While Congressional action often receives more recognition and media attention, the policies enacted by state legislatures are equally worth exploring, as they often have more direct impact on local constituents and communities. As many heartland states wrap up their legislative sessions in the coming weeks, Pulse of the Heartland will feature a policy update exploring legislation that relates to Heartland Forward’s key impact areas. Here is a snapshot of state legislation focusing on efforts to improve health outcomes and promote positive economic impact through healthier heartland communities. 

Alabama

HB 46: With their existing physician tax credit program set to expire in 2025, Alabama introduced legislation to extend the program through 2030. In the extended program, rural physicians would be able to claim a $10,000 tax credit annually for up to four years. This proposed legislation reinforces Alabama’s commitment to addressing its rural health shortcomings by incentivizing physicians to practice in rural areas and remains pending with the opportunity to be passed during a special session.

Arkansas

Act 124: Arkansas’ Act 124, also known as the Healthy Moms, Healthy Babies Act emphasizes Governor Sanders and the Arkansas legislature’s commitment to improving maternal health outcomes. The new law establishes presumptive Medicaid access while mothers’ applications are processed and expands pregnant individuals’ coverage to include:

• Remote ultrasounds
• Blood pressure monitoring
• Continuous glucose monitoring
• Increased number of reimbursed prenatal and postnatal visits
• Medicaid reimbursement for doulas and community health workers (CHWs)
• Mandated mental health screening for new mothers, covered by Medicaid

Act 435: In Act 435, Arkansas establishes a statewide certification program for CHWs to improve access to healthcare and formalize their role. It defines CHWs as trusted community members who help connect people with health and social services. The certification process includes age, training and experience requirements and is overseen by the Arkansas Community Health Worker Association. The act also allows CHWs to be compensated through Medicaid or insurance, expanding access to CHWs to many more Arkansas residents.

Indiana

HB 1003: With the passing of HB 1003, Indiana took significant steps to increase cost transparency in insurance billing. The new law mandates: 

• Public pricing for hospitals, labs and imaging centers on imaging procedures.
• Signed patient acknowledgment before treatment of out-of-network doctors at in-network hospitals to limit surprise out-of-network billing from medical providers.
• Fair and considerate behavior from insurance companies while navigating insurance regulations.
• Free personal health record requests.
• Clearly-defined mental health coverage.
• Audits for insurance plans and pharmacy managers.

Iowa

HF 972 and SF 618: These companion filings improve rural health care access and offer greater opportunity for health care professionals. By introducing a “hub-and-spoke” health care system, rural Iowans can visit smaller health care facilities (spokes) rather than travel to larger hospitals in urban areas (hubs). Additionally, the legislation incentivizes entering the health care workforce by swapping previous student loan policies for updated, flexible repayment programs, including fellowships in hard-to-staff areas. 

Oklahoma

SB 424: Oklahoma SB 424 defines CHWs andcreates a voluntary certification program. The law outlines basic CHW eligibility requirements and allows experienced workers to be certified without formal training. This law’s goal is to strengthen community support and promote access to care through an increase in trained, experienced CHWs.

HB 2049: With the passing of HB 2049, Oklahoma establishes greater parity in mental and physical health care provided by health insurance companies working with Medicaid. The law mandates that these insurance companies make regular checks to ensure that the parity standards established by the Oklahoma Health Care Authority are being followed and publish their de-identified findings. The law aims to expand mental health coverage and improve mental health care.

Heartland Forward maintains that a healthy heartland is a dynamic one. There is no single way to improve health outcomes, just as there is no single way to promote economic development. That being said, there is a clear connection between healthy workers and economic impact. Heartland state legislatures understand this connection and have taken significant strides to capitalize on it.