Health and Human Services (HHS)

SUPPORTING THOSE WITH CHRONIC KIDNEY DISEASE/AMKD

WHEREAS, more than 1 in 7 (15% of US adults or 37 million people) are estimated to have Chronic Kidney Disease (CKD) and as many as 9 in 10 adults with CKD do not know they have CKD;

WHEREAS, kidney disease disproportionately affects communities of color;

WHEREAS, African Americans are almost four times more likely, and Hispanics are 1.3 times more likely to have kidney failure compared to White Americans;

WHEREAS, although they make up only 13.6% of the population, African Americans make up more than 35% of dialysis patients;

WHEREAS, 90% of patients with CKD stages 1-3 are undiagnosed and less than 3% of Black patients believe that they are at high risk for CKD;

WHEREAS, CKD, when diagnosed, is often diagnosed in late stages of the disease, when irreversible damage to the kidneys has already occurred;

WHEREAS, 15% of people diagnosed with CKD are unaware of the cause of their disease;

WHEREAS, the overall Medicare costs for people with CKD were $87.2 billion and the total Medicare fee-for-service spending for patients with ESRD or kidney failure reached $37.3 billion in 2019;

WHEREAS, recent scientific advancements have shown that some of the health disparities associated with CKD have a genetic basis;

WHEREAS, this genetic risk factor for CKD was discovered in 2010 when scientists learned that people who inherit two variants of the APOL1 gene are at significantly increased risk of developing kidney disease;

WHEREAS, these APOL1 risk variants are found exclusively in people of sub-Saharan African ancestry, including people who identify themselves as African American, Afro-Caribbean, and Hispanic, as the risk variants originally offered protection from a parasitic disease known as African human trypanosomiasis;

WHEREAS, 13% of people of African descent carry two APOL1 risk variants, and estimates suggest that up to 1 in 5 people with two APOL1 risk variants will develop kidney disease;

WHEREAS, APOL1-mediated kidney disease causes high levels of protein in the urine, or proteinuria, and can lead to various symptoms, including swelling in the legs and/or feet, fatigue, and weight gain;

WHEREAS, research has also shown that the course of kidney disease is more rapidly progressive in individuals with two APOL1 risk variants than in patients without them;

WHEREAS, the disease may eventually lead to kidney failure, requiring dialysis or a kidney transplant;

WHEREAS, there are simple tests to diagnose chronic kidney disease, including blood and urine tests, and a genetic test exists to identify presence of APOL1 risk variants; and

WHEREAS, it is imperative to improve diagnosis and treatment of CKD in African Americans through community-based programs that address racial and ethnic disparities in the awareness, diagnosis, and treatment of chronic kidney disease.

THEREFORE, BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) urges state and federal policymakers to ensure that high risk individuals are screened for chronic kidney disease, and that genetic testing and counseling services are offered to at risk individuals diagnosed with CKD as recommended by the best scientifically validated data;

BE IT FURTHER RESOLVED, that state Departments of Health should develop and fund chronic kidney disease screening programs that provide for referrals for follow up care, including genetic testing if appropriate;

BE IT FURTHER RESOLVED, that in developing chronic kidney disease screening programs, the state Department of Health and/or the appropriate state agency shall solicit and consider input from the general public, with specific emphasis on attempting to receive input from persons or groups with knowledge and experience in the area of chronic kidney disease, including, but not limited to, patients, caregivers, patient advocacy organizations, nephrologists, and primary care providers;

BE IT FURTHER RESOLVED, that in planning CKD screening the Department of Health shall identify opportunities where disease education, CKD disease services, access to care, access to information and resources for CKD patients can all be improved;

BE IT FURTHER RESOLVED, that state Medicaid programs should work to ensure that high risk patients in state Medicaid programs are fully screened for CKD, including genetic testing if appropriate;

BE IT FURTHER RESOLVED, that state and federal policymakers take all necessary actions to identify and remove other impediments on CKD patients and their families, such as logistical and financial challenges, including access to genetic counseling services, time off from work, childcare, transportation, and other related expenses, that may prevent or otherwise impede all patients including CKD patients from accessing needed care;

BE IT FURTHER RESOLVED, that payers should encourage and fund CKD screening and diagnosis, including appropriate genotyping, as part of appropriate preventive care; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials and agencies as appropriate.

