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Issue pack

Healthcare Access

"Nobody dies for lack of coverage."

Healthcare offers the cleanest difficulty curve in legislating. An insulin copay cap is concrete, sympathetic, and cheap on the fiscal note: the kind of bill that passes with both parties' fingerprints on it.

A state public option is the opposite: a structural challenge to the insurance market, opposed by the most sophisticated lobby in the building, with a fiscal note that becomes the entire debate.

The 2 bills you can carry

Same issue, different ambition, and ambition is what the legislature makes you pay for.

Insulin Price Cap

"The Insulin Affordability Act"

Difficulty: Approachable Impact: Medium

Cap all covered insulin needed in a 30-day period at $35 total in state-regulated plans and fund emergency access for eligible gaps.

"I skipped doses for a week to make rent. I ended up in the ER for three days."

— Danielle, server, Type 1 diabetic
Why it can pass
  • Bipartisan: nobody defends insulin pricing publicly.
  • Easy to explain. Easy to rally.
Why it might not
  • PBMs will fight quietly but brutally.
  • Narrow scope means narrow impact.

State Public Health Option

"The Public Health Option Act"

Difficulty: Legendary Impact: Transformative

Create a state-run health plan available on the exchange.

"I make too much for Medicaid, too little for real insurance. One accident and I'm done."

— David, construction contractor
Why it can pass
  • Biggest possible impact on real lives.
  • Unions and faith groups are with you.
Why it might not
  • Every health-industry dollar lines up against you.
  • Actuarial complexity is extreme.