National Conference of State Legislatures Our American States

Our American States

The high cost of prescription drugs is a focus for legislators across the country. Over the past year, this podcast has talked with lawmakers about controlling the price of insulin, bringing more transparency to the work of pharmacy benefit managers, increasing efforts to gather drug cost data and creating drug affordability boards.

In this fourth and final episode of the series, we sat down with Rep. Iman Jodeh (D-Colo.) to talk about legislation passed in her state, requiring pharmaceutical benefit managers and health plans to demonstrate how rebates collected for manufacturers are used to reduce health insurance premiums. The legislation also requires certain state regulated health plans to implement co-payment only structures for all cost sharing tiers in their drug formularies.

Also joining for this episode is Colleen Becker of NCSL. She tracks legislation related to prescription drug costs and was instrumental in putting this series of podcasts together. She talked about the different types of legislation passed in 2022 and what we can expect to see coming out legislatures on this issue in the future.

Resources

• OAS Episode 176 Transcription
• Prescription Drug State Bill Tracking Database | 2015-Present
• Rep. Iman Jodeh, Colorado General Assembly

Previous Episodes in the Series

• Shining a Light on Drug Prices
• Tackling Prescription Drug Costs
• How Two States Took on the Cost of Insulin

Across the Aisle

When the 11 women in the Missouri Senate met socially one evening in 2021, they realized they were making history--the most women ever to serve at one time--and they wondered how to mark the occasion.

They decided to write a book telling the story of all the women who have served in the Senate. They called it “You Can Too” to show young readers--girls and boys--there are many paths to becoming a senator. But they didn’t stop there. They became known as The 11, and joined forces to shut down two key filibusters and to write a comprehensive approach to literacy that passed with nearly unanimous support in both chambers.

In this episode of "Across the Aisle,"" we hear how their collaborations and friendships developed and how it improved the legislation they work on.

NCSL’s Kelley Griffin is the host and producer. She has 28 years experience as a reporter and editor in public radio, and she invites you to share your stories of bipartisanship at acrosstheaisle@ncsl.org.

Resources

• ATA Episode 2 Transcription

Legislatures: The Inside Storey

Peverill Squire may know more about state legislatures and their history than anyone, and was a perfect guest for host Tim Storey on this episode of “Legislatures: The Inside Storey.”

Squire is a professor at the Truman School of Government at the University of Missouri, with a distinguished career researching state legislatures since colonists began the work in 1619. He has taught in Japan and Hungary and been part of the international committee of legislative specialists.

With new sessions starting in January with more than 1,500 newly elected legislators will alongside the veterans, Squire and Storey sat down to discuss how legislatures have changed over the centuries and how, in some respects, they’ve stayed the same. They also discussed the value of diversity, the need for more resources as legislatures deal with increasingly complex issues and why it’s important to give the minority its say.

Resources

• LTIS Episode 15 Transcription
• Peverill Squire, University of Missouri

Our American States

The $1.2 trillion Infrastructure Investment and Jobs Act (IIJA) signed into law in November 2021 included $65 billion for high-speed internet, or broadband. The bill includes nearly $45 million to serve parts of the country that are not well-served with broadband and also provide other services so people can both connect and make use of the service.

We sat down with Angela Siefer, the executive director of the National Digital Inclusion Alliance, and Erlinda Doherty in NCSL’s Washington office, to better understand the effect that money will have on communities across the country.

Doherty broke down the funding, explained how the federal government will administer the program and actions states need to take to participate.

Siefer discussed what communities are most in need of broadband service, the importance of providing not just service but also devices and the critical role of teaching digital skills and literacy.

This is the fifth and final installment of our podcast series on the IIJA and the massive infusion of infrastructure money to the states. Our earlier episodes broke down the overall financing; the water projects covered under the bill; the highways, bridges and transportation programs; and the impact the legislation will have on the nation’s energy system.