• Resolution ID: HHS-24-14
• Sponsored by: Rep. Terry Alexander (SC)
• Policy Committee: Health and Human Services (HHS)

IMPROVING SAFETY IN THE OPPERATING ROOM

WHEREAS, certified surgical technologists serve as a surgeon’s co-pilot in the operating room, providing instruments and supplies to the surgeon and preventing patient death related to medication, surgical fires, instruments, implants, infection, and bleeding;

WHEREAS, certified surgical technologists are the surgical team member that maintains the sterile surgical field to ensure the surgical team adheres to sterile technique to prevent surgical site infections;

WHEREAS, certified surgical technologists must perform very effectively to ensure that certain “Never Events” like medication errors, surgical implant errors, unintended retained surgical items, patient burns, and incorrect site surgeries do not take place;

WHEREAS, the persons who perform must be highly skilled and well trained with ample operating room experience;

WHEREAS, for nearly fifty years, the standard for surgical technologist education has been accredited education, including classroom time plus 225 hours of skills lab before entering the operating room for 540 hours of supervised clinical rotation training;

WHEREAS, in recent years, unaccredited programs have popped up that do not require such intensive training, including some online only programs that require no operating room experience before completion of the program;

WHEREAS, qualified, well trained certified surgical technologists are vital to a safe operating room and good patient safety practice; and

WHEREAS, certain exceptions may be made for currently employed surgical technologists and military-trained surgical technologists, or in cases where workforce shortages call for using lesser trained individuals depending on a number of factors.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators calls upon states across the country to implement certain minimum standards for certified surgical technologists to ensure safer operating rooms, to protect patients from preventable mistakes in the operating room, and to protect student consumers from predatory educational programs that will not prepare them for long term success in their field; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• Resolution ID: HHS-24-22
• Sponsored by: Sen. Gloria Butler (GA)
• Policy Committee: Health and Human Services (HHS)

ADDRESSING MENTAL HEALTH IN THE WORKPLACE

WHEREAS, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 21%, or more than 50 million Americans, are experiencing a mental health condition and Americans’ mental health has been exacerbated by the COVID-19 pandemic, with reported symptoms of anxiety and/or depression increasing from 11% to nearly 32%;

WHEREAS, over half of adults with mental health conditions do not receive treatment and 42% reported they were unable to afford the treatment they need;

WHEREAS, according to the Department of Health and Human Services Office of Minority Health, African American adults in the US are more likely than white adults to report persistent symptoms of emotional distress, such as sadness and feeling like everything is an effort;

WHEREAS, African American adults living below the poverty line are more than twice as likely to report serious psychological distress;

WHEREAS, despite the needs, only one in three African American adults with mental illness receives treatment, according to SAMHSA;

WHEREAS, according to the Kaiser Family Foundation, 11.5% of African Americans versus 7.5% of white Americans are uninsured;

WHEREAS, according to the American Psychiatric Association, African Americans are less likely to receive guideline-consistent care, less frequently included in research, and more likely to use emergency rooms or primary care rather than mental health specialists;

WHEREAS, untreated mental health conditions can negatively impact employee performance, rates of illness, absenteeism, and accidents;

WHEREAS, individuals are quitting their jobs due to mental health conditions, and may be dropping out of the workforce altogether;

WHEREAS, most employees look for workplaces that support mental health when looking for new job opportunities;

WHEREAS, workplaces are a significant contributor to Americans’ mental health and well-being;

WHEREAS, there is a severe shortage of mental health service providers in the United States, with an estimated 350 individuals for every one mental health provider;

WHEREAS, only 2% of psychiatrists and 4% of psychologists in the United States are Black;

WHEREAS, people with mental health conditions often struggle to find and afford mental health care in their areas;

WHEREAS, accessing mental health care can be particularly challenging for individuals from underserved communities, including Black, Indigenous, People of Color (BIPOC) and rural communities;

WHEREAS, minority groups have less access to mental health services and are less likely to receive high-quality care and provider discrimination and lack of culturally competent mental health care create barriers for underserved communities seeking care;

WHEREAS, individuals in rural and underserved communities face barriers to receiving mental health care, including provider shortages, transportation barriers, and social stigma;

WHEREAS, unequal access to mental health care may exacerbate negative outcomes, making treatment and recovery more difficult; and

WHEREAS, the State Exchange on Employment and Disability (SEED), an initiative of the U.S. Department of Labor’s Office of Disability Employment Policy, convened the Mental Health Matters National Task Force on Workforce Mental Health Policy, which made recommendations for policy improvements to address nondiscrimination, parity and benefits, workplace care and supports, underserved racial and ethnic and rural communities, and behavioral health workforce shortages and state behavioral health resource systems.

