The Trump Administration’s Safe Importation Action Plan lays out two pathways to support importation of lower-cost prescription drugs, but raises questions that need responses. In Pathway 1, the Administration gives a nod to state efforts to create wholesale importation programs for certain high-cost drugs, mirroring the provisions of current state efforts and federal requirements. That’s […]
Author Archive for: trish-riley
About Trish Riley
Trish Riley is executive director of the National Academy for State Health Policy (NASHP) and president of its corporate board. She helped build NASHP as CEO from 1988 to 2003.
Previously, she was a senior fellow in State Health Policy at George Washington University and at the Muskie School of Public Service, University of Southern Maine. From 2003 to 2011, she served as director of the Maine Governor’s Office of Health Policy and Finance, leading Maine’s effort to develop a comprehensive, coordinated state health system that included increasing access to affordable health insurance. She was the principal architect of Dirigo Health Reform and served as Maine’s liaison to the federal government and Congress, particularly during deliberations around national health reform. She chaired the Governor’s Steering Committee to develop a plan to implement the Affordable Care Act in Maine.
Riley has also held appointed positions under five Maine governors, directing the Office on Aging, Medicaid and state health agencies, and health planning and licensing programs.
Riley has published and presented widely about state health reform. She served as a member of the Kaiser Commission on Medicaid and the Uninsured, the Medicaid and CHIP Payment and Access Commission (MACPAC), the Health Services Committee of the Institute of Medicine, the National Academy for Social Insurance, and the board of directors of Maine’s co-op insurance plan. She was a member of the Institute of Medicine’s Subcommittee on Creating an External Environment for Quality. She also previously served as a member of the board of directors of the National Committee on Quality Assurance. Riley holds a BS and MS from the University of Maine.
Entries by Trish Riley
State-based marketplaces (SBMs) give states more control over their local health insurance markets and consistently outperform states that use the federal marketplace with higher enrollment, more insurance plan choices for consumers, lower premium rate hikes, and a younger consumer base. These accomplishments are especially notable given recent federal policy actions that have unsettled insurance markets […]
As Congress and the Trump Administration propose strategies to address surprise balance billing – charges for unexpected, out-of-network medical care – states have significant experience in implementing surprise billing laws that can inform the discussion. Importantly, state authority cannot protect individuals covered by self-insured plans, which are pre-empted by Employee Retirement Income Security Act (ERISA,) […]
Delaware’s state Legislature has established the Interagency Pharmaceuticals Purchasing Study Group to recommend steps to leverage bulk purchasing of drugs to effectively negotiate lower prices by using interagency and multistate purchasing contracts, and other approaches. The measure easily passed the House on a voice vote and unanimously passed the Senate. The study group has an […]
New Mexico Gov. Lujan Grisham recently signed into law SB 131, establishing a state Interagency Pharmacy Purchasing Council to leverage public purchasing power by reviewing and coordinating cost-containment strategies through procurement of pharmaceuticals, pharmaceutical benefits, and pooling of risk among state agencies. Cosponsored by state Sen. Jeff Steinborn* and Rep. Joanne Farrary, the law also […]
Rising health care costs are an intractable problem in the United States, but states, faced with balanced budget requirements and growing voter concern, aren’t waiting for a federal solution. This report explores state initiatives to curb health care costs by: Leveraging Medicare’s well-established reimbursement rates as reference prices for state employee plans to address rising […]
States with state-based insurance marketplaces (SBMs) have consistently outperformed states that use the federal platform in enrollment, affordability, and increased plan offerings and competition, prompting states to consider launching their own marketplaces and Congress to propose new funding to support states that want to transition. New Jersey may become the next state to convert to an […]
On March 5 and 6, 2019, state-based exchange directors convened in Washington, DC for peer-to-peer discussions and meetings with Congressional staff and federal officials, hosted by the National Academy for State Health Policy (NASHP). The meeting has become an important annual event for the state-based exchanges – which provide the infrastructure, websites, and customer support […]
State health policymakers enter 2018 buffeted by unsettled insurance markets, reductions in public health and prevention revenue, and uncertain funding for Medicaid and health care delivery reforms. Will state innovation and more flexibility to restructure insurance and payment and delivery systems be enough to reduce medical costs and safeguard access to health care? Will new […]
The new Administration has signaled a willingness to give states more flexibility to address health and prevention in new and innovative ways under Section 1115 of the Social Security Act. This provision allows the Department of Health and Human Services to approve experimental and innovative projects that promote the goals of Medicaid. This comes at […]