2015 Legislative Issues and the Impact on Low-Income Communities and Communities of Color


Same-sex-marriage-House-of-Delegates-debate-300x225Photo Credit: Maryland ReporterLegislators are tackling issues ranging from public pensions funds to Common Core, and from body cameras to infrastructure. The National Black Caucus of State Legislators (NBCSL) has ratified several resolutions that offer lawmakers guidance on solving issues that affect our communities. Below are summaries addressing the trending policy debates in legislatures: Public Pensions, Health Insurance Subsidies, Medicaid, Carbon Emissions, Infrastructure, Net Metering, Marijuana, Police Oversight, and Common Core State Standards.






Public Pensions Funding

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The Government Accounting Standards Board (GASB), a private non-governmental organization which provides states and local governments with accounting standards, released two new accounting rules impacting states and their public pension plans.  The first requires states to apply a more conservative formula in calculating the actuarial value of plan assets.  This impacts governments that have not been making their full actuarial payments.  The second rule requires governments to report unfunded pension liabilities on their balance sheets, instead of subversively placing them in the notes section.  States such as Illinois, New Jersey, and Pennsylvania that have been underfunding their pension funds are suffering serious pension deficits and are finding ways to respond to the new GASB rules.

The United States Department of Labor published a report in which the department found retirement security disparities for minorities and women in relation to their white male counterparts.   Women and people of color are often employed in vocations that do not offer retirement benefits, such as non-union construction and daycare.  Moreover, minority communities tend to live paycheck to paycheck and are unable to put money into retirement or savings.  The public sector is an area that provides retirement plans.  Because African Americans account for 14.5% of public sector workers, matching pension funds promotes retirement security for a portion of the population that often lacks access to retirement savings outside of Social Security benefits.


The Supreme Court and Insurance Subsidies

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Courtesy of HSA for America-Insurance SubsidiesPhoto Credit: HSA for AmericaStates retooled and revamped their insurance marketplaces to guarantee a better sign-up experience in the second round of Open Enrollment.  Despite improved systems and increased insurance carriers, states await the U.S. Supreme Court’s decision in King v. Burwell, to learn if subsidies will be available to states operating a federal exchange instead of a state exchange.  Subsidies have enabled over 60 percent of 6.8 million uninsured African Americans to receive health care coverage. The Court’s decision will have a rippling effect throughout the 34 states that do not have state exchanges and affect the millions of Americans who are able to receive low or no-cost health care due to subsidies. 

 

Medicaid Expansion Waivers

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For states that are not expanding Medicaid, Medicaid expansion waivers are being considered as an alternative.  These waivers, known as Section 1115 waivers, allow states to design and improve programs to give individuals who do not qualify for Medicaid access to health coverage.  One such way is to provide subsidies to individuals to purchase insurance plans from private insurance companies.  In order to use a waiver, a state must receive federal approval.  Indiana and New Hampshire are two states that recently received approval for their Medicaid waiver requirements.  

Tennessee’s alternative Medicaid expansion bill seemed as though it was going to pass but at the last minute was rejected by a Senate panel earlier this year.  Medicaid expansion has received a second life in Tennessee with a new measure in both chambers.  Florida may also be on the road to expanding Medicaid with an alternative bill is making its way to a floor vote. Utah and Wyoming debated Medicaid expansion waivers that were proposed by their governors.  Both states were unable to get the necessary votes, killing any expansion for the year.   

African Americans have the highest mortality rate of any racial or ethnic group for cancer, are 40 percent more likely to have high blood pressure, and are twice as likely to be diagnosed with diabetes.  Despite the prevalence of chronic disease and lack of health care, 55 percent of African Americans live in states that have not expanded Medicaid.   Medicaid expansion has provided coverage for millions of previously uninsured African Americans and will greatly reduce health disparities among minorities.   The fate of the Children’s Health Insurance Program in Congress will also put states in a precarious position if the program is not reauthorized, leaving states to come up with a solution on providing 2 million children with health care.


Doctor Shortages and Pay Cuts

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Courtesy of blackdoctor.org-Doctor ShortagesPhoto Credit: blackdoctor.orgTo meet the needs of Medicaid patients, particularly with the increased number of patients, states will also have to address practitioner shortages and pay cuts.  Many doctors who serve Medicaid patients began the year with a pay cut.  This affects communities that rely heavily on doctors who accept Medicaid.  Managed care regulations, which impact Medicaid delivery systems, are also on the floor this year.  Reports from the Health and Human Services Office of Inspector General found that there was a need for better oversight from the Centers for Medicare & Medicaid Services in states and their patient access to doctor networks.




Hepatitis C

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Hepatitis C drugs were a hot topic of discussion in the states last year. Sovaldi, approved by the Food and Drug Administration (FDA) in 2013, received a lot of attention, much of which was due to its high cost ($1,000 per pill, approximately $84-90,000 for a full round of treatment).  As individuals living with Hep. C tend to be low-income and/or on Medicaid, some state Medicaid offices and legislatures opted to create strict criteria, such as requiring severe infections, before paying for the drug.  Gilead Sciences, the manufacturer of Sovaldi, and CVS Health entered into an agreement in 2014 which excludes all available drug options from its formulary--essentially reducing the likelihood of competition and a reduced price.  Hep. C-related liver disease is prevalent among African Americans and many living with chronic Hepatitis C may not be able to afford the treatment without more flexible regulations.  The National Association of Medicaid Directors proposed a series of federal solutions, but the issue has not been taken up by Congress.  In the meantime, states have been left to improvise with policies that address the high need and high cost. 


