Our American States

Biosimilars, a group of drugs that are similar to biologic drugs, which are medications produced using living organisms and are often used to treat complex medical conditions. Biosimilars were first introduced to the prescription drug market about a decade ago and as of March, the FDA had approved scores of products that may be used interchangeably for some of the most expensive brand-name biologic pharmaceuticals, treating conditions such as diabetes and cancer. While biologics make up only about 2% of prescriptions, they account for as much as 46% of total drug spending in the U.S.The three guests on this podcast all have expertise on different aspects of this topic and discuss the use of biosimilar medicines in health care and the possible cost savings when they are used in place of originator biologic medications. Luca Maini is an economist who studies the pharmaceutical industry and is an assistant professor at Harvard Medical School. Chad Pettit is executive director of global government affairs for Amgen, a biotechnology company. Erin Glossop is a policy specialist at NCSL who follows state policies around pharmaceuticals.Maini discussed his research into how the introduction of biosimilars into a market affects the price of brand-name biologics. Pettit explained the perspective from the biotechnology industry and how he thinks the industry will develop in the next several years. Glossop explained how some states are developing bipartisan policy around biosimilar access and efforts to find cost-savings these products might offer. ResourcesAmgen BiosimilarsAssessing the Biosimilar Void in the U.S., IQVIABiosimilars in the United States 2023-2027, IQVIABiosimilar Uptake In The US: Patient And Prescriber Factors, Dongzhe Hong, et al.Coverage for Biosimilars vs Reference Products Among US Commercial Health Plans, James D. Chambers, et al.Exploring the Influence of Health Insurance Plans on Biosimilar Adoption Rates, Mariana Socal, et al.Factors Associated with Biosimilar Exclusions and Step Therapy Restrictions Among US Commercial Health Plans, Tianzhou Yu, et al.Luca Maini website

Defiance is often thought as a negative trait, but as our guest on this podcast explains, it can actually be a positive force both in the workplace and in our lives generally. Dr. Sunita Sah, a professor at Cornell and an organizational psychologist, is the author of “Defy: The Power of No in a World that Demands Yes,” published earlier this year.Sah's book explores why people say yes and go along at work and in other relationships in their lives, even when they want to say no. In this conversation, she explains how most people are conditioned to see defiance as a negative trait. Instead, she argues, defiance based on deeply held values can be a positive.She discusses how to evaluate a situation where you may want to defy, how we need to train ourselves to see defiance in a different light and why it is so difficult to make that transition. Sah also addressed defiance in the legislative workplace and the complications that can arise in a complex hierarchy. Sah also explained that while defying is not risk free, going along when you know you should object carries its own hazards.Sah will conduct a webinar on May 5 at noon MT as part of this year's NCSL Legislative Staff Week. ResourcesDr. Sunita Sah's website

Oral health care for children is required in every state under Medicaid or the Children's Health Insurance Plan. But dental coverage for adults is optional. And while nearly every state provides some level of coverage for adults, what is covered and who is covered varies widely from state to state and even within states.Our first guest on this podcast is Ian Hedges, the director of Medicaid and Medicare program policy for the American Dental Association. Hedges explained how oral health care affects overall health and why different levels of coverage for adults under Medicaid can lead to higher costs later on for health complications that arise from neglected oral health issues. One study found that untreated oral health conditions can lead to health complications that cost the U.S. about $45 billion each year in lost productivity.Our other guests are Sen. Evan Vickers, a Republican of Utah, and Sen. Malcom Augustine, a Democrat from Maryland. Senators Vickers and Augustine explained how their states have approached broadening coverage for adults covered by Medicaid, the challenge in assembling a group of providers that will accept Medicaid reimbursement and some of the particular problems in providing care to those with low incomes and those living in rural areas.ResourcesMedicaid Adult Dental Benefits Are on the Move in 2024, CareQuestVariation in Use of Dental Services by Children and Adults Enrolled in Medicaid or CHIP, KFF

This is one in a series of podcasts celebrating the 50th anniversary of the National Conference of State Legislatures. On this episode we focus on legislative staff, the approximately 30,000 professionals who keep the trains running at this nation's legislatures.While legislative staff outnumber legislators by more than 4 to 1, their role is often poorly understood by the public and even by their own families.  Yet the work they do from drafting legislation to providing bill research to keeping the IT systems running is critical to these institutions. We talked to a variety of staffers and others who reflected on the growth of staff, their critical role in providing nonpartisan professional advice to legislators, the changing role and challenges staff have faced especially in the last 50 years and what the future holds for them.ResourcesLegislative Staff, NCSLNCSL Marks 50th Anniversary of Strengthening States, NCSL

A new book published jointly by NCSL and the U.S. Election Assistance Commission is aimed at serving as a resource for election administrators, secretaries of state, state legislators and legislative staff. It will be available soon in digital form on the NCSL website. “Helping America Vote: Election Administration in the United States” was the focus of this podcast and features a discussion with Commissioners Ben Hovland and Donald Palmer.The EAC was established by the Help America Vote Act of 2002, which was Congress' response to the problems with the 2000 election. The commission's goals include adopting voluntary voting system guidelines, serving as a national clearinghouse for election administration and certifying voting systems. The commissioners are bipartisan. Hovland, chairman until earlier this year, is a Democrat, and Palmer, the current chairman, is a Republican. The commissioners discussed a variety of topics related to elections including the pros and cons of our decentralized voting system, the importance of election administration as a profession, the value of a bipartisan approach to election administration and who they hope will read this book. ResourcesElections and Campaigns Program, NCSLU.S. Election Assistance Commission

