Why Should Delaware Care?
The Delaware General Assembly passed a slew of bills that will alter health care coverage related to abortion, Medicaid and costs. A handful of health care bills to expand abortion access and Medicaid coverage now await Gov. John Carney’s signature.
The 152nd Delaware General Assembly convened Sunday after sending numerous health care-related bills to Gov. John Carney’s desk for signature. Many health bills have already been signed, while others have stalled or failed to pass.
Health care legislation during this legislative session ranged from Medicaid funding and medical marijuana to medication abortion and a hospital cost review board.
Here is what is on the table.
PASSED
Health Care Cost Review Board
House Bill 350: A bill to establish a hospital cost review board to review hospital budgets in order to rein in health care spending. Hospitals will be required to submit yearly budgets, audited financial statements and other financial information to the board.
The bill faced fierce opposition from hospital leaders who launched a robust lobbying campaign against it.
Hospital officials argued that their boards of directors were best suited to meet the needs of local communities – not a state-appointed board. The boards of the largest Delaware hospital systems, however, only reflect a fraction of the growing diversity in the state.
Lawmakers and hospital leaders eventually forged a compromise on the legislation before it was passed and signed into law by Carney on June 13.
Physician-assisted death
House Bill 140: Allows adult Delaware residents who are terminally ill to self-administer medication to end their life, foregoing further suffering. The bill establishes a 14-day waiting period after the initial verbal request and a 48-hour waiting period following the final written medication request, in order to avoid hurried decisions to end one’s life.
The medication cannot be requested by anyone other than the patient. The bill, known as the Ron Silverio/Heather Block End of Life Options Law, also allows physicians or institutions to opt-out of the program.
Attempts to pass medical aid in dying legislation stretch back nearly a decade in the First State. If signed, Delaware would become the 12th state to allow physician-assisted suicide.
Medicaid boost
Senate Bill 13: Would tax the state’s hospitals to bolster Medicaid funding for thousands of low-income Delawareans. The legislation would unlock $175 million in federal funding to expand Medicaid services in the state.
The bill would levy a 3.58% tax on net patient revenues from Delaware’s acute-care and behavioral health hospitals. By taxing hospitals, the bill would increase the amount of state funding available for Medicaid and prompt the return of more federal matching dollars.
Most of the collected tax money would then be returned to hospitals in lump-sum payments. Lawmakers described the process as “borrowing” money from hospitals to then increase Delaware’s Medicaid funding and use federal dollars to bolster state Medicaid programs.
The bill is awaiting consideration by the governor.
On-campus abortion pill
Senate Bill 301: Requires public universities to provide medication abortion and emergency contraception on college campuses.
Providing access to abortion pills like mifepristone would allow students to end pregnancies up to 70 days after conception without having to undergo a more significant abortion procedure.
The University of Delaware and Delaware State University already offer access to emergency contraception medication, known as Plan B.
Critics argue the requirement is an overextension of available services, describing the legislation as “death on demand.” Supporters say the legislation would mitigate reproductive health care barriers for college-age people, such as transportation and economic hurdles.
The bill is awaiting consideration by the governor.
Abortion coverage expansion
House Bill 110: Expands most private health insurance plans, Medicaid and the state employee health insurance plan to cover abortion-related services.
Medical coverage under the bill would not be subject to any “deductible, coinsurance, co-payment, or any other cost-sharing requirement” and must cover the full range of services allowed under the law.
The bill has a cap of $750 per person per year related to abortion-related services. A religious employer may be excluded from the requirement if it conflicts with the organization’s religious beliefs or practices.
The bill has a roughly $1.5 million fiscal note attached. If signed, the bill would go into effect on January 1, 2025.
Food desert study
Senate Bill 254: Creates the Delaware Grocery Initiative to expand access to healthy foods in food deserts and areas at risk of becoming food deserts. Food deserts are areas that lack access to fresh, healthy foods and grocery stores.
Food deserts particularly impact low-income communities that must rely on neighborhood corner stores that may not carry healthy foods. Lack of access to healthy foods can lead to health issues such as obesity and diabetes, while also taxing the state’s workforce and health care costs.
The bill would establish a three-year statewide pilot program to mitigate food deserts. The Division of Small Business would provide grants and other forms of financial assistance to eligible food resources.
The bill is awaiting consideration by the governor.
Medical marijuana expansion
House Bill 285: Broadens the accessibility of medical marijuana for patients in the First State.
The legislation allows health care providers to determine whether a patient has a diagnosed medical condition that would be mitigated by the use of medical marijuana. The legislation removes the requirement that a patient must have a debilitating medical condition to qualify for a registry identification card.
The bill also allows patients who are 65 and older to self-certify their qualification for an ID card without a written certification from a health care provider. The bill requires the issuance of an ID card with an indefinite expiration date for patients with a terminal illness.
Carney signed the bill into law on May 28.
Doula coverage
House Bill 80: Expands Medicaid coverage to include doula services for pregnant people before, during and after pregnancy. Doulas provide physical, emotional, and educational support to pregnant people.
The legislation would cover three 90-minute prenatal and postpartum visits, respectively, as well as doula attendance during labor and birth. The bill required doula services to be covered by Medicaid by January 1, 2024.
The legislation follows up on House Bill 343 from the 151st General Assembly that required the Division of Medicaid and Medical Assistance to submit a plan to implement the coverage. House Bill 80 draws on the completed report from the previous General Assembly.
House Bill 80 had a fiscal note of nearly $600,000 ranging from fiscal years 2024 to 2026. Carney signed the bill into law on Aug. 9, 2023.
FAILED
Medicaid for undocumented children
House Bill 150: A bill to create a limited medical assistance program to provide medical care for Delaware children unable to receive Medicaid or Children’s Health Insurance Program (CHIP) benefits. The bill would largely provide medical care for undocumented children.
The bill, known as the Cover All Delaware Children Act, directs the Department of Health and Social Services to provide prenatal, postpartum, labor and delivery care to all people, regardless of immigration status.
Medicaid is only available to undocumented people through emergency services, including labor and delivery. The program does not cover vital prenatal and postpartum care, however.
The bill was passed in the House Health & Human Development Committee before being assigned to the House Appropriations Committee in May 2023. The legislation remained in the committee and failed to be considered before the legislative session ended.
