NCSL Podcasts

NCSL

Learn about the people, policies and politics of America's state legislatures with NCSL's three podcasts: "Our American States," "Across the Aisle" and the special limited series "Building Democracy."

  1. The Lifesaving Potential of Prehospital Blood | OAS Episode 261

    12. APR.

    The Lifesaving Potential of Prehospital Blood | OAS Episode 261

    Prehospital blood programs that allow emergency responders to administer blood at the scene to trauma victims are drawing increased attention from state lawmakers. A technique with origins on the battlefield, these military methods have made their way to civilian EMS programs. Research suggests a significant number of lives can be saved with this approach, especially in car crashes.  On the podcast to discuss these programs are Jonathan Morrison, the administrator of the National Highway Traffic Safety Administration or NHTSA; Randi Schaefer, a former career Army trauma nurse who has helped set up programs around the country; and Aneesa Turbovsky, who tracks EMS-related legislation for NCSL.  Morrison discussed why these programs are a priority for NHTSA and how these programs could reduce the approximately 40,000 traffic crash fatalities in the U.S. each year. Schaefer reviewed some of the challenges in setting up prehospital blood programs and the role state lawmakers can play. And Turbovsky went into detail on the steps legislatures are taking to make it possible for paramedics to administer blood and how lawmakers can bring together the various parties needed to make these programs work. Resources EMS Legislation Database, NCSL Prehospital Blood Transfusions Give EMS Crews a Lifesaving Option, NCSL State Legislatures News Office of EMS Prehospital Blood Transfusion, NHTSA   Office of EMS Prehospital Blood Transfusion Infographics, NHTSA    Prehospital Blood Transfusion Coalition   Prehospital Blood Coalition Scope of Practice Map "Removing the Barrier to Prehospital Blood: A roadmap to success,"Journal of Trauma and Acute Care Surgery Funding Stat! States Secure Timely Support for EMS Systems, NCSL

    36 Min.
  2. The Evolution of Alzheimer’s Diagnosis and Treatment | OAS Episode 260

    29. MÄRZ

    The Evolution of Alzheimer’s Diagnosis and Treatment | OAS Episode 260

    Alzheimer’s disease affects a significant number of Americans over 65—more than 7 million—and is the sixth leading cause of death in that age group. It’s expected that more than 13 million people will be diagnosed by 2060. Beyond Alzheimer's, roughly 10% of U.S. adults over 65 have dementia.  On this podcast we talked with Dr. Ronald Petersen, a neurologist at the Mayo Clinic and an expert in Alzheimer’s disease and other cognitive disorders, and Jennifer Rosen, vice president for state affairs at the Alzheimer’s Association. Joining the podcast to offer the legislative perspective were Senator Laura Murphy of Illinois, a Democrat, and Senator T.J. Shope of Arizona, a Republican.  Dr Petersen explained the remarkable progress that has been made in recent years in the diagnosis and treatment of Alzheimer’s and the importance of early intervention. Rosen outlined the enormous financial impact of the disease on society, and the role state legislatures can play in supporting early detection and treatment.  Senators Shope and Murphy each laid out the legislation enacted in their states and how that legislation will aid both people with the disease and their families.  Resources Alzheimer’s Disease Treatment Clinic, Mayo Clinic Alzheimer’s Association Comprehensive Policy Approaches to Support the Aging Population, NCSL State Policy Approaches to Improving Alzheimer’s and Dementia Care, NCSL State Strategies to Reduce Costs and Provide Quality Care for Older Adults and People with Disabilities, NCSL