Medicaid is a program jointly funded by the federal and state governments. It provides health care coverage to nearly 80 million people, primarily those with low incomes, people who are living with disabilities or are in long-term care. On this episode we discussed the nuts and bolts of how Medicaid is financed and how states are handling some new challenges in the post-pandemic world. The pandemic affected both who Medicaid covered and the share paid by the federal and state governments.  In the first segment, NCSL's Kathryn Costanza was joined by Akeiisa Coleman from the Commonwealth Fund to break down the details of how the program is funded, including how the federal-state share is determined for each state. They also discussed the key drivers of cost in the Medicaid system. On the second segment, guests Neda Jasemi from the National Association of Medicaid Directors, and Robin Rudowitz from KFF talk about what they are hearing from Medicaid officials around the country. They discussed how the post-COVID unwinding of patients who had remained on the rolls during the pandemic had significant effects on the program. They also discussed steps states are taking to try to ensure access for Medicaid patients and how states are preparing for any changes in the program at the federal level. ResourcesCommonwealth Fund/MedicaidHealth Costs, Coverage and Delivery State Legislation Database, NCSLHow We Pay for MedicaidKFF/Medicaid“Medicaid Financing 101,” NCSL“Medicaid Toolkit,” NCSLNational Association of Medicaid Directors“Results from an Annual Medicaid Budget Survey for State Fiscal Years 2024 and 2025,” KFF“State Legislatures Address Medicaid Coverage and Payments in the 2024 Legislative Session,” NCSL“State Tax Actions: 2024,” NCSL“Top five Medicaid budget pressures for fiscal year 2025,” NAMD

The Women's Legislative Network of NCSL is celebrating its 40th anniversary. Every female state legislator in the 50 states, territories and the District of Columbia belong to the Women's Legislative Network. The network sponsors informational briefings, hosts skill building workshops for women and opportunities for female legislators to interact. Senator Dafna Michaelson Jenet, a Democrat of Colorado and the current president of the WLN, and Representative DeAnn Vaught, a Republican of Arkansas and the incoming president of the group, joined the podcast to discuss the anniversary and women in legislatures more generally.They discussed how they decided to run for the legislature, the obstacles they faced and the perspective female legislators bring to the job. They also shared their passion for encouraging other women to run for office.  ResourcesWomen's Legislative Network of NCSL 

Since 2008, Charles Stewart III, a professor of political science at MIT, has conducted the Survey of the Performance of American Elections, asking voters in every state and Washington, D.C., about their voting experience after every presidential and midterm election. His report from that survey offers a window into how Americans voted—not who they voted for— and if they were satisfied with their voting experience. Stewart joined the podcast to offer a preview of the 2024 report, that includes questions about whether voters cast their ballots by mail or in person, how confident they were in the election results and other matters.Stewart, who is also the head of the head of the MIT Election Data + Science Lab, said some people might be surprised to learn that most voters are both satisfied with the voting experience and have confidence in the results.ResourcesMIT Election Data + Science Lab 

Power-sharing in tied legislative chambers is typically no picnic. But about 15 years ago in Oregon when the House faced a historic tie, things went so smoothly people from both sides of the aisle are still talking about it today.

At the start of each year, we sit down with NCSL CEO Tim Storey to discuss the most important issues facing state legislatures in the upcoming session. While the November election did not bring big changes for state legislatures—there was minimal turnover at both the legislative and executive levels—the big change in the federal government may mean significant changes in the state-federal relationship.State budgets, which determine much of what states can do in the new year, are stable in most states and rainy day funds generally are in good shape, Storey said. But revenues are not on the rise and, as is true at the federal level, that means less willingness by legislatures to fund new programs.A trend of rising health care costs will also affect states through their Medicaid programs and likely result in a strong focus on controlling costs. Storey also discussed other key areas of policy, including K-12 education, social media and kids and AI. One wild card for states is immigration and how they will respond if the new administration follows through on aggressive plans for deporting people in the country without documents. ResourcesSpecial Report: A Look at 2025's Trending Legislative Topics, NCSL

Nuclear energy plays a significant role in our national energy supply picture and is seen by some as an invaluable piece of a future clean energy system. About 20% of the nation's energy supply comes from nuclear generation at more than 90 reactors and some experts believe the nation needs another 200 gigawatts of electricity from nuclear generation in the next 25 years.On this podcast, we spoke with Jake Kincer, a program manager at Clear Path, a center-right think tank focused on accelerating efforts to reduce global energy emissions, and with Rowen Price, a policy adviser on nuclear energy at Third Way, a center-left oriented think tank focused on a range of public policy issues.Kincer and Price discussed how nuclear energy policy may or may not change in the transition from the Biden to the Trump administration. They explained the role nuclear energy will likely play in the coming decades as energy use soars with the added demand of data centers, AI, new industrial facilities and the electrification of the transportation fleet. They also talked about the state role, the challenge of nuclear waste, and the increasing role of private companies contracting with nuclear power providers to guarantee energy for new developments.ResourcesClear PathNuclear Energy InstituteNuclear Power and Clean Energy Transition, NCSLThird Way