Resources

• Biden-Harris Administration Announces $5.6 Million in Internet for All Grants to Two Minority-Serving Colleges and Universities in California, National Telecommunications and Information Administration
• Digital Inclusion Trailblazers, NDIA
• High-Speed Internet for All
• Join the NDIA Community
• The New Broadband Maps Are Finally Here, Federal Communications Commission, FCC
• OAS Episode 175 Transcription
• State Digital Equity Plan Toolkit, NDIA
• See more about NDIA
• Updates on the Affordable Connectivity Program, NDIA

Across the Aisle

NCSL is launching a new podcast called Across the Aisle to explore how bipartisanship is working in state capitols. We’ll hear how state legislators connect across party lines to get things done, sometimes in unlikely ways, and how they build relationships that allow them to work together on common goals.

Sometimes that collaboration starts on a mountain. Our first episode covers a bipartisan group of Nebraska senators who climbed Mt. Kilimanjaro together - while one was battling cancer - and built connections that serve them back at the statehouse.  We’ll have new stories every month and we hope we can include your experiences with working across the aisle.

NCSL’s Kelley Griffin is the host and producer. She has 28 years experience as a reporter and editor in public radio, and she invites you to share your stories of bipartisanship at acrosstheaisle@ncsl.org.

Resources

• ATA Eisode 1 Transcription

Legislatures: The Inside Storey

Host Tim Storey, CEO of NCSL, sits down with Terry Gerton, president and CEO of the National Academy of Public Administration (NAPA), to discuss the critical role of those who work in government service.

Gerton explains the important role expert public administrators play in roles such as handling federal grants and ensuring the money is spent responsibly. She also discussed the formation of NAPA, and why Congress gave it a charter to gather the best information and practices for managing the work of government. Gerton and Storey also discussed the challenge of attracting young people to public service and the path that took her from West Point to her current role.

Resources

• LTIS Episode 14 Transcription
• National Academy of Public Administration

Our American States

The U.S. energy system will see significant change as a result of two huge pieces of federal legislation: the $1.2 trillion Infrastructure Investment and Jobs Act signed into law in November 2021, and the more recent Inflation Reduction Act, which invests $369 billion over the next 10 years in climate and energy security programs.

The guests for this podcast are Ali Nouri, assistant secretary for Congressional and Intergovernmental Affairs at the U.S. Department of Energy, and David Terry, the executive director of the National Association, a State Energy Officials.

Nouri discussed programs to improve the resiliency of state electric grids, nuclear power, electrical vehicle charging infrastructure, hydrogen carbon capture and storage, reducing home heating and cooling costs, and other issues. Terry explained how state energy offices are working with federal officials, the role of state legislatures in implementing these programs, and how this new funding will affect state energy policy goals.

Resources

• Infrastructure Investment and Jobs Act: Implementation and Key Resources, NCSL
• National Association of State Energy Officials
• OAS Episode 174 Transcription
• Office of Congressional and Intergovernmental Affairs, U.S. Department of Energy

Our American States

Since 2018, state lawmakers in at least nine states—Alabama, California, Connecticut, Georgia, Massachusetts, New Jersey, New York, Washington and Vermont—have introduced legislation that would establish portable benefits programs for gig workers, create funds to foster innovative experimentation in this area or study related issues.

Portable benefits are just what they sound like—unemployment insurance, health care insurance, paid family leave coverage and more—that a worker can hold onto as they move from job to job.

The guests on this podcast--Senator Elena Parent, a Democrat from Georgia, and Senator Arthur Orr, a Republican from Alabama—both discussed the large number of workers in their states who would benefit from legislation that made portable benefits easier.

They discussed how the pandemic put a spotlight on nontraditional workers, the need for all workers to have access to robust retirement savings and changes in federal law that would help states innovate.

Resources

• OAS Episode 173 Transcription
• Portable Benefits for Gig Workers, NCSL LegisBrief

Legislatures: The Inside Storey

Charlie Cook has been observing, analyzing and chronicling America’s political trends for decades.

He founded The Cook Political Report in 1984 as an independent, nonpartisan newsletter that reports on elections and campaigns for Congress, president and governors. He left his publisher/editor role in 2021, a position now held by Amy Walter, another veteran observer of Washington politics.

Cook remains a regular contributor to the Cook Political Report and still almost as busy as ever keeping a keen eye on this election.