THEREFORE BE IT RESOLVED, the National Black Caucus of State Legislators (NBCSL) urges state policymakers to take actions to enhance nondiscrimination, mental health parity and benefits to protect people with mental health conditions by:

• Adopting state nondiscrimination laws that protect people with mental disabilities from discrimination and require insurance plans to provide coverage for medically necessary mental health treatment;
• Requiring health insurance plans to provide equal coverage for mental health treatment as for other medical treatment;
• Requiring workers’ compensation to provide eligibility for workers exposed to psychologically traumatic work-related events;
• Requiring employers to allow sick leave to be used for diagnosis, care and treatment of mental illness;

BE IT FURTHER RESOLVED, that the NBCSL urges state policymakers to take actions to enhance workplace care and supports for people with mental health conditions, such as by:

• Educating employers on the reasonable accommodations available to support workers with mental health conditions;
• Ensuring that state Medicaid programs provide reimbursement for tele mental health services after the end of the COVID-19 public health emergency;
• Requiring health insurance benefit plans to cover tele mental health care;
• Providing low- or no-cost mental health care to state employees;
• Requiring health insurance plans to cover annual mental health wellness examinations;
• Educating employers and providing resources about worksite wellness and/or Mental Health First Aid;
• Providing tax credits for employers who provide worksite wellness programs;
• Providing Employee Assistance Programs for public employees;
• Providing tax and other incentives for employers to provide Employee Assistance Programs;
• Creating state infrastructure and offices to study, provide resources about, and make recommendations for state mental health care;

BE IT FURTHER RESOLVED, that NBCSL urges state policymakers to target underserved racial and ethnic and rural communities for mental health resources by:

• Creating equity-focused agencies, task forces, offices, and advisory councils to make recommendations regarding behavioral health disparities and social determinants of health;
• Requiring state legislation and regulations to recognize and address historic and systemic barriers to health and economic equity by including racial impact statements;
• Requiring state agencies to prepare blueprints, reports and plans to ensure that equity is addressed systemically, including via collaboration and coordination among agencies;
• Requiring data collection regarding equity-related issues, health care disparities, and social determinants of health;
• Increasing access to culturally relevant education and training for behavioral health providers;
• Requiring implicit bias continuing education for mental health providers;
• Establishing and funding mental health crisis services and criminal justice diversion programs;
• Encouraging recruitment, training and retraining of mental health professionals who reflect the diversity of the populations they serve;
• Deploying community broadband access in underserved and rural communities;

BE IT FURTHER RESOLVED, that NBCSL urges state policymakers to address behavioral health workforce shortages by examining the following on a temporary basis:

• Joining the Interstate Counseling Compact, which allows eligible licensed professional counselors to practice in other compact states, provided they are licensed to practice in at least one compact member state;
• Allowing psychologists who complete certain additional training to prescribe mental health medications;
• Providing resources for training and degrees in mental health fields;
• Revising licensure requirements to increase the number of providers;
• Supporting greater use of behavioral support specialists, such as peer specialists, community health workers, and paraprofessionals;
• Requiring state Medicaid programs to reimburse for peer support services;
• Providing mental health hotlines, low- and no-cost mental health care services, and other support services for mental health care workers;
• Designating and funding crisis hotline centers or services and crisis care coordination for individuals accessing the 988 suicide hotline; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• Resolution ID: HHS-24-24
• Sponsored by: Rep. Vivian Flowers (AR) and Rep. Ajay Pittman (OK)
• Policy Committee: Health and Human Services (HHS)

ENCOURAGING STUDIES ON CARE FOR LUPUS AND LUPUS NEPHRITIS

WHEREAS, Systemic lupus erythematosus (SLE) or lupus is a chronic, complex, and often disabling autoimmune disorder in which the body’s immune system attacks the body’s own cells, tissues, and organs;

WHEREAS, SLE can affect many parts of the body including the joints, skin, brain, heart, lungs, and kidneys;

WHEREAS, Lupus nephritis, or LN, is a serious manifestation of lupus that causes inflammation of the kidneys;

WHEREAS, LN can lead to irreversible kidney damage or even kidney failure, which may require dialysis or a transplant;

