Kentucky does not have the best track record when it comes to health. We come close to leading the nation in all the wrong things — particularly chronic illnesses like diabetes, heart disease, obesity. Lifestyle choices contribute to the prevalence of diseases, but access to quality medical care certainly plays a big part as well. Of course, these are painful, crippling, and expensive diseases, but the COVID-19 pandemic has made being chronically ill even more dangerous. If you have a pre-existing condition, you are more susceptible to the coronavirus and more likely to suffer complications if you get it.
This legislature worked diligently this session to improve health, focusing on access. One way we accomplished this is by giving more authority to physician assistants (PAs). This measure, House Bill 135, will allow PAs, who already practice medicine throughout the state, the ability to prescribe more medications as part of the medical care they provide to a patient. This is an important step in getting more providers into our state’s most rural areas, which has historically been a struggle. The bill passed with incredible bipartisan support.
Access to health care certainly means access to community hospitals in our rural areas. However, many of our rural hospitals were struggling financially before COVID-19, with half in danger of bankruptcy or closing. The state’s prolonged moratorium on elective procedures has made the struggle harder and hundreds of health care workers across the state are on furlough. All of this makes HB 387 one of the most important bills passed this session because of it’s potential to revitalize rural hospitals. The bill creates a revolving loan fund within the Cabinet for Economic Development for financially distressed rural hospitals. Loan funds could be used by hospitals to maintain or upgrade their facilities, to maintain or increase staff, or to provide new health care services. This measure also included language that allows the Governor to access funds for the purchase of personal protective equipment (PPE) to be used in the pandemic. Unfortunately, the Governor inappropriately used his line-item veto power on this bill — leaving the entire bill in question. The legislature is moving forward to get clarification, so I am hopeful the entire bill will become law.
If we want to increase access to health care, we have to invest in educating Kentuckians to be doctors and medical researchers. That’s one of the major goals of HB 99, which provided a loan to the University of Louisville as it turns around Jewish Hospital and the Kentucky One Health System. The university purchased the system late last year. If the purchase had not gone through, Kentucky may have lost one of its medical schools but also thousands of health care jobs. This would be a major blow at any time, but this pandemic makes the investment in future physicians and research, as well as today’s health care needs, even more critical.
The common goal of access continues with HB 129, which simplifies and focuses the goals of local health departments to reflect the needs of their communities. The bill, referred to as the Public Health Transformation Act, prevents duplication of services and encourages shared resources and expertise. The legislation will help local health departments control costs and will relieve the instability of the current system. This bill ensures the priority is on the most necessary functions. In a separate measure aimed at helping local health departments, we froze the employer contribution rate they are required to make towards pensions for one more year. Like so many, I am extremely troubled by the pension debt we inherited. However, this pandemic makes it even more difficult for health departments to make and meet their budgets.
Cost-cutting and improving customer services and delivery was a priority in passing Senate Bill 50, legislation that will simplify and reduce pharmacy costs for the Department for Medicaid Services. SB 50 requires only one pharmacy benefits manager to carry out the pharmacy benefits for all Medicaid recipients. We have heard extensively of the discriminatory pricing and reimbursement practices of pharmacy benefit managers, or PBMs. PBMs are an unnecessary regulatory burden, and I was proud to support this measure to begin to carve them out of our state Medicaid program.
We took a step forward in addressing the youth vaping epidemic by passing SB 56. This bill prohibits the sale and use of tobacco products, including vapor products, to anyone under 21. The youth vaping epidemic is exceptionally problematic and unhealthy. Hopefully, this bill will snuff out this dangerous practice in our teens by raising the age of purchase from 18 to 21.
Before I close, I want to offer my thanks to the health care workers, frankly to all the men and women who have continued to serve our state through this crisis. Just like in wartime, everyone has a role to play and everyone’s role is important. As we move forward to reopen our state, I think the time has come to focus on how we can do so safely and strongly. I was pleased to be part of a General Assembly that adopted CDC guidelines to keep serving our constituents. And, I know that businesses and organizations here in this community will do the same thing to get back to work safely.
As always, I hope you will contact me with any questions or concerns you might have. I can be reached here at home anytime, or through the toll-free message line in Frankfort at 800-372-7181. If you would like more information, visit the legislature’s website legislature.ky.gov or email me at Chris.Freeland@lrc.ky.gov.
Rep. Chris Freeland, represents the 6th District, which includes Lyon, Marshall and part of McCracken County.