Legislature makes good-and bad-health policy – Indianapolis Business Journal

I offer this summary of selected health-related legislation during the 2022 session of the Indiana General Assembly through the lens of a family physician.

Some notable measures that were not considered or that did not survive the session:

◗ “Proposal for “independent” practice for nurse practitioners (not introduced) and looser physician oversight of physician assistants (not heard). A good result: These changes would be inconsistent with optimal quality of care.

◗ No legalization or decriminalization proposals for marijuana were heard, despite having 13 bills submitted for consideration.

◗ Senate Bill 405 would have removed the secrecy involving the millions of additional Medicaid dollars that are received by county hospitals to support their own nursing homes but are being diverted to other purposes. It also would have required the state health department to establish much-needed quality metrics for nursing home care. Not to address these issues is regrettable considering the problematic quality of care in these facilities.

◗ Although an abortion-related measure was enacted, bills explicitly restricting or banning abortions were not heard. Legislators are awaiting the US Supreme Court decision on Mississippi’s abortion law before actively considering legislation.

Important legislation that was enacted:

◗ Many patients are confused about who exactly is providing their medical care. SB 239 adds clarity and transparency to the identification of health care professionals. Advertising materials are required to include license type (such as physician, nurse practitioner, physician assistant). Also, certain medical-specialty designations (like endocrinologist and rheumatologist) are now reserved for physicians. Unfortunately, the badging with license-type requirement, originally included, was removed. Still, this is a great advancement for informed decision-making by patients.

◗ HB 1313 requires providers through 2026 to screen all patients from 9 months to 6 years of age once for lead toxicity if previously not tested. This time-limited measure will better define the Indiana lead problem and form the basis of future screening protocols.

◗ SB 382 contains horrible regressive tobacco-taxation policy that benefits only the tobacco industry and retailers—and at the expense of our children’s health. SB 382 lowers the taxation on closed vaping products (like Juul) and on other smokeless tobacco products (think Orbs and Snus). Absolutely reprehensible.

◗ SB 3 qualifies Indiana for enhanced federal funding for Medicaid and supplementary food assistance programs after the governor ends a state of emergency order. It also enables children 5 to 11 years old to receive vaccinations outside a physician’s office during an emergency order.

◗ Originally, HB 1001 would have essentially gutted the ability of employers to institute COVID vaccine mandates for employees. The bill was heavily amended to largely satisfy the business community’s objections. Religious exemptions (in the original bill unchallengeable) can now be rejected if not considered legitimate. The bill allows verified medical exemptions and exemptions for those who tested COVID-positive in the previous three months. Those exempted could be required to be regularly tested at the employee’s expense. This a reasonably good result for a really bad bill.

◗ HB 1217 addresses “coerced” abortions. It requires providers to report suspected coercion to law enforcement, which has the potential of disrupting the provider-patient relationship, especially if the pregnant woman doesn’t want it reported. The bill does not allow provider discretion in determining what is a coercive action (a felony) and doesn’t contain a definition of coercion. Bad public policy.

There are plenty of controversial issues apt to arise next session. Further restrictions on abortions, marijuana legalization and pharmacist-prescribed birth control are just a few. Should be a wild time.•

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Feldman is a family physician, author, lecturer, and former Indiana State Department of Health commissioner for Gov. Frank O’Bannon. Send comments to ibjedit@ibj.com.


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