On this podcast, he talks with host Tim Storey about everything from high school debate to how Washington has changed to what he expects to see when all the ballots are counted in this year’s election.

Resources

• Looking Ahead: Charlie Cook on the Midterms, NCSL
• LTIS Episode 13 Transcription
• The Cook Political Report With Amy Walter

Our American States

Medicaid agencies and enrollees around the country will face big changes in the new year.

The current federal public health emergency for COVID-19 has resulted in about a 25% increase in people enrolled in Medicaid. Under the emergency declaration, Medicaid agencies have not reviewed the eligibility of people in the program since early 2020. Once that emergency declaration expires, probably in early 2023, experts expect millions of current enrollees will no longer be eligible.

To help understand what’s coming, we sat down with Andrea Maresca and Jane Longo of Health Management Associates. Both have deep expertise in Medicaid policy at the federal and state level.

Maresca discussed the details of the changes at the federal level, the increase in the number of enrollee and how it affected care for people in the Medicaid program.

Longo explained how state Medicaid agencies responded to the increase in clients, how state legislatures are helping to manage the coming changes and the scale of the challenge facing Medicaid agencies around the nation.

Resources

• Health Management Associates
• Medicaid: Unwinding From the Public Health Emergency, NCSL
• OAS Episode 172 Transcription

Our American States

Traffic fatalities have been on a disturbing upward trend for a couple of years, largely coinciding with the pandemic. In 2021, the National Highway Traffic Safety Administration (NHTSA) estimated that 42,915 people died in motor vehicle traffic crashes. That was the largest number of fatalities since 2005 and the largest year-over-year percentage increase since NHTSA instituted its present system for recording fatalities in 1975.

Ron Thaniel, the director of Governmental and External Affairs for NHTSA, is the guest on this podcast. He talked about what NHTSA is doing to combat this surge of traffic fatalities, including working with states and legislatures, which are responsible for traffic laws. In 2020, legislatures saw the introduction of more than 1,400 bills related to traffic safety.

Thaniel also said human behavior— impaired driving, speeding, not wearing a seatbelt—was the greatest factor in the increased number of fatalities in recent years. Thaniel also talked about efforts to protect vulnerable road users, such as pedestrians and bicyclists. Overall, he said, states will see increased spending from NHTSA with money for traffic safety included in the Infrastructure Investment and Jobs Act.

Resources

• 2020 Traffic Safety Trends Report, NCSL
• Autonomous Vehicles State Bill Tracking Database, NCSL
• Bicycle and Pedestrian Safety Webpage, NCSL
• Drunken Driving Webpage, NCSL
• Infrastructure Investment and Jobs Act: Implementation and Key Resources, NCSL
• Marijuana-Impaired Driving Webpage, NCSL
• National Highway Traffic Safety Administration
• NCSL Transportation Webpage, NCSL
• NHTSA Statement on Traffic Fatalities
• OAS Episode 171 Transcript
• Ron Thaniel bio
• Traffic Safety State Bill Tracking Database, NCSL
• Transportation Podcasts, NCSL

Legislatures: The Inside Storey

On this episode, host Tim Storey sits down with Clint Hurdle, a long-time baseball manager and player.

Hurdle is candid about his wins and losses. When he started out in his first year at the Kansas City Royals he was called a phenom in a cover story in Sports Illustrated. He also played for the Cincinnati Reds, the St. Louis Cardinals and the New York Mets.

After his playing days were over, Hurdle spent more than a decade back in the minor leagues before he was tapped to be manager of the Colorado Rockies in 2002. Hurdle talks about how those experiences shaped how he sees coaching and offers some lessons that work as well in the statehouse as they do on the diamond.

Resources

• LTIS Episode 12 transcription
• Clint Hurdle’s website

Our American States

Our focus on this podcast is the resilience of our electrical grid and systems in the face of extreme weather events and cyber threats. Just this summer, there’s been major flooding in Kentucky and Texas, extreme heat across the country and in Europe, and growing concern about wildfires in the western U.S.

State legislatures play a key role in shaping state policies that improve the security and resilience of energy systems. States also partner with federal agencies to identify risks, mitigate threats, and respond to disruptions.

