than 400% of the Federal Poverty Level, which is $120,000 for a family of four. It would also expand hospital financial assistance programs for low-income New Yorkers and limit monthly payments and interest charged for medical debt. 

Reproductive Rights

Since Roe v. Wade was overturned, reproductive rights have become a key issue across the United States. Thirteen states are set to address abortion in the 2024 elections. This includes:

• Arkansas
• Arizona
• Colorado
• Florida
• Iowa
• Maine
• Maryland
• Nebraska
• Nevada
• Montana
• Missouri
• South Dakota
• Pennsylvania

Voters in Colorado, Montana, and Nevada aim to uphold abortion rights through ballot initiatives. In Arizona, Arkansas, Florida, Missouri, Nebraska, and South Dakota, voters seek to expand abortion access. Iowa and Pennsylvania voters will consider constitutional amendments that would prevent abortion protection. Finally, both Maine and Maryland have referendums supporting abortion access. Maryland’s has already been approved for the 2024 state ballot.

Federal Healthcare Policy Priorities

The federal government is largely focused on making healthcare more affordable and accessible. Federal priorities include addressing social needs, expanding coverage, and ensuring access to care. Certain efforts to these ends are ongoing, due to the COVID-19 pandemic. These include reducing prescription drug costs, advancing health equity, and facilitating widespread vaccination. Measures are also in place to minimize out-of-pocket costs and provide enrollment assistance.

Expanding Access to Care

The FY24 budget includes Medicaid-like coverage for people in states that have not adopted Medicaid expansion under the ACA. It also includes financial incentives to ensure states with existing expansions maintain them. The budget also makes permanent the expanded ACA premium tax credits extended in the IRA.

COVID-19 Recovery

The COVID-19 pandemic is still ongoing and vaccinations continue to be necessary. Despite this, the federal government has deemphasized policy proposals for pandemic recovery.

Vaccination mandates and reporting provisions have drawn the ire of conservative lawmakers. Medicare currently requires that ambulatory surgical centers must report the COVID-19 vaccination status of their healthcare workers. On February 1st, a coalition of House Republicans introduced U.S. HR7216. The bill would effectively remove this reporting requirement. HR7049 also removes this requirement within the Veterans Health Administration. These policies are harmful to immunocompromised or elderly patients who are at greater risk of contracting COVID-19.

Reproductive Rights

The Biden Administration has placed a major emphasis on protecting reproductive rights. On January 24th, the administration released a series of statements related to this commitment. The Administration is committed to:

• Protecting access to abortion and abortion medication
• Ensuring access to Emergency Medical Care nationwide
• Expanding support for reproductive healthcare workers
• Defending reproductive rights in court

The administration has also created a Reproductive Rights Taskforce. Their most recent report outlines a multipronged approach to protecting reproductive rights both legally in practice. The Taskforce outlined practices to ensure access to medication abortion, the most widely used form of abortion care. The Taskforce also set forth best practices to:

• Enforce healthcare coverage for abortion procedures
• Provide education for patients and healthcare professionals
• Protect individuals’ ability to travel for abortion care when their states outlaw it 

How Healthcare Issues Will Play Into the 2024 Elections

Healthcare issues will remain paramount in the 2024 election. For years, President Biden has championed healthcare. The ACA, IRA, and his commitment to reproductive rights signal this priority. Donald Trump, his likely opponent, has emphasized a private insurance framework for healthcare. Trump often touts his involvement in COVID-19 response, while Biden emphasizes his administration’s recovery process. These differences alone make healthcare a salient issue for the 2024 elections. Likewise, many healthcare-related bills forthcoming across the country and within Congress mean that the issue will continue to be salient.

Get Started With Plural

Plural is the tool of choice for public policy professionals monitoring 2024 healthcare policy changes. Plural users can:

• Access superior public policy data 
• Be the first to know about new bills and changes in bill status
• Streamline your day with seamless organization features
• Harness the power of AI to gain insights into individual bills and the entire legislative landscape
• Keep everyone on the same page with internal collaboration and external reporting all in one place

Interested in seeing how Plural can supercharge your policy work? Request a demo today!

