Legislators expect to address youth vaping, maternal mortality, insurance issues and maybe abortion in upcoming session

State Rep. Kim Moser, Sen. Stephen Meredith, Rep. Rebecca Raymer and moderator Mark Marsh of Owensboro Health discuss issues at the Legislative Preview Conference. (Photo by Melissa Patrick)

By Melissa Patrick
Kentucky Health News

State legislators expect to address youth vaping, workplace violence, data collection, maternal mortality, and prior insurance authorization for medical procedures during the legislative session that begins Jan. 2.

And they could deal with abortion. So said lawmakers who participated in a health panel or otherwise attended the Kentucky Chamber of Commerce's 2024 Legislative Preview Conference Nov. 13.

Sen. Stephen Meredith, R-Leitchfield; Rep. Kim Moser, R-Taylor Mill; and Rep. Rebecca Raymer, R-Morgantown, spent the early part of the discussion talking about  health-care workforce issues and what could come out of the legislature's Certificate of Need Task Force.

Meredith and Moser agreed that the push to remove CON requirements as a way to level the playing field to create a true free market competition doesn't fit the current payment system, but the legislature could find efficiencies in the application process for health-care facilites.  

"Whatever comes out of our task force will probably be more administrative in nature," said Meredith. 

Raymer said she would be working on a bill that would address youth vaping, noting that it would likely include an education component, and a bill to get more sexual assault nurse examiners in rural areas. 

Moser said she will work on a bill to decrease maternal mortality.  One way to do this is to consider a bill that ensures women have health insurance during pregnancy. Since working on this issue, she said she has learned that pregnancy is not considered a qualifying life event that makes a person eligible to enroll in a federally subsidized or "qualified health plan" through Kynect during a special enrollment period. Having a baby or adopting a child are both considered qualifying life events. 

"We know that because of Kentucky's poor health metrics around obesity, hypertension, heart disease, cancer, that . . . those issues are affecting our maternal mortality," she said. "And so the best way to address that is with better prenatal care, and identifying those issues when you can control them." 

Other elements of a maternal-mortality bill would involve increasing access to psychiatric care, expanding the HANDS (Health Access Nurturing Development Services) program, a voluntary home-visitation program for new or expectant parents, and also include a section about doulas, women who provide assistance during labor.

Moser also said she will introduce another prior-authorization bill to reduce administrative burdens on health-care providers and provide better patient care. "I think this is the year that we're going to get that passed," she said. 

Around the issue of data collection, Moser said she was "looking at data and how we collect data around health care, how we better utilize it, and what's the best way to provide some transparency, and better inform policy decisions." One way to do that would be through an all-payer claims database, which is a policy priority of the Foundation for a Healthy Kentucky. 

Moser said when it comes to health-care workforce issues, she is working on a workplace-violence initiative. And she said she would "love to work on liability reform, tort reform" to limit lawsuits but says this is difficult because there needs to be a constitutional amendment to make meaningful changes. 

"I don't foresee that in the near future, but certainly, I think that's a conversation that we need to have," Moser said. "It really does affect the practice of medicine and the ability to attract and to retain our health-care workforce." 

The health panel did not discuss abortion, but after the meeting House Speaker David Osborne and Senate President Robert Stivers told the Lexington Herald-Leader that they were open to adding exceptions for rape and incest to the state's near-total ban on abortions.

“There is some interest in our caucus in passing those exceptions,” Osborne said, adding that opinions range widely among Republicans who control the House. They also control the Senate.

Stivers told the Herald-Leader, "We’re getting ready to have our caucus and kind of go through this. This will be a decision that everybody has varying opinions as to what should happen or what shouldn’t happen. . . . It is such a personal issue to people, we’re gonna have to have that type of discussion amongst ourselves and then collaborate with the House."

Abortion was a key issue in the recent governor's race, won by Democratic Gov. Andy Beshear, who criticized Republican Attorney General Daniel Cameron's opposition to rape and incest exceptions. Cameron then said he would sign such a bill if the legislature passed one.