About 1,000 new lawmakers were elected in November's election and will be joining their legislatures in the new year. Every legislature is different, of course, but we asked two veteran legislators to offer a little advice on a few issues that likely apply in most legislatures.Sen. Karen Keiser (D) from Washington state and Rep. Walker Thomas (R) from Kentucky shared some of their experiences as new lawmakers and advice on working with the media, responding to constituents and speaking on the floor. Keiser, who is retiring at the end of this term, is the president pro tem of the Washington Senate and is the author of “Getting Elected Is the Easy Part: Working and Winning in the State Legislature.” She started her career in the Washington House in 1995.Thomas has served in the Kentucky House since 2017. He is the chair of Veterans, Military Affairs and Public Protection Committee.ResourcesGetting Elected Is the Easy Part: Working and Winning in the State LegislatureNew Member Virtual Orientation, NCSLNew State Legislators, NCSL

Massive wildfires in the U.S. have caused widespread damage in recent decades. The Smokehouse Creek Fire in Texas this year, the Marshall Fire in Colorado in 2021 and a series of fires in California in 2020 that were the worst in the state's history are just a few examples. Over the past few decades, the U.S. has spent more than a billion dollars annually to fight wildfires, including $3.5 billion in 2022.In the past few years, legislators concerned about this trend have asked utilities to provide disaster mitigation plans. In Washington state last year, bipartisan legislation was enacted that requires utilities to provide wildfire mitigation plans for legislators to review. Rep. Kristine Reeves (D) of Washington state joined the podcast to discuss the origin of the legislation in her state and why it's important for legislators to review and understand the steps utilities are taking to reduce the risk of wildfires, particularly in Western states. Also joining the podcast was Anne Sherwood, area vice president for wildfire mitigation for Xcel Energy, a utility that operates in eight states. She explained how utilities are using wildfire mitigation plans to try to prevent wildfires and also to better manage the effect on utilities when fires do start. 

Recent polls find that many Americans have declining confidence in higher education, in large part because of the levels of student debt, the cost of college and concerns about uneven student outcomes. To better understand these challenges, NCSL formed a Task Force on Higher Education Affordability and Student Outcomes in 2022. The group has now issued its report. The co-chairs of the task force – Senators Ann Millner (R) of Utah and Michael Dembrow (D) of Oregon – talked with us about what they discovered. Also on the show is Austin Reid of NCSL, a federal affairs adviser in the Washington D.C., office, who worked with the task force.Reid explained the genesis of the task force and the importance of trying to better coordinate the efforts of state government, the federal government and institutions of higher education.Dembrow and Millner explained how the bipartisan group of legislators on the task force came to understand the importance of a degree of value. The also expressed hope that the task force's work will lead to greater coordination between state and federal officials.ResourcesTask Force on Higher Education ReportTask Force Report: Enhancing the Value of Higher Ed Degrees, NCSL

On this episode, we sat down with two election experts from NCSL to discuss the state legislative races and statewide ballot measures in the Nov. 5 election. Ben Williams, NCSL's associate director of Elections and Redistricting, discussed the 5,508 legislative seats on ballots in 44 states, more than 78% of all legislative seats nationwide. He also explained how the outcomes could affect legislative control in the states, overall state control and veto-proof majorities in some states. Helen Brewer with NCSL explained the range of topics covered by the more than 150 statewide ballot measures voters will decide. She discussed the large number of abortion-related measures and others uses such election administration, taxes, criminal justice and education. ResourcesNCSL State Elections 2024

This is one of the series of shows this year and next reflecting on the 50th anniversary of NCSL. For this episode, our focus is the legislative institution and how today's legislatures evolved over the last 400 years.Guests include historian Pev Squire, who sketches out how legislatures developed both from the colonial assemblies and from the territorial legislatures. We also spoke with three people who have spent considerable time in legislatures and given a great deal of thought to the institution itself— Kentucky Senate President Robert Stivers, Colorado House Speaker Julie McCluskie and Raul Burciaga, who recently retired as director of the New Mexico Legislative Council Service. They reflected on where the institution is now and the challenges it will face in the next 50 years. ResourcesNCSL Marks 50 Years of Service to State Legislatures, NCSL

Artificial intelligence, most broadly thought of as the use of computer systems to perform tasks that normally require human intelligence, is being employed in a wide array of ways, from self-driving cars to health care. But concerns about the potential misuse and unintended consequences of AI is prompting legislatures around the country to study the issue and in many cases, pass legislation.In 2024, NCSL is tracking more than 400 pieces of legislation related to AI. This year at least 45 states, Puerto Rico, the Virgin Islands and Washington, D.C., introduced AI bills, and 31 states, Puerto Rico and the Virgin Islands adopted resolutions or enacted legislation.Our three guests on this episode offer a look at AI's legislative impact. Chelsea Canada from NCSL, who tracks state legislation around the country related to AI, is one of our guests and she explained the breadth of the legislation proposed in the states and also noted a trend in some states toward comprehensive AI laws focused on consumer protection.Our other guests are Sen. Shelley Hughes (R) of Alaska, who worked this year to move a comprehensive bill through the legislature but was unsuccessful. She explained her bill and her hopes for its passage in the next session. Our third guest is Colorado Rep. Manny Rutinel (D). He was one of the House sponsors of a successful bill focused on consumer protection and trying to remove discriminatory results from the use of AI. ResourcesArtificial Intelligence 2024 LegislationArtificial Intelligence 2023 LegislationArtificial Intelligence 2019-2022Volume of AI Bills Rises, Even as Use of Systems Evolves 