WHEREAS, prompt diagnosis and treatment are crucial for patients with SLE and LN;

WHEREAS, SLE and LN disproportionately impact women and patients of color;

WHEREAS, according to the Lupus Foundation of America, Lupus is three times more common in African American women than in Caucasian women; and

WHEREAS, too many SLE and LN patients in the U.S. and especially marginalized patients face harmful delays in diagnosis and treatment.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL), urges all states to conduct studies to determine the prevalence, impact, and needs of individuals with lupus and those with lupus nephritis in their respective states;

BE IT FURTHER RESOLVED, that these studies shall specifically determine: the prevalence, by geographic location, of individuals diagnosed with lupus and LN; the availability and affordability of screening services for lupus and LN; the frequency in which lupus patients are screened for LN; the treatment infrastructure for lupus and LN; and the unmet medical, psychological, and social needs encountered by individuals with lupus and LN;

BE IT FURTHER RESOLVED, that the studies be submitted to the state legislatures in a timely manner and include actionable recommendations to address identified shortcomings; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate

• Resolution ID: HHS-24-25
• Sponsored by: Rep. Vivian Flowers (AR)
• Policy Committee: Health and Human Services (HHS)

AFFORDABLE PRESCRIPTION DRUGS AND HEALTH DISPARITIES

WHEREAS, the Centers for Disease Control and Prevent define health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations”;

WHEREAS, health and health care disparities are a persistent challenge in the United States;

WHEREAS, across the country, racial and ethnic minority populations experience higher rates of poor health and disease in a range of health conditions, including diabetes, hypertension, obesity, asthma, and heart disease, when compared to their White counterparts;

WHEREAS, Black Americans have the highest mortality rate for all cancers combined compared with other racial and ethnic groups according to the U.S. Department of Health and Human Services;

WHEREAS, according to the Centers for Disease Control and Prevention (CDC), Black Americans are most affected by HIV, accounting for 40 percent of all new HIV diagnoses in 2021 despite only representing 12 percent of the U.S. population, while Hispanic people accounted for 29 percent of all new HIV diagnoses while only representing nineteen percent of the population;

WHEREAS, the COVID-19 pandemic further highlighted health disparities in the U.S., with Black American, Hispanic, American Indian and Alaska Native populations experiencing higher rates of hospitalization and death compared to White populations, according to the CDC;

WHEREAS, a large proportion of Black Americans experience poor environmental quality in Black communities and receive less advanced care from health care providers, both of which contribute to health inequity;

WHEREAS, Black Americans see less access to quality medical care where they live as the top reason that they have worse health outcomes than other adults;

WHEREAS, the number of uninsured Black and Hispanic Americans has dropped significantly over the past decade, decreasing from 20 to 11 percent for Black Americans and from 33 percent to 21 percent for Hispanic Americans, according to the Kaiser Family Foundation;

WHEREAS, although access to insurance has increased over the last decade, out-of-pocket costs for patients continues to increase, creating access barriers for patients;

WHEREAS, insurance cost-sharing for prescription drugs in the form of higher deductibles and coinsurance, has placed a particularly high burden on patients that need the most innovative therapies such as cancer, arthritis, multiple sclerosis, and cystic fibrosis, among others;

WHEREAS, state legislators are seeking policy solutions to lower costs for patients, including establishing quasi-governmental bodies called Prescription Drug Affordability Boards (PDABs);

WHEREAS, PDABs are tasked with lowering the cost of prescription drugs that cause “affordability challenges” to the health care system or patients;

WHEREAS, some PDAB laws empowered the PDAB to lower the price that insurers and pharmacy benefit managers pay for certain drugs through “upper payment limits”;

WHEREAS, the prescription drug supply chain operates through national wholesalers and, often, national chain pharmacies whose operations extend well beyond a single state’s borders;

WHEREAS, an upper price limit set by a PDAB may limit the ability of pharmacies and doctors in that state to access the drug, thereby threatening patient access to the medicine;

WHEREAS, the types and classes of drugs targeted for upper payment limits vary by state, PDABs have focused on the most innovative medicines that treat chronic, debilitating, and rare diseases, including conditions with higher prevalence or worse treatment outcomes among Black and Hispanic Americans; and

