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States Are the 'Laboratories' for Healthcare Reform

December 22, 2021

Washington lawmakers have utterly failed to enact meaningful, patient-centered healthcare reform.

But there are plenty of free market reforms states can enact to improve access and affordability, Goldwater Naomi Lopez Director of Healthcare Policy Naomi Lopez told the Heartland Institute podcast last week.

Here are the top 10 quotes from Lopez’s interview:

1. “What most people don’t know is that states often lead the way to healthcare reform. And let’s give a recent example: That’s the telehealth reform that just passed in Arizona that really is revolutionary in that it removes a lot of the government restrictions and obstacles that were standing in the way.”

2. “State lawmakers have the authority and the responsibility to take action in some key areas when it comes to healthcare that impact healthcare access and affordability. And those would be things like scope of practice: What are the rules surrounding what healthcare providers can do? Can they practice at the top of their education and training?”

3. “Regardless of what’s happening in Washington, there is a lot that states can do to really impact patient access and affordability, and that often creates the groundswell for Washington to take action. And I do think that there are opportunities where lawmakers can work across the aisle to demonstrate that constantly at the state level, where, when it comes to healthcare access and affordability, there really are some great solutions that everyone can get on board with.”

4. “It’s not just that I believe the states can be the leaders on health reform—the states often are the leader on health reform. And we know this from the past couple of decades, where states have gone and made policy changes that impacted scope of practice, or that really set forth the agenda that focuses on access and affordability at the state level. And as many people know, the Goldwater Institute was instrumental and led the effort for Right to Try at the state level before taking it to Washington, and now that is federal law.”

5. “We know how to make change at the state level. It is a bit slower, of course, because you’re going state by state. But it’s absolutely possible. The dynamics of the states are always a little bit different, but one thing that the states have in common is that state lawmakers really are a bit closer to their constituents. And they’ll run into them more frequently at the grocery store, or at church, or at their kids’ schools. And so, there really is a little—there’s a closer association with a lawmaker, there’s more access. And so I do think that that impacts how responsive state lawmakers are.”

6. “There are still political divisions at the state level…But for some issues, like telehealth for example, there really was a consensus that those rules—that removing the barriers and obstacles…the rules and regs that made telehealth difficult were removed during the pandemic. And it was good policy during the pandemic, and it should be made permanent. And so there really was a belief across party lines that that was good policy. And that’s how Arizona was able to move this landmark telehealth legislation across the finish line.”

7. “The media in Washington, and a lot of times the lawmakers in Washington, aren’t always as tuned in to what is happening at the state level, but there really is a lot of innovation taking place. And when you think back to things like welfare reform, and you take a look at what’s happening in healthcare today, with really innovative solutions coming up, states really are the laboratories for reform. And I think that’s something that we often forget, but that is truly where, I think, the best policy innovations take place and are tested, and then that makes it a lot easier to elevate it to the federal level.”

8. “I’m very optimistic about the future of healthcare reform…We wouldn’t be doing this work if we didn’t believe that we could make impactful reforms that would allow us to truly realize the vision of healthcare access and affordability.”

9. “Today, I think especially because of COVID, we actually do have a unique opportunity, because a lot of the flexibilities that were enacted at both the federal and the state level that allowed for broader scope of practice, for example, for more telehealth, and the like—and a lot of other reforms as well—really shed a bright light and provided a proof of concept that there really is an opportunity to do a lot more so that individuals can have access much faster than before.”

10. “I think that we’re really getting to the point where Americans are really starting to understand that there’s the potential to use innovative, patient-centric medical care using the already available technology and communications, that that’s already possible. We don’t have to build something new, it already exists. And so often, we also see federal overreach into the healthcare area, and I think that’s becoming more apparent too. And so I do think that with really strong, bold leadership, coupled with very positive, successful reforms at the state level, we’ll be able to realize a lot of the potential that already exists for realizing access and affordability in healthcare.” 

Watch Lopez’s full interview above, and read more about Goldwater’s plan to unleash innovation in healthcare here.

Joe Setyon is a Digital Communications Associate at the Goldwater Institute.




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