5 Things Maryland: Overdose deaths, ACA subsidy expansion, Vaccine equity

I know it can be a little confusing hearing from me about two conferences we have coming up — one focused on Maryland health policy on May 13th and a federal conference coming up on April 7-8th.

We are going to try to keep information about the Maryland event in your inbox on Tuesday, and email about the federal event in your inbox on Thursday…

For the hassle, if you register for the federal event in April, I’m happy to give you a 50% discount for the Maryland event in May. It means you get access to a graduate level course in health policy: 54 hours of conversation live and on demand, with the slide decks to go with it, all for about $300 total for them both.

It’s a pretty good deal, and one I hope you can put to use to hear from some of the most thoughtful voices in Maryland and US health care in 2021.





With help from Emily Boerger

1. Innovations to address vaccine inequities

Despite making up 30% of the state population, Black individuals account for 35% of Maryland’s COVID deaths and just 17% of the state’s vaccinations. Eleven percent of Maryland’s population is Hispanic, yet just 4% of vaccinations have gone to this cohort. White individuals make up 55% of the population, but 64% of vaccines administered have gone to this demographic. To address these disparities, state leaders are pursuing a range of innovative consumer engagement efforts.

In a recent Q&A with State of Reform, Mark Martin, PhD, Deputy Director for the Office of Minority Health and Health Disparities at DOH, described old school technique of using sound trucks to communicate information to communities disproportionately impacted by the pandemic. On Friday, Gov. Larry Hogan and Brigadier General Janeen Birckhead announced the release of the Maryland Vaccine Equity Task Force Operations Plan.


2. Legislation, process and deadlines

Next week’s deadline in the General Assembly requires committees to move legislation out of committee to stay alive. Among the list of bills we’re watching is a pharmacy-related bill that would require pharmacists to advise patients if a less-expensive version of a drug is available, and a bill that aims to provide continuity of health coverage for those who file an unemployment claim.

The Health and Government Operations Committee heard testimony last week on two bills that look to continue pandemic-induced health policy practices. The legislation includes HB 1287, which would expand access to mental and behavioral services by allowing trainees to provide services through telehealth to those dealing with substance abuse issues, and HB 1040, which would authorize pharmacists to administer certain vaccines to children as young as 3 years old.


3. Federal Detailed Agenda coming Thursday

On Thursday we will release the Detailed Agenda for the 2021 State of Reform Federal Health Policy Conference! That is a list of over 100 speakers lined up to be with you on April 7-8th. This will be perhaps the single best way to interact directly with the actors shaping federal health policy in both Congress and the Biden administration. We’ll also have a state learning lab focused on elevating the most prominent lessons in state health reform from states and initiatives across the country. Maryland’s success will be one of our case studies to teach the nation.

Be sure to check out the Topical Agenda to get a feel for the two-day event and take a look at our Convening Panel to see some of the folks who helped put the agenda together. If you haven’t registered to be with us yet, we’d be honored to have you join us!


4. Overdose deaths soar in first 3 quarters of 2020

Maryland saw a 12.1% increase in drug overdose deaths during the first three quarters of 2020 compared to the same period in 2019. With 2,025 deaths, this number nearly matches the total number of overdose deaths that took place in 2016 (2,089 total). With one quarter left to report, the 9 month total so far in 2020 is only about 10-20% below previous annual highs, meaning Maryland is on track for it’s worst year ever for overdose deaths.

Prescription drug overdose deaths increased during this time along with fentanyl-related deaths, which saw a 16.7% increase. For the first time, the OOCC included a demographic analysis in its report, finding that in the first three quarters of 2020 opioid-related deaths increased by 15.8% among non-Hispanic whites, 13.1% for Black individuals, and 27.3% among Hispanics.


5. Health reform in federal COVID bill

Over the weekend, the US Senate approved the $1.9 trillion COVID federal relief package. The House is expected to vote on the amended legislation early this week. In a recent piece, State of Reform columnist Jim Capretta outlines the health measures in the bill that “will be significant for policy debates in the years ahead.”

Among the list of changes is an increase in premium tax credits for households receiving insurance through the ACA exchanges. The bill would fully subsidize coverage for households below 150% FPL, it would increase subsidies for those up to 400% FPL, and it would remove the 400% FPL cap, allowing any household to get coverage through the ACA exchanges with a premium of no more than 8.5% of annual income.

recent analysis estimates that for an enrollee in Maryland at 430% FPL, the expanded subsidies would decrease monthly premiums from $471 to $123 (lowest-cost bronze), $738 to $390 (benchmark silver), and $695 to $347 (lowest-cost gold). While the subsidy increase is set to expire after 2022, Capretta reasons that once in place, Congress will make the changes permanent.