WHEREAS, lowering patient cost is a critical goal for reducing health and health care disparities and ensuring all communities benefit from the latest health care innovations, PDAB may worsen health disparities by reducing access to innovative therapies.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) recognizes the continued challenges of health and healthcare disparities and acknowledges that Prescription Drug Affordability Boards should work to ensure that medications remain available to patients to not create greater health and health care disparities in the United States; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• Resolution ID: HHS-24-28
• Sponsored by: Rep. Ajay Pittman (OK)
• Policy Committee: Health and Human Services (HHS)

CHOLESTEROL EDUCATION MONTH

WHEREAS, High cholesterol, also called hypercholesterolemia, is the chronic presence of high levels of cholesterol in the blood that can lead to cardiovascular disease (CVD), and even cardiovascular (CV) events like heart attacks or strokes;

WHERAS, the Centers for Disease Control and Prevention (CDC) estimates that CVD is arguably the most underappreciated public health crisis of our time, and someone in the US has a heart attack every 40 seconds – yet about 80% are preventable;

WHEREAS, low-density lipoprotein cholesterol (LDL-C), or ‘bad’ cholesterol, is an easily modifiable risk factor for CVD; lower LDL-C is associated with a reduced risk of heart attack and stroke;

WHEREAS, heart disease is the leading cause of death in the United States among African Americans and other racial and ethnic minority populations;

WHEREAS, more than 80 million adults have high LDL-C, according to the CDC;

WHEREAS, the American Heart Association (AHA) indicates that CVD disproportionately affects minority populations; 52.3% of Hispanic males and 42.7% of Hispanic females over the age of 20 are affected by CVD, and 60.1% of Black males and 58.8% of Black females 20 years of age and older have CVD;

WHEREAS, the CDC found that 1 in 3 deaths in the U.S. are due to heart disease and this results in more than $216 billion in healthcare costs;

WHEREAS, a study published in the American Journal of Preventative Cardiology found cholesterol testing — an important preventive measure for reducing the risk of cardiovascular disease — declined during the COVID pandemic;

WHERAS, the resources needed to bend the curve in CVD exist, yet 71% of hypercholesterolemia patients at high risk of a CV event never achieve recommended LDL-C treatment guideline thresholds;

WHEREAS, the LDL-C Action Summit, a consortium of the nation’s leading cardiovascular stakeholder groups, seeks to cut cardiovascular events in half by 2030;

WHEREAS, the Centers for Disease Control and Prevention’s Million Hearts program seeks to improve access and quality of care to reduce heart disease, stroke, and death; and

WHEREAS, September is recognized as National Cholesterol Education Month to raise awareness of cardiovascular disease and the importance of knowing one’s LDL-C number.

THEREFORE BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) urge all State Departments of Health to update the state’s cardiovascular plan to accelerate quality improvements and measures to achieve improved health outcomes for CVD patients;

BE IT FURTHER RESOLVED, that the NBCSL encourages all Americans to know their LDL-C number;

BE IT FURTHER RESOLVED, that the NBCSL urges providers to treat all CVD patients in accordance with American College of Cardiology treatment guidelines;

BE IT FURTHER RESOLVED, that the NBCSL urges states to recognize September as Cholesterol Education Month and September 1 as LDL-C Awareness Day; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• Resolution ID: HHS-24-30
• Sponsored by: Sen. Raumesh Akbari (TN)
• Policy Committee: Health and Human Services (HHS)

ENSURING EQUITIBLE HEALTH OUTCOMES

WHEREAS, concerns over rising health care costs have led to renewed interest in the use of value assessment methodologies to set coverage or payment policy for medicines and other interventions. Many forms of value assessment can devalue the lives of underserved patients – especially those forms that rely on new methods for value assessment (such as the quality adjusted life year (QALY)), which can devalue the lives of the disabled, the chronically ill, seniors, and communities of color;

WHEREAS, Government should not make judgements based on these one-size-fits-all methodologies that result in policies that ignore patient differences and equity considerations;

WHEREAS, many value assessment methodologies obscure important differences, such as race, health disparities, and socioeconomic disadvantages, that are disproportionately faced by underserved populations;

WHEREAS, inappropriate use of these flawed methodologies to determine coverage or reimbursement could devalue the specific needs of these populations, limit access to medicines, and further perpetuate health inequities.

WHEREAS, value assessment determines what works for an “average” patient population, generating inaccurate results for the value of treatments to Black patients.