A class of drugs that are used in the treatment of type 2 diabetes and obesity are becoming increasingly popular as a weight-loss drug. However, the high cost of these GLP-1 drugs—the annual list price is around $12,000—has posed a dilemma for states as they decide whether to cover the drugs in their own state health plans, Medicaid and possibly require private insurers to cover the drugs. On this episode, we get perspectives from three people involved in the debate: Kristen Niakan, a pharmacy management consultant with the actuarial and consulting firm Milliman; North Carolina Treasurer Dale Folwell (R); and Colorado Senator Dafna Michaelson Jenet (D).Niakan explained the background of these drugs, who's using them, the costs involved, and the insurance coverage landscape across the country. Folwell walked through the decision in his state not to cover GLP one drugs for the state's employee health plan, and also discussed a separate decision in his state to extend coverage of the drugs to Medicaid recipients. Michaelson Jenet discussed her efforts to pass legislation that would've required all private insurance companies and the state Medicaid program in Colorado to provide coverage for the treatment of the chronic disease of obesity and the treatment of pre-diabetes, including FDA approved anti-obesity medication. ResourcesDiabetes State Mandates and Insulin Copayment Caps, NCSLEmployers feel the side effects of drugmaker control over Wegovy, Ozempic costs, PoliticoGLP-1 agonists in Medicaid: Utilization, growth, and management, MillimanImpact of anti-obesity medication coverage in the Medicaid and commercial marketsKFF Health Tracking Poll May 2024: The Public's Use and Views of GLP-1 Drugs, KFF

Americans of all ages do not score well on surveys of civic knowledge. One recent survey found a large majority of respondents could not pass a basic civics literacy test and another indicated a third of respondents could not name all three branches of government. And testing of eighth graders in the U.S. and other industrialized countries also reported a decline in civics proficiency.The vast majority of states, however, do require at least one course in civics and every state has some form of civics education. On this podcast, guest Tammy Wehrle, the legislative education and outreach officer in the Wisconsin State Legislature, talked about what she's learned about the state of civics education.Wehrle, who was a classroom educator and holds a doctorate, oversees a variety of programs in the legislature that can involve kids as young as 12. She thinks there is real value in young people seeing the legislature from the inside and understanding the range of roles necessary to run the legislature.ResourcesCivics Education at NCSLSenate Scholar Program, Wisconsin State LegislatureStaff Snapshots | Tammy Wehrle, NCSL

This podcast is the first of several to observe the 50th anniversary of NCSL. The organization has been an integral part of the change in state legislations over the last half century. NCSL provides research to the states on myriad public policy topics, offers a unified voice in Washington where it lobbies on behalf of the states, and serves as a convener of scores of meetings every year in person and virtually to help legislators and legislative staff from across the nation share ideas and solutions. On this episode we track the development of legislatures over the last 400 years and talk with a range of guests about the role of legislatures in the jigsaw puzzle of American governance.Our guests include political scientist Don Kettl; former NCSL staffer Karl Kurtz; Sabrina Lewellen, assistant secretary of the Arkansas Senate and current staff chair at NCSL; Bill Pound, longtime NCSL executive director; historian Pev Squire, former NCSL staffer Brian Weberg; and Natalie Wood, NCSL's vice president of policy and research.

After a tsunami of campaign spending on the 2022 governor's race in Oregon – a record-breaking $70 million – a broad coalition and lawmakers worked together to pass the state's first campaign finance reform this spring. Legislators scrambled during a short 5-week session to keep everyone at the table. Otherwise, it was shaping up to be a costly and confusing fight over campaign finance reform at the ballot box this fall with two competing measures. This episode of Across the Aisle examines how it came together.

Data centers, the increasing use of AI and reindustrialization in some parts of the country are driving a big increase in energy demand that concerns officials at all levels of government. State legislators in particular, are concerned about the ability of their state utilities to meet that growing demand and the effect on the price residential and business customers pay for energy.We sat down with two experts on data centers to find out what's coming in the next several years. Our guests are David Porter, vice president of electrification and sustainable energy strategy at the Electric Power Research Institute or EPRI, and Mukul Anand, global director at Johnson Controls dealing with data center cooling and energy management.Porter explained the range of energy demand scenarios and the very significant demand that will be put on both the generation and transmission of power in the next several years. Anand discussed the work he does to help data centers explore alternative energy sources and find innovative ways to dissipate the extraordinary amount of heat generated by the racks of servers in the centers. He also expects a tremendous increase in power demand and suggests more planning may be needed to be ready. ResourcesPowering Intelligence: Analyzing Artificial Intelligence and Data Center Energy Consumption, EPRI

This is the third of a three-episode series exploring the aftermath of the COVID-19 pandemic in legislatures and how it affected state legislative staff. We sat down with Jill Reinmuth, staff director for the Office of Program Research in the Washington House; Eric Nauman, principal fiscal analyst for the Minnesota Senate; and Sabrina Lewellen, assistant Secretary of the Arkansas Senate and the current NCSL staff chair. The three legislative staff leaders discussed how procedures changed in the aftermath of the pandemic, what they learned personally about leadership and how their staff performed under the extraordinary challenges of the health emergency. ResourcesLessons Learned: Legislative Staff and the Pandemic, NCSL's OAS podcastDr. Melissa Furman on the Pandemic and the Workplace, NCSL's OAS podcast