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By Jay Oliveira My time at Plural has been transformative.  As a third-year policy student at Suffolk University in Boston, I had already spent hours pouring over legislative websites for my coursework. I struggled to use legislative sources that would open up dozens of unreadable files, or would make it unclear what chamber the bill […]

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The post Navigating 2024 Healthcare Policy Changes: What You Need to Know appeared first on Plural Policy.

Legislative trends often emerge in the first few weeks of session. There is so much we can learn from the proposals considered across the country. In 2022, we identified trends in bills regulating discussions of race and gender in schools. That trend grew to be among the most hotly debated national issues this past year. This debate will only continue in 2024. Plural’s industry-leading open data and cutting-edge AI tools streamline and enhance legislative work.

The Biggest State Government Issues in 2024

It would be impossible to build a comprehensive list of the issues that each state will focus on in 2024. Instead, our research has allowed us to build a list of the topics which will be high on most state’s agendas this year. We’ve also identified specific proposals we see gathering momentum around the country. 

2024 Elections

Let’s get the big one out of the way first — elections will dominate political news coverage this year.  November’s elections will impact state legislative policy in a few distinct ways.

Voting Rights

Many bills related to voting rights will be considered across the country this year. In 2023, more than 1,100 bills expanding or restricting access to voting were introduced. Many of those same bills will come up again in 2024, and we expect hundreds more to be introduced. But prevalence alone does not make this our top legislative trend. The tenor and stakes of these debates will be extremely high. For better or worse, most voting rights proposals will be judged first by their potential impact on the 2024 elections. Advocates on both sides see these issues as central to ensuring a free and fair election. 

Culture Wars and Partisan Conflict

Federal elections, particularly the presidential election, will result in the nationalization of state legislative issues. Culture wars and partisan battles will prevail as legislators balance policymaking with politics. Abortion, parental rights in education, LGBTQ+ issues, and firearms regulation are areas we expect to see this dynamic play out. 

Session Logistics

Many state legislators themselves will be running for election in November. This being the case, we expect to see more sessions wrap up in a timely manner come spring. Legislators will be itching to get on the campaign trail. Fewer special sessions will take place this fall as election results signal priorities for 2025.

Affordable Housing

Housing affordability and homelessness have become a top issue at state legislatures. We recently wrote about the need for those in the housing space to monitor public policy. We expect to see proposals focused on:

• Affordable housing development
• State funding of shelters and emergency housing
• Continued action legislating the landlord-tenant relationship

Cannabis

At this point, state-level efforts to decriminalize or legalize marijuana are not novel. Despite this, recreational marijuana use remains illegal in just over half of U.S. states. Further, medicinal marijuana use is still prohibited in ten states. In Wisconsin, Hawaii, Florida, and New Hampshire, legalization will have a serious chance at passage this year. 

Even in states that have legalized marijuana, the subject remains prevalent. Delaware, Kentucky, Minnesota, and Ohio moved forward on legalization in 2023. However, there are significant intricacies in establishing a lucrative and regulated marijuana industry. Advocates can expect to return to their state houses frequently this year to monitor implementation plans. 

Diversity, Equity, and Inclusion (DEI)

DEI policies were an emerging legislative trend over the past few years. This is true especially at universities. In 2023, this trend accelerated. University policies regarding freedom of speech, antisemitism, and racism have garnered attacks from the right.

Utah’s HB 111 would restrict the ability of private employers to require training that includes certain concepts related to race and sex. Utah legislators have already moved the bill out of its committee; it will be voted on by the full House next. 

Education

As always, state education committees will be busy this year. Education spending represents a significant portion of every state’s budge. Because of this, debates over spending can seem omnipresent.

