As 2016 State Legislative Sessions Start, A Look Back at Notable Laws Passed in 2015
As former Supreme Court Justice Louis Brandeis put it, states are the “laboratories of democracy,” and every year state legislatures take up bills that directly impact the health and wellness of their residents. In 2015, we saw innovative efforts around tobacco control, data sharing, medical licensure, and antibiotic stewardship that can change the conversation around community wellbeing and lead the way for sustained improvements to public health. These notable achievements could be harbingers of more widespread legislative work in these areas.
Raising the Minimum Age of Legal Access to Tobacco Products
The majority of tobacco users in the United States start the habit before they turn 19. An Institute of Medicine report found that raising the legal age of tobacco use to 21 has the greatest impact in reducing the number of teenagers (15-17) that start smoking. Keeping teenagers from picking up the habit prevents serious, costly downstream consequences of tobacco use. With the passage of Senate Bill 1030, Hawaii joined over 100 cities, counties, and municipalities and became the first state to raise the legal age for tobacco use to 21. Ten other states and the District of Columbia considered bills to raise the age of tobacco use in 2015. In many instances, those bills will carry over into the current legislative sessions, so we may see more states taking steps to prevent youth access to tobacco products in 2016.
Sharing Data to Strengthen Public Health Reponses
Through Senate Bill 3220, the New Jersey legislature established the integrated Population Health Data (iPHD) Project. Housed in The Center for State Health Policy in Rutgers, this project would bring together publicly supported programs data from across government agencies and make it available for researchers The goal is to integrate the data from each individual agency to identify efficient, cross-cutting, and cost-effective solutions to improve health outcomes in the state. According to the bill’s sponsor, State Senator Kevin O’Toole, “Residents, especially those facing complex medical and social issues and those incurring the highest costs, rely on multiple public systems and services. Linking different datasets that already existing within these systems and programs is essential for a holistic understanding of patient needs.”
Supporters of SB 3220 stressed the improvements in patient care and programmatic efficiency. In his testimony before the New Jersey Assembly, Joel Cantor, ScD, director, Center for State Health Policy explained, “The careful and effective targeting of resources in one program can have significant impacts for other programs,” and cited the growing body of literature that providing targeted housing programs for high-need populations can reduce avoidable healthcare costs. Jeffrey Brenner, MD, executive director of the Camden Coalition Healthcare Providers, said the bill “creates the opportunity to connect Labor Department data, food stamp data, healthcare data, [and] incarceration data to do some much, much smarter work.”
Interstate Medical Licensure Compact
Beginning in 2013, the Federation of State and Territorial Medical Boards (FSBM) embarked on a process to create a streamlined process to make it easier for physicians to practice medicine across state lines. In 2014, FSBM released model legislative language for states to enter into an Interstate Medical Licensure Compact. Under these provisions, a physician who has a full and unrestricted license to practice medicine in a state that is a member to the compact can obtain a license through an expedited process to practice medicine in another member state. Each member state would retain full control over its disciplinary procedures and medical practice laws and regulations. In 2015, 18 states introduced legislation to join the compact, and the measures passed in 12 of them. Proponents of the compact stress that it is a way to address physician shortages in rural areas, advance telemedicine initiatives, maintain state control over the health professions, and ensure patients can access high quality care.
According to a 2013 report by the CDC, antibiotic-resistant infections cause more than 23,000 deaths and $20 billion excess healthcare costs per year. Rising concerns about the growth of antibiotic resistant superbugs have caused states to advance antibiotic stewardship in their healthcare systems and increasingly turn their attention to agricultural systems, where sales of antibiotics continue to increase.
In 2015, California’s legislature enacted an ambitious law to restrict the use of antibiotics in livestock feed. SB 27 prohibits farmers or ranchers from using important antibiotics to promote growth. The law also requires veterinary approval for antibiotic use to treat an animal who is sick or to prevent diseases from spreading and forbids antibiotics from being prescribed “in a regular pattern.” The bill had widespread support, with only seven lawmakers voting against the measure, and goes into effect in 2018.
KT Kramer, JD, MHA, is ASTHO’s director of state health policy. Kramer got her start in health policy as a Peace Corps Volunteer in Turkmenistan, and continued to gain experiences with the New Orleans Department of Health, Veterans Health Administration, and Health Law Advocates of Louisiana. Most recently, she served as a Winston Health Policy Fellow on the U.S. Senate Committee on Health, Education, Labor, and Pensions.