Housing historically has been a local issue that was handled by cities and counties. The rising crisis of housing cost and availability, however, has brought more attention from state governments. States have enacted more than 700 laws in 2022 and 2023 related to housing.The focus of this podcast is the nexus of housing and transportation, and particularly transit-oriented development. We sat down with Cameron Rifkin, a policy expert at NCSL who tracks housing legislation, and Doug Shinkle, who heads NCSL's transportation program, to discuss housing, transportation and the efforts by state legislators to take on challenges in both those areas. They discussed the types of legislation passed, how some states have passed legislation directly addressing transit-oriented development and why parking requirements for housing developments are sparking conflict.ResourcesCharacteristics of Middle Housing, Missing Middle HousingEconomic Mobility Enacted Legislation Database, NCSLExpanding Affordable Housing Opportunities: Zoning and Land Use Case Studies, Bipartisan Policy CenterHousing and Homelessness Legislation Database, NCSL“Housing and Homelessness Toolkit,” NCSL“Increasing the Housing Supply by Reducing Costs and Barriers,” NCSL“Middle Housing: Filling a Gap in Available Housing Options,” NCSLA Series of Policy Briefs on Zoning, Land Use, and a Solution to the Nation's Housing Shortage, American Enterprise InstituteTransit-Oriented Development, Federal Transit Administration   

Enrollment in higher education has been on the decline for a decade, and research indicates a growing skepticism about the value of higher education. In response, many state legislatures have enacted laws aimed at creating greater accountability in higher education.To explore the issue, we sat down with Brian Bridges, the secretary of higher education in New Jersey, to discuss legislation passed in that state. A 2021 bill established new requirements for academic programs including sufficient academic quality, evidence of labor market demand, lack of duplication, and requirements for additional state resources. Another bill in 2022 created performance quality standards for career-oriented programs and required the higher education secretary to develop minimum standards for state programs. Also on the program is Andrew Smalley, a higher education policy expert at NCSL, who discussed the trend in state legislation and what the statistics tell us about the value of higher education.ResourcesPostsecondary Bill Tracking Database, NCSL“Nondegree Credential Framework,” NCSL

Melissa Furman is a trainer, coach, and consultant to professionals and businesses who's worked with legislative staff. Furman was a college professor and Dean before founding her firm Career potential. Her expertise includes generational diversity, emotional intelligence and leadership.She's the guest on the podcast, the second in a series focused on legislative staff, the aftermath of the COVID-19 pandemic and how it changed the workplace. She addressed the persistent problem of burnout in the workplace, how leadership was critical to success during the pandemic, and some lessons to take away from the emergency. ResourcesCareer Potential

The Americans With Disabilities Act was signed into law in 1990, but who and what it covers has evolved over the decades. Behavioral health issues, long COVID or other conditions that substantially limit one or more major life activities can fall under the ADA. Joining the podcast are Eve Hill, one of the nation's top disability rights lawyers and the policy and legislative counsel for the U.S. Department of Labor's State Exchange on Employment & Disability or SEED, and Nevada Assemblywoman Tracy Brown-May, who has worked on numerous initiatives to aid those with disabilities. Both joined the podcast to discuss the current state of the ADA.Hill explained how interpretation of the law has changed since the early '90s when she started her law career, how it has been further altered by legislation and the substantial role state legislators can take in their states around the issue. Note that's Hill's personal observations do not represent those of the U.S. Department of Labor.Brown-May explained how her background working with people with disabilities has informed her legislative efforts and her experience with fellow lawmakers who come to her for advice on how to address a disability-related issue in legislation.ResourcesAssemblywoman Tract Brown-May, Nevada LegislatureEve Hill, Brown, Goldstein and LevyState Exchange on Employment & Disability, U.S. Department of Labor

This podcast kicks off Legislative Staff Week, an annual NCSL effort to focus on legislative staff. This episode is part of three-podcast services focused on legislative staff that will roll out over the next couple of months.Our guests include Sabrina Lewellen, assistant secretary of the Arkansas Senate and the current NCSL staff chair; Anne Sappenfield, director of the Wisconsin Legislative Council; and Jay Hartz, director of the Kentucky Legislative Research Commission. All three joined to talk about the long-term effects of the pandemic and how their institutions coped with the emergency.They talked about how their institutions were affected, some of the innovations staff devised to cope with the emergency and some of the lasting changes resulting from the pandemic. There was even discussion of how a stack of table, a laptop and a camera helped ensure transparent government.RESOURCESLegislative Staff homepage, NCSL

College enrollment among young people has been in a steady decline, according to research from Pew. Some indicators show young people increasingly turning toward apprenticeships and other work-based learning and credential programs that help them get a good job.Indiana and Maryland have been leaders in the field and on this podcast, we sat down with two legislators intimately involved in the issue--Rep. Bob Behning (R-Ind.) and Sen. Malcolm Augustine (D-Md.)Behning said participation in an NCSL study group helped inform legislation he has pursued to ensure more options for youth employment and to destigmatize technical education. Augustine explained the approach Maryland has taken to youth employment and the role of the Maryland Apprenticeship 2030 Commission in shaping future efforts.ResourcesBlueprint for Maryland's Future, Maryland Public SchoolsNondegree Credential State Policy Framework, NCSLOffice of Work-Based Learning and Apprenticeship, State of IndianaStrategies for Youth Employment, NCSL 

It's budget season and in the 46 states that start the new fiscal year on July 1, people are hard at work getting their budgets ready. Those state operating budgets amount to more than a trillion dollars a year. But what exactly does getting the budget ready entail? To discuss that, we sat down with Krista Lee Carsner, the executive director of the Fiscal Review Committee for the Tennessee General Assembly and the president of the National Association of Legislative Fiscal Offices. She explained the importance of accurate revenue forecasts, how the budget hearing process works on both the executive and legislative sides of state government and how individual legislators can get a say in the budget process. Our second guest on this podcast was Erica MacKellar, a fiscal policy expert with NCSL. She broke down the fiscal condition of the states, how they're coping in the post pandemic period and how revenue projections are very much on the mind of those crafting state budgets. ResourcesFY 2025 State Budget Status, NCSLVIDEO: State Budgets and Taxes, NCSL