About two dozen states must pass a budget by the end of this session. Those that don’t will likely still consider supplemental budget packages. New York Governor Kathy Hochul rolled out a budget that will increase state-provided school funding by more than $800 million. Legislators and interested parties will have their say whether the increase is too significant or not enough. They’ll also weigh in on the allocation of the funds.

Outside of education funding, other issues related to education will be hotly debated. We see continued trends in legislation relating to:

• Parental influence in the classroom
• Race in education
• Dual enrollment
• The expansion or restriction of charter schools

Environment & Climate Change Mitigation

In 2023, California enacted some of the most significant climate-related state action. The legislature passed laws requiring climate reporting by more large companies. As states adjust to meet their climate plans, we expect to see additional legislation. Twenty-four states have established greenhouse gas reduction targets. These states must evaluate their progress and adjust accordingly. Others may consider implementing targets of their own. 

As climate change continues, climate-related disasters increase in frequency and impact. Many states find themselves regularly considering how to respond to these tragedies. Hawaii’s devastating fires that took place in August 2023 will be a key focus of the state legislative session. Lawmakers will aid in the recovery of affected communities and victims. Further, they will plan for future fires and other climate-related disasters.

Criminal Justice & Law Enforcement Reform

Criminal justice and police reform efforts have received increased attention in recent rears. The murder of George Floyd and subsequent protests in 2020 catalyzed this focus. Despite progress by advocates, there is certainly more work to be done. This session, legislators in Maryland, Georgia, Minnesota, and California will prioritize justice reform.

Crime rates are decreasing throughout the United States. Despite this, growing public concern persists regarding increased crime rates. We expect some lawmakers to respond to this growing concern.

In Georgia, the development of a massive law enforcement training center has been the subject of debate.. Disagreements between lawmakers, law enforcement, have persisted for years over “Cop City.” Community activists have fought to prevent the construction of Cop City. As development continues, lawmakers have advanced legislation that could further criminalize protest actions. Cop City represents just one clash between those on both sides of the debate over police reform.

Transportation

We will monitor many major transportation issues in 2024. Among these is the continued development of electric vehicle policy. In 2023, some states followed the federal government’s lead in encouraging the adoption of electric vehicles. Tax rebates and other incentives aimed to encourage public entities to make the switch to electric.

While many efforts have been bipartisan, most have been led by Democrats. Some Republicans remain critical of electric vehicles. These lawmakers also oppose any encouraged transition away from gas-powered cars. In 2024, we expect to see increased opposition to electric vehicles in Republican states. This might involve increased fees on electric vehicles and reduced taxes on gasoline. 

Using Plural to Track State Government Issues

Hundreds of bills are introduced as sessions kick off. It can be overwhelming to analyze legislative trends in one state, let alone throughout the country. However, keeping track of legislative trends is vital to understanding public policy. Dominant issues and trends started in just one or two states before going “viral” nationwide.

Plural makes the process of identifying and tracking legislative trends accessible and efficient. We’re committed to ensuring that every American can access high-quality legislative data. Using artificial intelligence, we leverage our data to identify trends and patterns.

Interested in learning more? Book a demo today!

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State-Specific Resources

2025 Legislative Committee Deadlines Calendar

Staying on top of key deadlines is manageable in one state, but if you’re tracking bills across multiple states, or nationwide, it quickly becomes overwhelming. That’s why we created the 2025 Legislative Committee Deadlines Calendar. Stay ahead of important dates and download our calendar today. Get started with Plural. Plural helps top public policy teams get […]

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State-Specific Resources

End of Session Report: Florida 2024 Legislative Session

The 2024 Florida legislative session saw significant activity in the realm of insurance and financial services, reflecting key themes of consumer protection, market stability, and regulatory modernization.

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The post Top Issues for State Legislatures in 2024 appeared first on Plural Policy.

Criminal Justice Reforms in California

AB 360 addresses the classification of “excited delirium” as a cause of death. This terminology is controversial and was notably seen in the George Floyd case. Many argue that it stemmed from biased policing and investigations. This bill aims to eliminate certain discrimination against victims of police violence. 

