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Being an election year and with primary elections looming, the clear intention of the 2024 Indiana General Assembly leadership was for a short session avoiding controversial issues. Indeed, the session proved to be the lightest and most inconsequential in my memory.
Here’s my 2024 health-related legislative wrap-up from the perspective of a family physician. It is marked mostly by legislation that failed rather than bills that crossed the finish line.
Bills that died:
Senate Bill 3 would have tempered the insurance industry’s out-of-control prior authorization requirements for medical services, medications and testing. PA is largely unnecessary and inappropriate resulting in denied, interrupted and delayed medical care. The bill stalled but had excellent bipartisan support. It will be back.
House Bill 1053 would have essentially removed fentanyl test strips from criminal laws concerning possession of controlled-substance paraphernalia, potentially preventing overdoses.
HB 1059 would have created the independent practice of advanced practice registered nurses (nurse practitioners) with prescriptive authority, did not receive a hearing again this session. Good.
HB 1215 would have allowed immunizations by dental hygienists on the order of a dentist. What do dental hygienists and dentists know about vaccines?
HB 1167 required continuing education for physicians and other health-care providers on implicit bias. This important subject for equitable health care is already being addressed in health professional schools, medical schools and residencies.
HB 1266 stipulated that health care providers and entities would not be required to provide or refer patients for health care services that violate their moral, religious or ethical beliefs. The provider would not be subject to discrimination or other sanctions including civil actions. Balancing patient access with respecting closely held beliefs of individuals and institutions is a difficult issue.
HB 1071 provided exemptions for employer, child care facility and state educational institution immunization requirements. In addition to more traditional exemptions, the bill included that individuals could refuse vaccination after merely being informed of the health risks. This was not good public health policy and would have endangered others through exposure to vaccine-preventable diseases.
HB 1011 was a medical-aid-in-dying measure. MAID is legal in 10 states to better assure that those who voluntarily request it can die on their own terms, without dependence on others and with dignity. There is strong legislative opposition to this controversial issue. No way in Indiana.
There were nine marijuana-related bills introduced. None received a committee hearing. All surrounding states have enacted some form of marijuana legalization.
Enacted bills of most interest to the public:
HB 1259 supports psilocybin (a psychedelic drug) research for the treatment of resistant depression, PTSD, addictions and other mental health conditions. Psilocybin treatment is revolutionary and is not based on fringe science.
HB 1426 requires hospitals to offer long-acting reversible implanted contraceptives to Medicaid mothers after delivery. The bill was controversial because it did not include IUDs that some consider abortifacient. But in light of the new abortion statute, anything done to prevent unwanted/unintended pregnancies is a step forward.
SB 273 mandates insurance and Medicaid coverage for biomarker testing important for diagnosis and treatment of certain diseases.
SB 9 requires health care entity mergers of at least $10 million dollars (mostly hospital systems and insurance companies) to file with the Attorney General’s Office for review for antitrust concerns and effects on the community. The apprehension is that mergers may potentially decrease patient access and choices and increase health care costs.
Next year will be very busy.•
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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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