States began this year by tackling ongoing concerns about health coverage and costs, insurance mandates, employee paid and unpaid leave programs, and other benefit issues carried over from 2019. But the COVID-19 emergency overtook state agendas, as legislators and regulators pivoted to address the urgent concerns raised by the pandemic. States pushed through insurance guidance to ease the impact on patients, employers and the healthcare system. Many jurisdictions also broadened or established leave programs to meet the immediate needs of employees and their families. 

This GRIST summarizes selected state health-related developments and COVID-19 efforts in the first quarter of 2020. Download the 12-page print-friendly PDF to read the full article. Here are highlights of what’s covered.

State healthcare programs

As the year began, states looked to address healthcare costs and ongoing funding. A Connecticut executive order calls for setting healthcare growth benchmarks and providing transparency. New York posted the 2020 covered-lives assessment rates imposed by its Health Care Reform Act.

Reporting

While New Jersey and San Francisco have delayed or cancelled employers’ annual healthcare reporting obligations, Vermont has kept the April 25 deadline for employers’ quarterly reports and payments under the state’s play-or-play mandate.

Insurance

Action on insurance laws, regulations and compliance continued to target drug costs, wellness, surprise medical bills, mental health parity and contraceptive coverage. However, state lawmakers and regulators shifted their focus as the COVID-19 pandemic emerged in the first quarter of 2020. In response to the public health emergency, states are:

• Acting to expand COVID-19 coverage
• Issuing COVID-19 cost-sharing guidance
• Asking insurers to extend premium payment deadlines

Leave

In the past few years, state leave laws — unpaid or paid sick days and paid family and medical leave — have proliferated. These efforts have taken on added urgency due to the COVID-19 pandemic.

Existing paid family and medical/disability leave programs. Six states and Washington, DC, have some combination of paid family and/or medical/disability leave in place. These jurisdictions have updated contribution rates, limits, benefit caps and other relevant information for 2020. Massachusetts has continued to trickle out guidance for its paid family and medical leave (PFML) program, which has begun collecting contributions for benefits that will become available in 2021. New York has enacted a statewide paid sick leave mandate taking effect later this year. Amendments to Washington’s law clarify the PFML program now in effect.

COVID-19 leave. The pressing need for COVID-19 leave for an employee’s or a family member’s illness or inability to work due to a quarantine or an isolation order has spurred states and many municipalities to take further action. Here are some resources to help keep track of these actions:

• The National Conference of State Legislatures (NCSL) has been tracking states’ COVID-19-related legislation, including measures on health and paid leave. The NCSL Coronavirus Resources for States outline pending and enacted COVID-19-related state legislation.
• New emergency paid leave or temporary expansion of existing benefits to address the COVID-19 pandemic is available in Arizona, California, Los Angeles, San Francisco, San Jose, Colorado, Michigan, New Jersey, New York, Philadelphia, Rhode Island, Seattle, and Washington, DC. For more information, see States, cities tackle COVID-19 paid leave.

Other employer issues

Unrelated to the pandemic, employers may want refresh their understanding of common-law marriage and its implications for employee benefits. In February, a Utah appellate court clarified the necessary elements to establish a common-law marriage in the state. Eight states and Washington, DC, continue to allow couples to establish common-law marriages — that is, valid marriages created by the couple’s mutual agreement and public behavior, without an official license and solemnization.