Reproductive Health In the second legislative session since the Supreme Court overturned Roe v. Wade, we expect state legislatures to once again propose more reproductive health-related policies than on any other health policy issue we follow. So far in 2024, trends include protective states instituting “shield laws” preventing penalization of clinicians or patients who receive abortion care and restrictive states considering what exceptions, if any, will be allowed under abortion bans. ACP is also watching how state proposals related to mifepristone, a medication used in most medication abortions, that is the subject of a Supreme Court case challenging its FDA authorization.

Scope of Practice After the last couple of years have seen a growing number of bills proposing scope of practice expansion for health professionals including but not limited to nurse practitioners, physician assistants and pharmacists, ACP is tracking related state scope of practice policies across the country. Starting this year, ACP is a member of the Steering Committee of the American Medical Association’s Scope of Practice Partnership, a collective of more than 110 national, state and specialty medical organizations working to safeguard the quality of patient care by ensuring that care is led by highly trained physicians.

Prior Authorization On January 17, the Centers for Medicare & Medicaid Services (CMS) released their Final Rule on Interoperability and Prior Authorization. This rule will have wide-ranging effects, including on all state Medicaid plans, which are subject to CMS oversight. Meanwhile, more than twenty states are considering their own legislation on prior authorization, with many states also taking a particular interest in step therapy reforms.

Firearm Injury Prevention Although progress on firearm injury prevention appears to be once again stalled at the federal level since the enactment of the Bipartisan Safer Communities Act in 2022, state legislatures are still considering a significant volume of firearm-related bills. ACP is particularly following state actions related to extreme risk protection orders, firearm safe storage, and preventing suicide by firearm, including nearly 200 bills in more than 30 states.

Gender-affirming Care Since Arkansas first banned gender-affirming care services for minors in 2021, more than twenty states have followed suit and enacted restrictions on this care. A growing number of states are also proposing restrictions that would directly or indirectly impede transgender adults' access to care as well. While the number of restrictions grows, other states are considering shield laws, either as amendments to previously enacted laws related to abortion or as standalone measures that incorporate protections related to both types of care.

Voting & Elections After state legislatures enacted an almost record number of voting-related measures in 2023, ACP is expecting similar activity for 2024, especially considering it is an election year. See our new toolkit on Voter Registration and Equitable Access to Elections for more information on supporting voting by health professionals and their patients.

As you consider engaging with 2024 legislative sessions, ACP has prepared the following resources for members interested in understanding and advocating for health policy issues in their states.

• Learn more about ACP policy on select topics and view resources for members in our State Health Policy Toolkits, or check ACP’s Policy Compendium to confirm our position on an issue.
• Register for our upcoming State Health Policy Webinar, which will take place on March 12 at 3:00PM EST. The webinar is a forum to learn about key health policy issues and discuss common concerns.
• Submit a question to ACP’s State Health Policy team using the Advocacy Assistance Request Form.