State Policy Network
Conquering the coronavirus: State think tanks empower policymakers to save lives in a time of pandemic
Thanks to state think tank ideas and state policymakers’ leadership, healthcare supply and access has expanded in response to the coronavirus pandemic.

This post was updated on June 1, 2020, to reflect new data.

On January 1, Americans welcomed 2020 optimistically. Before us stretched a new decade of possibilities, experiences, and opportunities to make cherished memories with family and friends.

A short couple of weeks later, on January 21, a threat emerged that would change daily life for all Americans and put the lives of family, friends, and neighbors at stake at an alarming rate. The novel coronavirus, COVID-19, had reached the United States from Wuhan, China, showing up first in Washington state.

As the coronavirus outbreak spread, policymakers had to face a critical challenge: How could the country ready our healthcare system to meet the demand for help, stop the spread, and avoid as many deaths as possible? The answer: Unleash the power of states.

Being close to the communities and people who would need help, states were in the best position to make a rapid difference. State governors and legislators needed practical, fast-acting solutions, and they found them in SPN’s 50-state Network of independent state think tanks.

SPN’s Healthcare Working Group identified a few key ideas that would be critical to increasing healthcare supply and access. Grounded in years of credible, thoughtful research, these ideas empowered state governors with healthcare solutions that could be enacted through executive orders and legislative reform and create immediate impact:

  1. Certificate-of-need reform: Free up healthcare resources for the sick by removing barriers restricting the use of healthcare beds and medical equipment.
  2. Scope-of-practice reform: Fortify and expand the number of healthcare responders by removing limitations on the types of care that trained healthcare professionals can offer.
  3. Telemedicine expansion: Allow patients to seek healthcare expertise remotely to avoid the spread of disease.
  4. License reciprocity: Allow healthcare professionals to serve where needs are greatest by recognizing out-of-state licenses.
  5. Surprise billing elimination: Give patients financial peace of mind by being more transparent about what treatment will cost and eliminating unanticipated exorbitant medical bills.

In the first six weeks of the pandemic, every state took some action to pass healthcare reforms. In 24 of those states, state think tanks worked with policymakers to create policies that expanded the number of practitioners available, removed regulations to increase equipment and bed, and instituted telemedicine.

Since the pandemic began, at least 40 state think tanks have taken executive action to expand healthcare access. Many of these positive results have roots in the momentum for healthcare reform that has built up over the last several years. Throughout its eight-year history, SPN’s Healthcare Working Group has identified and recommended these solutions as ways states can make positive changes to the healthcare system. To date, all 50 states have enacted some version of market-based healthcare reform.

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State action leads to national impact

Thanks to state think tank ideas and state policymakers’ leadership, the tide began to turn, and the swift pace of healthcare solutions crossing state lines soon rivaled the spread of the coronavirus. In responding to the pandemic, all 50 states have made at least one of the changes that SPN’s Healthcare Working Group identified as critical, many doing so through executive orders.

The reforms passed have ranged from narrow adjustments to broad changes, as state policymakers have decided how to act on these Network recommendations. States accomplished reforms through a mix of executive orders, legislation, or a combination of both.

Deep Dive: A state-by-state guide to healthcare reforms during the pandemic

Explainer Video (11 minutes)

Patrick Ishmael, a policy expert at the Show-Me Institute in Missouri and a member of SPN’s Healthcare Working Group, joins SPN Senior Policy Advisor Russ Walker, to share a brief overview of the state-by-state data on the nation’s healthcare response to the pandemic.

State-by-state tracker

View the full state-by-state tracker

What comes next: Making sure the good changes are permanent

As states have acted, several solutions have evolved from narrow orders to broad laws.

Many states have placed expiration dates on the executive orders that make these reforms possible. But this pandemic has taught us all a valuable lesson: These solutions can save lives, and we need them in place long-term to build a healthcare system that is prepared to weather any crisis, not just the present one. As the coronavirus pandemic response has demonstrated, states are best positioned to lead that charge.

The next opportunity for state policymakers is to make these solutions permanent and increase the supply of healthcare for all Americans for years to come. SPN’s state think tanks stand ready to collaborate with state leaders to make this a reality and give Americans an even stronger reassurance that they will be able to receive safe, quality healthcare in the moments when they need it most.