Cities, states, courts and district attorneys' offices levy fines and fees on defendants at nearly every stage of the criminal justice system. Fines and fees are often used to finance essential functions of the court and as a deterrent for people from committing future offenses. In recent years, critics have argued that fines and fees used to fund the judiciary create a perverse incentive for judges to impose more fees. Another target for critics are jurisdictions that use criminal justice fees as revenue generators. For those with few resources, fines and fees stemming from traffic tickets and criminal convictions can perpetuate a cycle of poverty.A significant state legislative trend has been to limit the number and amount of fines and fees in the justice system or abolish them altogether. Our two guests on this episode both sponsored successful legislation in their states to abolish fees and fines for juveniles. Rep. Sean Lynn, a Democrat from Delaware, and Rep. Kerri Seekins-Crowe, a Republican from Montana, talked about why they got involved in this policy area and the changes they want to see in their states. ResourcesNCSL's Criminal Records and Reentry ToolkitAssessing Fines and Fees in the Criminal Justice SystemPolicymakers Weigh Pros and Cons of Court Fines and Fees

Kentucky has the second highest rate of maternal death in the nation. Women are dying during pregnancy and post-partum from conditions like high blood pressure, substance use, depression and diabetes. Black women are three times as likely to die in childbirth than white women. And a state report found that a whopping 90 percent of the deaths are preventable. Public health officials and lawmakers had been trying to address the complex issue for years. Rep. Kimberly Moser, who had long been a neonatal and intensive care nurse, decided it was time to bring the best minds together to finally improve the odds for Kentucky mothers and babies. The result of months of research and discussion yielded a range of solutions in a bill dubbed the “Momnibus.”

Overdose deaths from all drugs, including opioids, have risen to more than 110,000 in the 12-month period that ended last September. The vast majority of those deaths near 80% involved fentanyl and other synthetic opioids.State legislatures have been active in passing legislation to address the crisis and acting more than 180 bills in 2022 and 2023, most of them focusing on harm reduction strategies such as medication-assisted treatment. However, the number of deaths remain stubbornly High.On this podcast, we sat down with Michelle Putnam from the Division of Overdose Prevention at the Federal Centers for Disease Control and Prevention, and Charlie Severance-Medaris, who tracks state policy related to drug overdose prevention for NCSL.Putnam discussed the steps her office is taking to understand the patterns of drug use and overdoses and working with local public health departments to better equip them to deal with the situation. She also talked about the frustration faced by state and local officials, families, law enforcement, and others at the ongoing death toll despite decades of efforts to control illegal drugs.Severance-Medaris discussed the trends in legislation aimed at addressing the drug overdose problem and whether states may change their approach. ResourcesInjury Prevention DatabaseState Options to Increase Access to MATSUD Tx DatabaseNonfatal Overdose Dashboards, Drug Overdose, CDC Injury CenterOverdose Data to Action: Funded Jurisdictions, Drug Overdose, CDC Injury CenterStop Overdose, CDCSUDORS Dashboard: Fatal Overdose Data, Drug Overdose, CDC Injury Center

State legislatures in blue and red states are taking up measures to protect children on social media, especially because Congress has been unable to agree on solutions and the evidence of harm to young users continues to mount. It's a complicated problem and most of the states' laws are being challenged in court by a trade association and other groups who believe they are unconstitutional.

A key part of modernizing the nation's electric grid involves adding long-distance transmission lines, the power lines that carry electricity over hundreds of miles. To better understand this critical part of the electrical infrastructure, we sat down with Melissa Birchard, a senior adviser in the Grid Deployment Office of the U.S. Department of Energy. The office was created in 2022 to work on a variety of issues related to the electrical grid and, in particular, integrating power from new renewable energy projects.Melissa talked about some of the issues involved particularly in the planning and siting of transmission lines. She explained the need for new transmission lines to bring renewable energy from remote areas of the country to the cities and towns where it's needed. Our other guest is Alex McWard from NCSL, who tracks legislation related to the state role in transmission line planning and siting. He discussed the role of state legislatures in transmission projects and in working with other states on regional projects.ResourcesCoordinated Interagency Transmission Authorizations and Permits Program, U.S. Department of EnergyElectric Transmission Planning: A Primer for State Legislatures, NCSLEngagement Between States and Regional Transmission Organizations, National Council on Electric PolicyGrid and Transmission Program Conductor, U.S. Department of EnergyGrid Resilience and Innovation Partnerships (GRIP) Program, U.S. Department of EnergyNational Interest Electric Transmission Corridor Designation Process, U.S. Department of EnergyTransmission Facilitation Program First Round Selections, U.S. Department of Energy 

Federalism is the foundational structure of our nation's government. The dynamic sharing of power among federal, state and local governments is the key to understanding American governance in the view our guest on this podcast, Don Kettl, professor emeritus and the former dean of the School of Public Policy at the University of Maryland, College Park, and an expert on federalism.Kettl, who is the author of more than two dozen books and also writes a monthly column for Governing, joined the podcast to discuss the current state of power sharing between the state and federal governments. He explained why he thinks states increasingly are the center of domestic policymaking, talked about the power relationship between legislatures and governors, and how he expects the balance of federalism to shift in the coming decades. 

Texas Senator Judith Zaffirini has broken state records by a long shot. She has cast more than 72-thousand consecutive votes. She has had a perfect attendance record—except that one time she skipped on purpose to make a point. She has passed 1,388 bills—more than any other legislator in Texas history. All with bipartisan support—no matter who was in the majority. After becoming the first Hispanic woman elected to the Senate in 1986, the Democrat will become Dean of the Senate as the most senior member this session.

