The state legislative session is in full swing, with many states having passed the halfway point. The ACR is currently tracking 114 pieces of state legislation across various issue areas. These include:
- 36 utilization management reform bills;
- 29 copay accumulator bills;
- 13 prescription drug review board bills;
- 12 pharmacy benefit manager reform bills;
- 6 rebate pass-through bills; and
- 6 white bagging bills.
Because most states are in the first year of a two-year session, bills that do not pass this session will carry over to the next session.
Anti-Vaccine Legislation
Over the past few years, vaccines have been under increasing public scrutiny and the subject of intense and, often clashing, debate. We are increasingly seeing this debate emerge in state legislation. In 2024, two states—Idaho and Montana—considered anti-vaccine legislation; this year that number is already at 18 and likely to grow. Here is a breakdown of some of the legislation that we are seeing:
- Wyoming, Oregon, Oklahoma and South Carolina (Florida likely): Proposals to prohibit “hiring discrimination” against unvaccinated individuals.
- Iowa, Montana and Idaho: Bills restricting or banning mRNA vaccines.
- Texas and Kentucky (Florida likely): Measures limiting mRNA vaccine use, with a specific focus on children.
- South Carolina: A proposal requiring providers to inform patients that the long-term safety of vaccines is “unknown.”
- Texas: A bill requiring providers to give patients an information sheet created by an appointed committee on the potential short- and long-term side effects of mRNA vaccines.
- Arizona, Arkansas, Connecticut, Indiana, Minnesota, Mississippi, New Jersey, New York, Oklahoma, Oregon, Texas and Virginia: Efforts to modify vaccine mandates and increase exemptions.
Most of these bills are being pushed under the guise of “freedom of choice,” and some have fines and jail time for non-compliance. The ACR is committed to ensuring that medical decisions remain between the patient and provider. We are working with our partners and the American Medical Association to ensure that all patients living with chronic disease maintain access to FDA-approved vaccinations.
We are also examining the legislation that would prevent employers from requiring vaccination. Settings where employees would frequently be in contact with chronically ill and immunosuppressed patients may need an exemption to protect patients. Hospitals and physician offices need the freedom to implement policies aimed at protecting the patient population they serve.
Also, the Louisiana Department of Health recently banned state-sponsored vaccination events and ordered staff not to promote vaccination. For many uninsured or underinsured individuals, vaccination events are the only way they can receive vaccinations. These kinds of access restrictions create a real danger to the chronically ill and those who care for them, and the ACR will continue to weigh in where it is appropriate and needed.