To learn more about the state-federal partnership, we talked with two officials from the Office Of Cybersecurity, Energy Security, and Emergency Response, or CESER, at the U.S. Department of Energy. Ken Buell is the deputy director and Brandi Martin manages the State, Local, Tribal and Territorial Program.

Buell and Martin discussed how CESER responds to natural and man-made threats, how the office works with legislatures and other state entities, and the value of teaming up with state and local partners both during an emergency and at other times. They also highlighted efforts states are making to make their electrical systems more resilient.

Resources

• Energy Emergencies: The State Legislative Role in Planning and Response, NCSL
• FEMA Funding for Energy Resilience: Highlighting the Role of State Legislatures, NCSL
• NCSL Energy Homepage 
• NCSL Energy Resilience webinars
• OAS Episode 170 Transcription
• Office of Cybersecurity, Energy Security, and Emergency Response, DOE
• States Turn to Microgrids to Bolster Energy Resilience, NCSL

Our American States

When it comes to prescription drug policy, many lawmakers have focused efforts on reducing the cost of drugs to their constituents, such as limiting the copayment on insulin, or to their state budgets, as in the case of a reverse auction for a pharmacy benefit management contract.

Although these policies may lower costs, they do not alter a drug’s list price. Additionally, these laws only apply to people with health insurance. For uninsured or underinsured patients, they may be responsible for the full price of the drug. When it comes to drug pricing, legislators are considering a wide array of strategies to address this concern.

Our two guests on this podcast offer perspective on the route their state took. Delegate Joseline Pena-Melnyk is a Democrat from Maryland and Representative Tom Oliverson is a Republican from Texas. Both have backed legislation intended to make the price of prescription drugs more transparent.

Texas, along with nearly a dozen other states, is requiring reporting from manufacturers on price increases or initial launch prices, with some also requiring pricing and cost data from health plans, PBMs and wholesalers. Oliverson said that approach in Texas is already revealing useful information about rebates and other issues affecting the cost to consumers.

Maryland pioneered the idea of prescription drug affordability boards, or PDABs, to study drug prices, particularly for drugs that pose affordability issues for state, public and private programs. Pena-Melnyk explained how this sort of nongovernmental agency can examine drug pricing and costs in the state and how the system has worked in Maryland since it passed in 2019. Six other states have adopted similar legislation.

Resources

• OAS Episode 169 transcription
• Prescription Drugs Update: State Efforts to Boost Access and Lower Costs, NCSL
• Prescription Drug State Bill Tracking Database, NCSL

Our American States

The focus of this podcast is the transportation portion of the Infrastructure Investment and Jobs Act, or IIJA, signed by President Biden in November 2021. Overall, it provided $1.2 trillion for roads, bridges, highways, broadband, water projects and more. It’s the largest investment in transportation infrastructure since the Eisenhower administration.

The first guest on the podcast is Charles Small, the deputy assistant secretary for Intergovernmental Affairs at U.S. Department of Transportation. He explained what’s in the bill for transportation projects and discussed new programs related to bridges and electric vehicle charging, the investment in transit and how legislatures can make the most of the federal funds available.

The second guest is Joung Lee, deputy director-chief policy officer of The American Association of State Highway and Transportation Officials (AASHTO). He discussed the perspective of state directors of transportation, how they see the rollout of the bill so far and how the mix of formula and competitive grants affects states.

Resources

• Infrastructure Investment and Jobs Act Implementation, AASHTO
• Infrastructure Investment and Jobs Act, NCSL
• OAS Episode 168 Transcript
• U.S. DOT Infrastructure and Investment Jobs Act information

Our American States

Two years of the COVID-19 pandemic have put a spotlight on the many challenges faced by public health professionals. A key one is the collection and analysis of public health data information that can then be used to determine strategies to control a disease outbreak.

Joining the podcast is Janet Hamilton, the executive director of the Council of State and Territorial Epidemiologists. She discussed what was learned about health care data and analysis during the pandemic, why anemic funding of public health in many areas created problems, and how legislators can work with their state epidemiologists to ensure they have the information they need in the next public health crisis.