AB 452 eliminates of the statute of limitations for childhood sexual assault victims. This bill brings overdue justice to survivors. It comes after a 2017 law that allowed a ‘look back window’ during which victims of childhood sexual assault may come forward. After this law lapsed in 2022, the state decided to bring back the intent of the law into permanence. California becomes one of the first states to implement this type of law. 

AB 2282 enforces stricter penalties for hate symbols in public spaces. This includes symbols like swastikas and nooses. The bill aims to combat hate crimes and foster a safer environment in California.

Housing Initiatives in California

AB 12 places restrictions on landlords. Under the new bill, landlords may not charge more than one month’s rent for a security deposit. This bill offers relief to renters and decreases barriers to housing in California. California is already facing a housing crisis, and measures like AB 12 lessen some of the strain

SB 4 grants certain entities the right to build housing on their properties. This includes religious institutions and independent higher education entities. The bill aims to streamline the housing development process.

Healthcare Advances in California

SB 345 reflects California’s commitment to reproductive rights. The bill aims to protect healthcare providers who mail certain medications out-of-state. This includes abortion pills or gender-affirming medications. SB 345 is one of many laws implemented in CA after the fall of Roe v. Wade in 2022. The bill will allow women and the LGBTQ community to continue to access life-saving care.

SB 385 empowers physician’s assistants to perform surgical abortions without direct doctor supervision. It’s one of many efforts to expand access to reproductive healthcare.

SB 848 enacts workplace protections for those experiencing reproductive loss. It mandates five days of paid leave for those experiencing a reproductive loss, including miscarriages. The bill promotes compassion and support for pregnant people in the workplace.

SB 43 signals the legislature’s focus on mental healthcare. The bill allows for involuntary medical holds for those with severe mental illness. Individuals suffering from drug addiction or alcohol dependence also fall under the provisions of the bill.

Consumer Protections in California

AB 1084 states that retailers must establish a gender-neutral toy section. The bill promotes inclusivity in shopping experiences for those of varied gender identities.

SB 244, also known as The Right to Repair Act, requires that manufacturers provide consumers and repair shops with the tools and information necessary for device repairs.

Finally, SB 478 is another effort to increase consumer protections. Beginning in July, websites must transparently display the actual cost of services or items. This bill aims to increase transparency and prevent hidden fees.

California Minimum Wage Increases

Under AB 1228, fast-food workers will see an increase in the minimum wage to $20 an hour come April.

With SB 525, healthcare workers will experience wage increases based on facility type. The bill sets forth with an industry-wide $25 minimum wage goal by 2033.

SB 700 and AB 2188 protect cannabis users from employment discrimination. These acts further decriminalizing cannabis in California. Certain trades and federal workers are excluded from the protections set forth by both bills.

Miscellaneous New Laws in California

AB 587 requires social media companies to disclose their approach to hate speech and disinformation. It’s an effort to promote accountability in a sector that’s recently come under fire.

SB 497 is also known as The Equal Pay and Anti-Retaliation Act. The bill streamlines the process by which employees can make retaliation claims against their employers.

SB 616 creates increased protections for workers. Under the bill, employers must provide at least five paid sick days per year for both hourly and salaried workers.

Monitoring New Laws in California in 2024

California’s legislative agenda for 2024 demonstrates a commitment to addressing issues affecting Californians. Major bills address criminal justice, housing, healthcare, consumer protection, and employment. As these policies come into effect, the state aims to create a more equitable, inclusive, and compassionate society, setting a precedent for other regions to follow.

Plural is catered to the needs of public policy teams monitoring new laws in California in California. Unlock premium legislative data, advanced searching and tracking, tools for easy organization and collaboration, and AI-powered insights, catered to your needs in California.

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The post California’s Legislative Reforms in 2024: A Comprehensive Overview appeared first on Plural Policy.