Carbon Emissions

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Courtesty of National Geographic News-Carbon EmissionsPhoto Credit: National Geographic NewsThe Environmental Protection Agency (EPA) proposed new regulations to states with the aim of reducing carbon emissions, in most states by 30% from 2005 levels by 2030.  The EPA’s proposed rules are estimated to reduce air pollution by 25% with a public health benefit of between $55 billion to $93 million once fully implemented.  It would also eliminate an estimated 140,000 – 150,000 asthma attacks each year and prevent 2,700 to 6,600 premature deaths. A 2012 report by the NAACP found that coal power plants tended to be disproportionately located in low-income neighborhoods and communities of color.  Additionally, a 2010 report by the National Research Council estimated 1,530 excess deaths per year were caused solely by particulate matter pollution resulting from coal power plants.   States have been tasked with developing their own way to reduce emissions, and several states have challenged the regulations arguing the EPA has overstepped its authority.  Additionally, the regulations have been criticized as potential “job killers” by employers, especially in states such as Washington, which is required to lower CO₂ emissions by 72 percent.  A number of states have joined together in a lawsuit to block the proposed rules.  Others are opting to not comply with the rules and are choosing to wait out President Obama’s administration.  


Transportation and Water Infrastructure

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Transportation and water infrastructure funding requests come up nearly each year in legislatures and are not given the attention other hot button issues receive.  This year may be different, however, as temporary streams of money dedicated to transportation funding expire in May.  America’s crumbling roads, bridges, and highways are long overdue for funding.  The American Water Works Association (AWWA) estimates it could cost more than $2 trillion over the next 25 years to replace and expand drinking water and wastewater systems across the U.S.  EPA regulations on reducing raw sewage and untreated storm water that enters lakes and other bodies of water are causing states to make upgrades to their systems.  Other states, such as California, which face water shortages, are looking for ways to create new water sources including desalinization plants, aquifers, reservoirs, and water recycling plants.  Efforts to update water systems will invariably result in an increase to consumers by utilities.


Net-Metering

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Courtesy of the Guardian-Net MeteringPhoto Credit: GuardianNBCSL has spoken on the impact of antiquated net-metering policies and the future of distributed generation.  Solar policies often provide subsidies to users who generate electricity through solar panels and sell excess energy back to utility companies to be used by others on the electric grid.  Utility companies have argued the subsidy formulae do not properly account for the maintenance and other costs associated with the grid and should be adjusted.  NBCSL has also been concerned that if the cost of subsidies is being shifted to low-income consumers, this be addressed and rectified.   



Marijuana

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In last year’s election, marijuana was found on ballot initiatives, and legalization/decriminalization measures were successfully passed in Alaska, the District of Columbia, and Washington.  Medical marijuana measures were also up for vote in Florida, but did not pass.  This year, legislatures are debating ways to decriminalize or legalize marijuana in some form.  Meanwhile, states like Colorado and Washington are focusing on legislation to address the growing marijuana industry.  

Legalized/decriminalized marijuana will have a significant impact on criminal justice resources in states.  Fines, instead of arrests, will reduce the number of individuals with criminal records related to nonviolent drug offenses.  This enables states to redirect dollars into other programs and uses.  States are also looking for ways to address prison overcrowding and its exorbitant costs.  States may begin easing rules on parole violations, early release, and penalties related to low-level, non-violent drug offenses.


Police Oversight and Policies

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After the events in Ferguson, Missouri and Staten Island, New York, lawmakers have been introducing bills related to data reporting on deaths in police custody, citizen review boards, body cameras for police, and other policing matters.  Congressional members have also responded with measures of their own, including The Grand Jury Reform Act , The End Racial Profiling Act, and the REDEEM Act, to name a few.  In the months following grand jury decisions in each of those cases, protests have blocked streets and highways with civil rights organizations calling for justice and criminal justice reform, and an end to racial profiling.     


National Education Standards

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Courtesy of AtlantaBlackStar-EducationPhoto Credit: AtlantaBlackStarCommon Core State Standards has seen its fair share of detractors recently.  Indiana, Oklahoma and South Carolina have all pulled out of the program.  The state standards initiated by governors and bipartisan legislative agreement, has been criticized in large part because of federal government involvement.  Repealing Common Core could cost states their No Child Left Behind waivers, which allow states more flexibility in defining underperformance.  Despite the possible loss of these waivers, several other states are discussing repeal.  With no Congressional guidance, states must devise assessments and accountability measures for students and teachers.  Student assessments have often been decried for bias, especially for students of color and for missing key aspects of the learning experience.  Legislators focus on how to bring student assessments in line with appropriate curriculum standards while considering how to make them fully evaluate learning.

States had a lot of policy issues to tackle this year, and some barely have a full year to do it.  With so much on the floor and so much at stake, legislators are working diligently to ensure laws positively affect their constituents.  Working towards fair solutions requires compromise and cooperation among legislators.  For NBCSL members they will be tasked with advocating for the communities they represent, particularly the underserved and the often ignored.


Resources
  • Government Accounting Standards Board (GASB): is the independent organization that establishes and improves standards of accounting and financial reporting for U.S. state and local governments.