Chartis, a comprehensive healthcare advisory firm, recently released a new report, Trends in Health Equity Legislation by State and Implications for Healthcare Organizations. The analysis reveals that the number of new state-based statutes aimed at reducing health disparities and inequities issued each year is on pace to nearly quadruple between 2020 and 2023.
Chartis’ assessment used more than three years of data from state departments of health and state legislatures, spanning from January 2020 to August 2023. This analysis covers all 50 states, Washington, D.C., and U.S. territories, with a focus on the adoption of state-based regulations aimed at reducing health disparities and inequities. Almost all adopted at least one statute to advance health equity.
For example, 41 states have new, expanded, or planned Medicaid initiatives to address racial and ethnic health disparities. In addition, states have established requirements in other areas, such as increasing cultural humility of providers and staff, expanding outreach to underserved populations, and establishing the infrastructure and capabilities to assess and reduce disparities.
“Healthcare inequities continue to be one of the most significant and complex challenges in healthcare today,” said report co-author Shaifali Ray, Principal and Vice President, Chartis Center for Health Equity & Belonging. “In order for organizations to advance on their health equity journeys, they need to be informed about the dynamic health equity regulation landscape. These policies are undoubtedly affecting how care is accessed and delivered—and who can afford that care.”
To facilitate the understanding of the legislative landscape, Chartis developed an interactive tool for users to explore the various policies implemented by each state.
- States with the most statutes included Washington, Illinois, Maryland, Colorado, and New York.
- States with the fewest statutes included Arkansas, Idaho, North Dakota, Mississippi, Nebraska, South Carolina, Texas, Wisconsin, and Wyoming.
- Four states did not enact any statutes from January 2020-August 2023: Kansas, Montana, New Mexico, and South Dakota.
Areas of Focus by Timeframe
Since 2020, states have collectively enacted 300 new legislative statutes. Areas of focus include increasing access, addressing social drivers of health, providing timely behavioral healthcare, and improving outcomes in maternal health.
- At least 35 states and the District of Columbia have enacted more than 100 bills since 2020 to support birthing individuals.
- Behavioral health was a consistent focus, with states implementing statutes related to increased investment, coverage, and integration of services.
- States have implemented policies that require healthcare professionals to undergo training that helps identify and address biases within the healthcare system and improve care for diverse patient populations.
- Several bills now require healthcare organizations to track and report on disparities by race and ethnicity and monitor progress.
- Numerous states have adopted requirements for coordination between healthcare organizations and community organizations to support individuals’ specific social needs, such as broadband coverage, housing, environmental harm, and food insecurity.
A brief summarizing the analysis is available on Chartis.com.
Chartis is a comprehensive healthcare advisory firm dedicated to helping clients build a healthier world. We work across the healthcare continuum with more than 600 clients annually, including providers, payers, health services organizations, technology and retail companies, and investors. Through times of change, challenge, and opportunity, we advise the industry on how to navigate disruption, pursue growth, achieve financial sustainability, unleash technology, improve care models and operations, enhance clinical quality and safety, and advance health equity. The teams we convene bring deep industry expertise and industry-leading innovation, enabling clients to achieve transformational results and create positive societal impact. Learn more.