Our other guest is Shannon Kolman from NCSL, who discussed how legislatures have responded to the public health data challenges laid bare during the pandemic.

Resources

• Council of State and Tribal Epidemiologists
• State Public Health Legislation Database, NCSL
• Using Data Exchange to Improve Public Health, NCSL

Our American States

Robyn Benincasa learned her leadership lessons the hard way--taking part in extreme endurance races, including several seasons on the reality TV show called the “Eco-Challenge,” a grueling 10-day team race. She’s written a book – “How Winning Works: 8 Essential Lessons from the Toughest Teams on Earth.”

She’ll be sharing stories of the races and the lessons they taught as a featured speaker at NCSL’s Legislative Summit in Denver Aug. 1. She says the lessons are particularly pertinent to legislators and their staffs.

Resources

• Robyn Benincasa website
• OAS Episode 166 Transcription
• 2022 Legislative Summit agenda

Our American States

Our focus in this podcast is state securities administrators. These are the agencies in every state that oversee investor protection and efficient capital formation. Their key focus is protecting consumers who purchase investment advice or securities.

Guests on the podcast are Melanie Senter Lubin, the Maryland securities commissioner and president of the North American Securities Administrators Association, and Faith Anderson, the chief of Registration and Regulatory Affairs of the Securities Division of the Washington state Department of Financial Institutions.

They discussed the various roles state securities regulators play, the assistance they can offer state legislators and legislative staff, and how state regulators work with their federal counterparts. They also sketched out their perspective on a variety of policy topics, including licensing and digital currency. Both Lubin and Anderson also wanted legislators to know that the securities regulars in your state are always available to answer questions for you or your constituents.

Resources

• North American Securities Administrators Association
• Find your state securities regulator
• Regulation Best Interest
• NASAA Whistleblower Model Act
• NASAA Senior Model Act
• NASAA Restitution Assistance Fund Model Act
• OAS Episode 165 Transcription

Our American States

What can lawmakers and legislative staff learn from entrepreneurs?

Plenty, says Kevin O’Leary, an investor best known as a host of “Shark Tank,” the Emmy Award winning venture capital reality program. He’s the guest on this podcast.

O’Leary also is a keynote speaker at NCSL’s Legislative Summit. He will appear on Aug. 3 at 3 p.m. at the Colorado Convention Center in Denver.

O’Leary explained why he believes sound public policy is the foundation of a dynamic economy, what lawmakers can learn from the entrepreneurs on “Shark Tank” and why it’s critical to have people who are successful in business get involved in government.

Resources

• Kevin O’Leary website
• Closing General Session: Of Spaceships and Shark Tanks, NCSL 2022 Legislative Summit
• OAS Episode 164 Transcription

Our American States

While cannabis remains illegal under federal law, states have regulated cannabis for nearly 30 years. But policymakers have had few evidence-based policy tools to inform them. More than two-thirds of the states and territories regulate cannabis for medical use and more than 20 states and territories allow for nonmedical adult use.

Michael Sofis, Ph.D., director of research for the Cannabis Public Policy Consulting, is one of the few researchers looking at the policy issues of concern to lawmakers. His firm does extensive surveying around public policy affecting cannabis.

On this podcast, he discusses some of the surprises from his findings, the questions states are trying to answer and explains why the cannabis black market still does a brisk business even in places where it’s legal.

 You can learn more about the policy issues surrounding cannabis during the session “Growing Fields of Data: Public Health and Cannabis Policy” at NCSL’s Legislative Summit Aug. 3 from 1:30-2:45 p.m. at the Colorado Convention Center in Denver.

NCSL tracks and assists legislators with their questions about many policy topics, including state regulation of cannabis. NCSL takes no position on individual state cannabis policies. The federal Controlled Substances Act lists cannabis in Schedule I, with heroin, LSD, ecstasy and other products considered to have the highest potential for abuse with no currently accepted medical use in treatment in the United States

This podcast is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $563,000 with 100% funded by CDC/HHS. The contents were created by NCSL and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

Resources

• Cannabis decriminalization overview, NCSL
• Cannabis Public Policy Consulting
• State cannabis policy enactment database, 2022, NCSL
• State medical cannabis laws, NCSL