WHEREAS, in ignoring population diversity and health disparities, many value assessments generate biased results that can exacerbate system inequities and create access barriers for underserved populations and those at higher risk for poor health outcomes, and decision-making that relies on biased value assessments that are likely to reinforce these inequities;

WHEREAS, value assessment methodologies can fail to incorporate the effects of racism, prejudice, stigma, or social inequalities in their assessments of the value of medicines;

WHEREAS, the quality of life assigned to populations with various conditions used in value assessment methodologies is based on large surveys of the general public that are typically majority White and thus minimizes the value of medicines for non-majority racial/ethnic populations, who face various conditions at larger rates than the general population;

WHEREAS, to conduct value assessments, researchers may need to assign a value to a person’s health, and this can lead to the systematic undervaluing of communities of color, who may have pre-existing health conditions due to numerous inequities resulting from the negative consequences of social determinants of health and racism, including reduced access to care, reduced quality of care, and higher prevalence of disease and disease-related mortality;

WHEREAS, life expectancy in the U.S. Black population is lower than for the white population, which leads value assessment methods to undervalue treatment that extends life, and as a result of disparities in life expectancy, when using QALY-based methods, the value of a life-saving treatment for Black patients’ lives can be valued up to 10% less than for white patients;

WHEREAS, State Governments are considering and implementing policies that may rely on value assessments, which could potentially minimize the value of medicines for non-majority racial/ethnic populations without adequately considering the impact of these policies; and

WHEREAS, government use of value assessment methodologies could override patient-provider decisions regarding which treatment is best for each patient and their families based on the results of those methodologies, which ignore and/ or undervalue the needs of minority and ethnic populations.

THEREFORE, BE IT RESOLVED that the National Black Caucus of State Legislators (NBCSL) believes that it is imperative that people of all ethnic and racial backgrounds have equitable access to treatment and recognizes that health inequities are often rooted in community-level factors like where we live, work, and play;

BE IT FURTHER RESOLVED that NBCSL believes that each state should examine value assessment metrics as one of many tools available to decisionmakers and ensure that any data used reflect the diversity of and inequities faced by patient populations, that differences in value across communities are uncovered in subgroup assessments, and, as a corollary, that transparency be improved to consistently acknowledge important gaps in evidence when they exist;

BE IT FURTHER RESOLVED, that the NBCSL should discourage use of any discriminatory metrics, and work to ensure that all metrics take into account full racial and ethnic data when appropriate; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• Resolution ID: HHS-24-36
• Sponsored by: Sen. London Lamar (TN)
• Policy Committee: Health and Human Services (HHS)

PROTECTING AN EQUITABLE HEALTHCARE MARKET

WHEREAS, uninsured and underinsured patients rely on patient assistance to help them access the prescription medicines needed to protect their health;

WHEREAS, vendors in partnership with health insurers, health plans, and pharmacy benefit managers implement alternative funding programs, which remove coverage of certain specialty medicines and shift the cost of covering these medicines onto third party patient assistance programs intended for uninsured or underinsured patients;

WHEREAS, patients are compelled to share personal financial information to facilitate enrollment into the patient assistance program and may be forced to self-pay if they refuse to provide this information or do not qualify for the patient assistance program;

WHEREAS, commercially insured patients, who otherwise may not be eligible for patient assistance, can access funds intended for uninsured or underinsured patients;

WHEREAS, patients face undue stress, confusion, and delay in treatment when their needed medication has been denied under their health insurance coverage as a result of these alternative funding programs;

WHEREAS, patients with chronic or pre-existing conditions are disproportionately impacted by these alternative funding programs;

WHEREAS, helping patients navigate patient assistance program applications and insurance appeals requires significant paperwork and added burden on healthcare providers; and

WHEREAS, patients need equitable and accessible health coverage that does not impose unfair burdens upon them.

THEREFORE, BE IT RESOLVED, that the National Black Caucus of State Legislators (NBCSL) believes that it is our duty as public servants to enact legislation that does not undermine insurance coverage and access to needed health care to foster improved health outcomes;

BE IT FURTHER RESOLVED, that NBCSL believes that each state should prohibit health insurers and health plans from setting health plan coverage terms based on the amount of patient assistance available; and

BE IT FINALLY RESOLVED, that a copy of this resolution be transmitted to the President of the United States, the Vice President of the United States, members of the United States House of Representatives and the United States Senate, and other federal and state government officials as appropriate.

• Resolution ID: HHS-24-37
• Sponsored by: Sen. London Lamar (TN)
• Policy Committee: Health and Human Services (HHS)