Expanding Access to Naloxone

Efforts to curb the opioid crisis have been central to recent legislative sessions in Maine. 2023 was no different. Maine lawmakers passed seven bills expanding access to the overdose-reversal drug, naloxone. This includes the following measures:

• LD 600 – Allows municipalities to provide public access to naloxone on municipal property and in municipal buildings.
• LD 1036 – Requires more law enforcement officers to be trained and equipped to administer naloxone.
• LD 1315 – Requires secondary schools to offer annual training in the administration of naloxone.

Expanding Access to Abortion

Democrats passed several bills expanding or protecting access to abortion. While each was contentious, LD 1619 was the subject of particularly heated debates. The bill, signed in July, allows physicians to provide post-viability abortions when deemed necessary. Previously, post-viability procedures could only be performed if the mother’s life was in danger. 

Incentivizing Workforce Development

Workforce growth is another perennial priority for Maine lawmakers. In particular, lawmakers seek to incentivize growth in sectors experiencing shortages. Workforce incentivization bills passed this year include:

• LD 937 – Resolve, To Establish The Commission Regarding Foreign-Trained Physicians Living In Maine
• LD 1366 – An Act To Address Educational Technician Shortages In Public Schools By Establishing An Alternative Certification Pathway
• LD 1539 – An Act To Promote A Diverse, More Experienced Construction Workforce And Ensure High-Quality Careers By Increasing Registered Apprenticeship Programs

Other Notable Changes

• LD 769 makes it easier for some small political parties to secure and maintain official party status.
• LD 1002 requires that all school lunch periods be at least 30 minutes long.
• LD 1029 will establish a commission to begin planning a celebration of the 250th anniversary of the founding of the United States.
• LD 1155 will increase Maine legislative salaries beginning with the next state legislature.

Looking Ahead to 2024

While the 2023 legislative session was productive, over 1,000 bills will carry over to the 2024 legislative session. Lawmakers are expected to return in January to take up these bills, and offer new proposals as well. As ever, Plural will have all of the details and updates you will need to follow this activity.

Get Started With Plural

In the world of public policy, it’s all about sorting through the noise to get to what matters. With Plural, you’ll only get exactly what you need, and none of what you don’t.

Unlock the power of Plural in Maine — that’s premium legislative data, advanced searching and tracking, tools for easy organization and collaboration, and AI-powered insights, catered to your needs.

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The post New Laws Passed During Maine’s 131st Legislature appeared first on Plural Policy.

California’s Legislature has a total of 120 legislators, 80 Assemblymembers and 40 State Senators. The Assembly is composed of 62 Democrats and 18 Republicans, while the Senate is composed of 32 Democrats and eight Republicans.

Before the session began, Democratic leaders announced their legislative priorities:

• Housing
• Climate change
• Economic investment
• Big oil industries
• The opioid crisis
• Healthcare
• Systemic racism
• Public transportation.

Republican leaders shared their own, including: cutting government costs, tackling crime, acting on homelessness, investing in students, building water storages, and reducing wildfires.

Governor Gavin Newsom broke tradition by not delivering a State of the State address, where governors make the case for their agenda. Instead, he traveled throughout the state to share priorities. Governor Newsom’s legislative priorities include SB 2, ‘The Price Gouging Penalty Bill.’ This bill passed on March 27, 2023, and went into effect on June 26, 2023.

Key 2023 Session Data

In California, 3,036 bills were introduced during this year’s legislative session. Of those, nearly 40% (1,196) were passed by the Senate and Assembly. Governor Newsom has signed nearly 400 bills into law. He will sign many more throughout the rest of September. New laws relate to abortion, education, climate change, the LGBTQ+ community, and consumer protections.

Key Legislative Trends in California

• Gun control
• LGBTQ+ rights
• Climate change
• Abortion and reproductive healthcare
• Education
• Elections and voting rights
• Anti-discrimination
• Criminal justice reform

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The post Recapping California’s 2023 Legislative Session: The First Half of the Biennium appeared first on Plural Policy.