ACA Increased Coverage and Access to Care for Rural and Urban Populations Alike, Report Finds

Individuals living in rural areas experienced an 8 percentage point increase in coverage between 2012 and early 2015, similar to the coverage gains seen in urban and suburban areas, according to a new report from HHS's Office of the Assistant Secretary for Planning and Evaluation. However, the report notes that the overall coverage gain for rural individuals is “particularly striking” due to the disproportionate concentration of uninsured rural individuals living in states that have not expanded Medicaid: 65% of the rural nonelderly uninsured live in non-expansion states versus 51% of the nonelderly uninsured in urban areas. The report also found that the portion of rural individuals who reported being unable to afford medically necessary care decreased by 5.9 percentage points compared to 5.4 percentage points for urban individuals, though the latter saw greater gains in the report’s other access measures.

Illinois: Lawmakers Respond to Opioid Epidemic

The Legislature overrode Governor Bruce Rauner’s (R) partial veto to pass a bill requiring Medicaid to cover all Food and Drug Administration-approved, medication-assisted opioid and alcohol dependence treatments. The law, which is part of an effort to address the State’s opioid addiction crisis, also includes: a mandate that law enforcement agencies, fire departments and emergency medical service providers possess anti-overdose drugs; authorization for trained pharmacists to dispense the anti-overdose drug naloxone without a prescription; a directive aimed at requiring private insurance companies to cover anti-overdose medications; and the expansion of drug courts. The bill’s implementation is ongoing and impacts several State agencies.

New York: Legislation Mandates Coverage for Opioid Addiction Treatment

The Legislature introduced a package of bills that would mandate insurance coverage for overdose medication and eliminate pre-authorization requirements for opioid addiction treatment. The package, which is expected to pass the Legislature and be signed by Governor Andrew Cuomo (D), also increases emergency treatment options, requires hospitals to provide follow-up treatment upon discharge, and reduces prescription limits for addictive opioids from 30 to seven days. The legislation implements some of the recommendations issued by New York's Heroin and Opioid Task Force in its final report, which emphasized expanding access to treatment programs and prescriber education.

North Carolina: Antitrust Lawsuit Challenges State’s Largest Health System’s Commercial Contracting Practices

The U.S. Department of Justice and the North Carolina Attorney General filed a civil antitrust lawsuit against North Carolina's largest health system, Carolinas HealthCare System (CHS), challenging its use of "steering restrictions" in contracting with commercial insurers. The complaint focuses on CHS's use of its dominant market position (it has a 50% inpatient market share in the Charlotte region) to secure favorable provisions in insurer contracts that reduce competition, such as barring insurers from offering tiered networks with competing hospitals in top tiers. According toModern Healthcare, some experts believe the lawsuit may signal the beginning of a wave of steering-related regulation.