Paying for college and other post-secondary education continues to be a challenge for many. Already, 44 million Americans owe more than $1.7 trillion in student loan balances. At the same time, there's strong evidence that lifetime earnings increase for those who attend and complete college or other post-secondary education. The guests for this podcast are Ethan Pollack , a senior director at Jobs for the Future, a national nonprofit aimed at expanding economic opportunity, and Andrew Smalley, an education policy expert at NCSL.Pollack discussed a number of innovative financing strategies involving philanthropic organizations, employers, government and financial institutions that offer the promise of helping students pay for their education at a lower cost. And in some instances that better scale the cost to the potential earnings of the graduate.Smalley explained the steps states are taking to help facilitate these innovative approaches and also broke down what most students and families pay for post-secondary education. ResourcesJobs for the Future“How Can Innovative Finance Transform Our Postsecondary Education and Training Systems?,” Jobs for the Future

Tim Storey, NCSL's CEO, joined the podcast to discuss the year ahead in legislatures and what we can expect in policy and politics in 2024.  Storey said most state budgets will start the year in excellent shape, though legislators will continue to cast a cautious eye on economic conditions. He also pointed out that it's important to keep in mind that 2024 is an election year and that tends to influence what happens in legislatures, including what is often a somewhat less active legislative agenda than you usually see in the first half of a two-year session. Storey expects concerns about technology, especially artificial intelligence, to be high on the priority list. Housing challenges and the fentanyl overdose crisis are also likely to get a great deal of attention in most legislatures. At least some legislatures also are likely to look at legislation affecting migrants, especially in light of inaction at the federal level. And, of course, education and health care, two big budget items for states, also will get considerable attention.ResourcesSpecial Report: A Look at 2024's Trending Legislative Topics

While many voters may think of primaries as the warmup act for the general election, many races in this country at the local, state and federal level are decided by primaries. By some estimates, fewer than 40 seats in the U.S. House of Representatives are actually competitive between the parties. In most districts, whoever wins the primary in the dominant party wins the general election. The 2024 primaries are right around the corner so on this podcast, we sat down with Ben Williams, an elections expert at NCSL, to talk about the different types of primaries and why primaries are so important. Williams explained the different approaches states take to the primary system and some of the election history that brought us to this system we now use. He also discussed NCSL's recent publication, “The State's Primary Toolkit,” that includes extensive background information on primaries' changes in states since 2000 and a great deal more.ResourcesState Primaries Toolkit

The popularity of remote work soared during the pandemic, but only for those is some jobs, particularly tech focused or computer-based jobs. While exact figures are not available, some estimates are that more than 25% of the workforce still is working remotely or in a hybrid arrangement, where employees spend some time in the office and some working remotely. That's a decline from the pandemic but still a significant portion of the workforce. On this episode, we explore the tax ramifications for states of remote work. We're joined by Charlie Kearns, a tax attorney, and James Privette, until recently a legislative specialist in NCSL's Washington, D.C., office.They discussed how remote work affects personal income taxes and business taxes, and how states are responding to the changing landscape. They also had suggestions for learning more about the issue. ResourcesRemote Work Revolution: How Can Remote Work Taxation Affect State Budgets, NCSL WebinarState And Local Tax Considerations of Remote Work Arrangements, NCSL 

NCSL's yearlong Legislator Police Academy brought together lawmakers from very different backgrounds to work across the aisle and across the country on policy topics related to police accountability. In this episode, we learn how the legislators put aside seemingly insurmountable differences and, with patience and constructive conversation, discovered plenty of common ground.

Emergency medical services face significant challenges in rural America. Just one is the time it takes to summon an ambulance. While most people living in urban and suburban areas expect an ambulance to show up within minutes of making a 911 call, the situation is very different for about 4.5 million Americans who live in ambulance deserts, according to a nation study conducted by Maine Rural Health Research Center and the Rural Health Research & Policy Centers. Those folks can expect to wait 25 minutes or more for emergency services to arrive. We sat down with two experts on the subject -- Dia Gainor, executive director of National Association of State EMS Officials, and Davis Patterson, director of the WWAMI Rural Health Research Center at University of Washington—to discuss that and other challenges to EMS in rural areas. Other issues they discussed included the severe workforce challenges in staffing rural EMS services, the role of legislatures in addressing rural EMS needs and the promise of community paramedicine in addressing both emergency and nonemergency care in rural areas.RESOURCESAmbulance Deserts: Addressing Geographic Disparities in the Provision of Ambulance Services, Rural Health Research Gateway (May 2023)Beyond 911: Expanding the Primary Care Role of First Responders through Community ParamedicineCommunity Paramedicine: Connecting Patients to Care and Reducing CostsEMS Legislative DatabaseThe EMS and Community Paramedic Workforces Respond to COVID-19, WWAMI Rural Health Research Center (June 2023)The National Association of State Emergency Medical Services OfficialsState Actions To Address EMS Workforce ShortagesYou might need an ambulance, but your state may not see it as ‘essential,' Stateline (September 2023)WWAMI Rural Health Research Center

