2024-08

Removing Barriers to Access to Alternative Therapies for the Treatment of Pain

Sponsored by

Sen. Wlnsvey Campos (OR), Rep. Lillian Ortiz-Self (WA) and Rep. Louis Ruiz (KS)

Reported to the Caucus by the NHCSL Healthcare Task Force

Rep. Alma Hernández (AZ), Chair

Unanimously ratified by the Caucus on November 23, 2024

WHEREAS, the crisis of opioid addiction and overdose continues to be an urgent national problem;[1] and,

WHEREAS, the National Center for Health Statistics at the Centers for Disease Control and Prevention (CDC) reports that more than 107,000 lives were lost from drug-involved overdoses in 2022,[2]  with more than 75 percent of drug overdose deaths involving opioids[3]  and nearly 15,000 opioid overdose deaths in 2022 involved prescription opioids;[4] and,

WHEREAS, the rate of drug overdose deaths among Hispanic Americans continues to rise -- from 21.1 drug overdose deaths per 100,000 population in 2021 to 22.7 drug overdose deaths per 100,000 population in 2022 -- while the rate of overdose deaths in the general population has been essentially flat during this period;[5] and,

WHEREAS, almost two decades ago, in Resolution 2006-07, NHCSL adopted an approach to drug policy that prioritizes public health, not criminal justice, and is “measured by a standard that reduces the harms of both drug abuse and unjust drug policies within our communities;” and,

WHEREAS, in Resolution 2018-17, NHCSL called for legislation to give legal protection to people who suffer from opioid problems or are prone to suffer opioid related overdoses, or call an emergency service regarding an overdose; further provision for Naloxone availability and legislation to encourage prescription and require coverage of in-home electronic monitoring using the best technologies available for patients who have been prescribed opioids or who are being treated for a suspected opioid overdose; and,

WHEREAS, that resolution took into account that opioids are within a class of drugs that not only includes the illegal drugs heroin and illicit fentanyl, but also legal medicines prescribed for pain management; and,

WHEREAS, the CDC issued updated guidance in 2022 emphasizing that nonopioid therapies are at least as effective as opioids for many common types of acute pain, and recommending that clinicians maximize use of nonopioid pharmacologic therapies as appropriate because they do not carry the same risks as opioids;[6] and,

WHEREAS, states can play an important role in combating the opioid crisis by establishing standards for medical practice and insurance coverage in Medicaid programs and commercial insurance markets; and,

WHEREAS, recent reforms by the United States Department of Health and Human Services remove requirements for states to defray costs of state insurance coverage mandates in certain circumstances.[7]

THEREFORE, BE IT RESOLVED, the National Hispanic Caucus of State Legislators recognizes the need for further steps to combat our country’s crisis of opioid overdose and addiction through expanded access to non-opioid options for pain management, including, but not limited to, non-opioid pharmacologic pain medications; and,

BE IT FURTHER RESOLVED, that the National Hispanic Caucus of State Legislators urges states to secure and expand access to non-opioid pharmacologic pain medications in their state Medicaid programs by ensuring that such medications are not subject to more restrictive or onerous utilization management requirements than opioid pharmacologic pain medications; and,

BE IT FURTHER RESOLVED, that the National Hispanic Caucus of State Legislators recommends states undertake legislation or regulation to require parity in coverage and cost-sharing between opioid and non-opioid pharmacologic pain medications in commercial insurance; and,

BE IT FINALLY RESOLVED, that the National Hispanic Caucus of State Legislators recommends states ensure that their state Essential Health Benefits (EHB) benchmark plans establish coverage parity for non-opioid pharmacologic pain medications and require coverage of several non-opioid pharmacologic pain medications.

THE NHCSL HEALTHCARE TASK FORCE, AT ITS MEETING OF JULY 9, 2024, UNANIMOUSLY RECOMMENDED THIS RESOLUTION TO THE EXECUTIVE COMMITTEE FOR APPROVAL.

THE EXECUTIVE COMMITTEE UNANIMOUSLY APPROVED THIS RESOLUTION AT ITS MEETING OF JULY 13, 2024.

THE NATIONAL HISPANIC CAUCUS OF STATE LEGISLATORS UNANIMOUSLY RATIFIED THIS RESOLUTION AT ITS ANNUAL MEETING OF NOVEMBER 23, 2024 IN DENVER, COLORADO.

[1] See the most recently renewed emergency declaration by Secretary of Health and Human Services (HHS) Xavier Becerra on March 27, 2024 at https://aspr.hhs.gov/legal/PHE/Pages/Opioid-25Mar2024.aspx

[2] https://www.cdc.gov/nchs/products/databriefs/db491.htm

[3] https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates

[4] https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#:~:text=Drug%20overdose%20deaths%20involving%20prescription,of%20deaths%20declined%20to%2014%2C716

[5] https://www.cdc.gov/nchs/products/databriefs/db491.htm

[6]. https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm

[7] Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2025; Updating Section 1332 Waiver Public Notice Procedures; Medicaid; Consumer Operated and Oriented Plan (CO-OP) Program; and Basic Health Program, 89 Fed. Reg. 26,218 (Apr. 15, 2024)