StateVitals | Deep Dives

Deep Dives

• NEW! Prohibition on PBM Ownership of Pharmacies (Updated 4.23.2025). Arkansas recently enacted legislation prohibiting PBM ownership of pharmacies and 39 Attorneys General sent a letter to Congress asking it to do the same. MultiState examines this new approach to PBM reform. Click here to download.

• Efforts to Limit mRNA Technologies (Updated 3.25.2025). Due to the controversies stemming from the COVID pandemic response as well as general opposition to vaccine mandates, several states are considering legislation to limit the use of mRNA vaccines. Click here to download.

• PDAB Quarterly Activity Update (January - March 2025) (Updated 3.24.2025). State PDABs are at different implementation stages with some actively reviewing drugs and others establishing organizational frameworks. MultiState provides a summary of board activities and provides an outlook on upcoming priorities. Click here to download.

• Certificate of Need Reform (Updated 3.23.2025). In response to rising health care costs, some stakeholders have leveraged Certificate of Need (CON) reform as a policy lever to drive healthcare affordability. MultiState examines the background and the key stakeholders and positioning involved, with an examination of legislative trends and key events pertaining to CON in 2025. Click here to download.

• State of the State Addresses (Updated 3.18.25). Governors have laid out policy priorities for the next year in their State of the State addresses and the majority have highlighted healthcare as a priority issue. The MultiState team has reviewed each governor’s address and analyzed key healthcare themes raised by governors across the country. Click here to download.

• AI in Healthcare (Updated 2.25.25). State legislation is increasingly focusing on regulating the use of AI in healthcare, particularly concerning the insurance processes of utilization management (UM) and prior authorization (PA). The MultiState healthcare team has taken a look back at federal and state action and outlines trends we expect to see in the 2025 sessions. Click here to download.

• State Budgets and Medicaid (Updated 2.25.25). Medicaid spending is putting a significant strain on state budgets. Taking the lead from the MultiState tax team, the healthcare team looked at states staring down budget challenges this year to see what lawmakers are doing and saying about Medicaid. Click here to download.

• GLP-1s and Taxpayer Funded Coverage (Updated 2.25.25). Over the past six months, states have been proactive in their consideration – or reconsideration – of next steps pertaining to coverage of Glucagon-like Peptide (“GLP”)-1s. MultiState examines the current coverage landscape of GLP-1s for weight loss purposes and how states are talking about coverage in 2025. Click here to download.

• 2025 Activity Assessment. The MultiState team has already reviewed and is tracking in excess of 11,200 healthcare bills for state legislative sessions in 2025. Based on trend analysis, conversations with stakeholders and contract lobbyists, and what we know about each state, MultiState is monitoring likely legislative activity pertaining to prescription drug affordability boards, the 340B drug pricing program, behavioral health, prior authorization and reproductive healthcare in a myriad of states. Here’s the breakdown of where MultiState believes some issues may see traction:

  • Prescription Drug Affordability Boards

  • 340B

  • Behavioral Health

  • Prior Authorization

  • Reproductive Healthcare

• Private Equity in Healthcare: Massachusetts Case Study and 2025 Preview. Massachusetts kicked off 2025 by enacting legislation to enhance oversight of private equity in healthcare. Massachusetts wasn’t the first state to do so but has to date been the most comprehensive. In 2025, MultiState expects other states to follow suit. Click here to download.

• Medical Debt Reform: 2024 in Review & State Approaches. An increasingly common occurrence, it’s expected that more than 100 million individuals owed medical debt. Laws in Illinois, Michigan and Wisconsin provide a spectrum as to how states have approached the issue. Understanding their frameworks should provide your organization with a better understanding of how states have opted to respond to concerns of medical debt. Click here to download.

• Hospital Price Transparency. Since 2021, the Centers for Medicare & Medicaid Services (CMS) have been on a path of implementing Final Rules to drive reform of hospital price transparency. Despite this federal effort, state lawmakers have continued to engage with hospitals on facility price transparency legislation. In this deep dive, MultiState breaks down what’s happened at the state level since the federal Final Rules went into effect January 1, 2021 and the questions that 2025 legislation will grapple with. Click here to download.

• 2025 Preview: Federal Influences on State Policy. As 2025 nears, states are preparing for an overhaul of federal healthcare policy priorities. Given the interconnectivity of federal and state health policy, states and industry stakeholders need to proactively strategize in the coming months on impending policy shifts happening at the federal level that will inevitably impact how healthcare organizations must engage in policy discussions at the state level. In this brief, MultiState breaks those policy shifts down for you. Click here to download.