Health care costs in the U.S. over the last 20 years have grown faster than the cost of other goods and services. Commercial health care costs, which include about half the health care market, have grown faster than Medicaid and Medicare spending. Our guest on this episode is Alyssa Vangeli, a senior consultant with Bailit Health, a consulting firm in Massachusetts where she works with states to provide health policy analysis and consulting around the commercial health market. Vangeli explained what's driving the increase in costs, which segments of the health care economy are seeing the greatest cost increases, and the efforts by the federal and state governments to better understand the cost drivers and try to contain them. She also offered examples of what different states are doing and the success of those efforts.Resources2023 Health Costs Seminar, NCSLBailit HealthHealth Costs, Coverage, and Deliver State Legislation, NCSLHealth Policy Snapshot: Addressing Commercial Health Care Prices, NCSLState Actions to Control Commercial Health Care Costs, NCSL 

On this episode, Tim Storey sat down with Bruce Mehlman, founder of Mehlman Consulting, a D.C-based bipartisan lobbying firm whose clients include Walmart, AARP, Boeing and the Mayo Clinic. Mehlman's perspective is also shaped by his experience as an assistant secretary of Commerce in the George W. Bush administration and time in private industry.Mehlman has a savvy, insider's take on how Washington works and sees the day's events with a historical perspective that is often missing from our political analysis. Mehlman and Storey talked about the forces shaping our political world, the turn to populism in recent years in numerous countries the challenge that poses to our institutions. They also talked about Mehlman's slide decks, that over the years have become well-known among policy types for their clear, data-driven, often humorous analysis of political, economic and social trends. ResourcesBruce Mehlman's PowerPoint DecksMehlman Consulting

Summary: Sometimes, the aisle lawmakers work across isn't the one that separates the two parties. It's the divide between rural and urban. That's what happened in Colorado when urban voters narrowly passed a plan to reintroduce the endangered gray wolf. Lawmakers from both parties representing the rural part of the state—where ranchers and hunting outfitters feared livestock and business losses with wolves on the prowl—teamed up to minimize any economic impact.

The ability to forecast how an infectious disease like COVID-19 will behave is a critical tool for public health officials.On this podcast, we sat down with Dr. Roni Rosenfeld, a computer scientist and a leader in the field of disease forecasting. Rosenfeld leads the machine learning department at Carnegie Mellon University in Pittsburgh and also works with Carnegie Mellon's Delphi Research Group, which is one of several organizations that are part of the newly developed Outbreak Analytics and Disease Modeling Network established by the Centers for Disease Control and Prevention. Rosenfeld explained that, over more than a decade, researchers working on disease forecasting have taken weather forecasting as their model in creating usable tools to better understand the path of infectious diseases. He explained the type of data disease forecasters use – everything from hospital records to Google searches—to develop their forecasts and how that information can help those in health care. He also discussed why it's important for legislators and others in state government to understand how to use and interpret disease forecasting.ResourcesMachine Learning Department, Carnegie Mellon University

Safeguarding energy systems from cyberattacks in a growing concern in the U.S. The Colonial pipeline ransomware attack a few years ago and some other high-profile incidents caught the public's attention. But as the guests on this podcast point out, energy systems are facing an increasing number of attacks. On the podcast to discuss the situation are Lynn Constantini, a cybersecurity expert with the National Association of Regulatory Utility Commissioners, and Patrick Miller, CEO and owner of Ampere Industrial Security who brings more than 35 years of experience in the security field to the discussion. While the federal government has some regulatory authority over utilities, state legislatures have a key role in this area through their oversight of public utility commissions. Since the start of 2021, states introduced nearly 500 bills and passed 99 measures related to energy security as of August 2022.Constantini and Miller discussed the rise in threats and attacks, the type of attacks that are most common and the difference between attacks on information technology, or IT, and operational technology, or OT. They also discussed the steps states already have taken to counter cyberattacks.Resources2021-2022 Energy Security State Legislative Review: Cybersecurity and Physical Security, NCSLAmpere Industrial SecurityCybersecurity, Energy Security and Emergency Response, U.S. Department of EnergyNational Association of Regulatory Utility CommissionersNorth American Electric Reliability Corporation, Cybersecurity Standards

Taylor Swift is making a big splash on stages this year, and also in state legislatures. That's because ticket sales devolved into online chaos, highlighting the problem of bots buying up tickets faster than humanly possible and putting them up for resale at exorbitant prices. The snafu became the catalyst for 24 states and Puerto Rico to consider 70 bills addressing ticket sales and fees. In this episode we look at how Texas came up with a bipartisan solution.

Reid Wilson is the founder and editor of Pluribus News, a 10-month-old news platform that focuses on the states and the policy trends that start there. On this episode, host Tim Storey sat down with Wilson to talk about how states are tackling some of their toughest issues: broadband, infrastructure projects, housing policy and artificial intelligence.Wilson started out his career as an assistant to Chuck Todd on the National Journal's Hotline and also worked for years at the Washington Post and The Hill before striking out on his own last year. He is an astute observer of state policy and politics as well as how the media covers those topics. In addition to state policy, Storey and Wilson also discussed the ongoing changes in the media coverage of legislatures.ResourcesPluribus News

Improv comedy may not be the first thing that comes to mind when you think of public policy, but Tane Danger suggests maybe it should be. Danger is the keynote speaker at this year's professional development seminar for two legislative staff groups—the Research Editorial, Legal and Committee Staff (RELACS) and the Legislative Research Librarians (LRL). The meeting is Sept. 19-22 in Minneapolis and at the state Capitol in St. Paul.Danger co-founded the Theater of Public Policy in Minnesota, which combines serious public policy discussion with improv comedy. On the podcast, he discussed how the skills you need for improv, such as careful listening, are also skills that can help in a legislative environment. He also laid out how his two-day presentation to the legislative staff groups will involve both a talk and a workshop. ResourcesRELACS/LRL Professional Development SeminarTane Danger websiteThe Theater of Public Policy