    1 Std. 3 Min.
  3. Understanding the Cost of Health Care | March 8, 2026

    8. MÄRZ

    Understanding the Cost of Health Care | March 8, 2026

    The U.S. health care system is massive. It's a $5 trillion behemoth, nearly 20% of the U.S. economy or more than $15,000 per person per year. The cost of health care for consumers, including the cost of health insurance continues to increase.  On this episode, we sat down with two people who pay close attention to the health care market and to how state legislatures are responding to rising costs. Our first guest is Katie Martin is CEO, and president of the Health Care Cost Institute, a nonprofit research group that collects and analyzes data on health care costs in the U.S. Also joining the discussion is Sarah Jaromin, who tracks health care issues for NCSL.  Martin noted that her organization taps into data from employers who provide insurance to about half the people in the U.S. as well as data from Medicare and Medicaid. She pointed out that as of 2023, health care costs had increased more than 50% since 2014, and the trend does not show any signs of slowing.  Jaromin sketched out the legislative landscape and explained how legislatures have tried to slow the growing cost of health care. She noted that NCSL has collected data showing that last year, 48 states, along with Puerto Rico, the Virgin Islands and Washington ,D.C., enacted nearly 500 bills related to health care costs and delivery.  Resources “2025 Legislative Landscape: States Tackle Health Costs, Coverage and Delivery,” NCSL “Annual Health Care Cost Utilization Report,” HCCI  “From Mergers to Market Power: 2025 Legislative Recap on Health Care Consolidation,” NCSL “From Prenatal to Postpartum Care, Total Spending on Childbirth Averaged over $25,000 among ESI Enrollees,” HCCI Health Care Cost Institute “Health Costs, Coverage and Delivery State Legislation,” NCSL “Issue Brief: System-affiliated hospitals associated with higher prices,” HCCI “Most Office Visit Facility Fee Spending is on Internal Medicine,” HCCI Prices in Hospital Outpatient Departments are Consistently Higher than Physician Offices among Site-Neutral Services, HCCI

    30 Min.
  4. The Legislature’s Oversight Role | OAS Episode 258

    22. FEB.

    The Legislature’s Oversight Role | OAS Episode 258

    In one fashion or another, all state legislatures exercise oversight of state agencies and programs. They do this in a variety of ways using standing committees, rules review, auditing offices, sunset provisions, and more.  On this episode of the podcast, we dive into the topic of oversight with three guests who all have different vantage points to observe the process. They include Kade Minchey, auditor general with the Utah Office of the Legislative Auditor General; Holly Trice, registrar of regulations in Virginia and on the staff of the Virginia Joint Commission on Administrative Rules; and Will Clark, who works with NCSL's Center for Legislative Strengthening.  Will Clark started our discussion with an explanation of some of the basics of oversight, the approaches used, and the tools available to legislators. Kade Minchey explained how his office in Utah uses performance audits to help agencies improve and how the legislative committee responsible for audits uses the information.  Holly Trice talked about the rules review process in Virginia, how the legislature and executive branch work together, and how they afford all legislators and the public a chance to weigh in.  Resources The Best Practice Handbook: Root Cause Analysis and Driving Results, Utah Office of the Legislative Auditor GeneralThe Best Practice Handbook: A Practical Guide to Excellence for Utah Government, Utah Office of the Legislative Auditor GeneralA Performance Audit of Utah State Correctional Facility: An Examination of Staffing, Culture, Safety, and Security, Utah Office of the Legislative Auditor GeneralA Performance Audit of Utah’s Behavioral Health System: A Case for Governance, Strategic Planning, and Accountability, Utah Office of the Legislative Auditor GeneralA Performance Audit of Utah’s Election System and Controls, Utah Office of the Legislative Auditor GeneralA Performance Audit of Utah’s Water Management: Ensuring Data Integrity, Program Best Practices, and Comprehensive Water Planning, Utah Office of the Legislative Auditor GeneralSeparation of Powers: An Overview, NCSLSeparation of Powers: Legislative Oversight, NCSLVirginia Register of RegulationsVirginia Regulatory Town Hall

    49 Min.
  5. Big Changes for Medicaid | OAS Episode 257

    1. FEB.

    Big Changes for Medicaid | OAS Episode 257

    SUMMARY Medicaid is the joint state -federal program created in 1965 that provides free or low -cost health care to about 70 million Americans, including low-income elderly people and those living with disabilities. The changes in the 2025 legislation, also known as the One Big Beautiful Bill or H.R. 1, affect eligibility standards for the program and changes in the way states can finance their portion of Medicaid costs. On this episode, we’re joined by two policy experts on Medicaid. Kathryn Costanza is a fellow at NCSL who closely follows Medicaid policy and Neda Jasemi is a senior policy analyst at the National Association of Medicaid Directors. They both sat down to talk about the significant changes in Medicaid that were included in the 2025 Budget Reconciliation Act.  Jasemi discussed the challenges state legislatures will face as they craft budgets for Medicaid in their states while facing significant uncertainty about both revenue and how many people will be signed up in their state. Costanza explained the ins and outs of provider taxes and how that will affect state revenue intended for Medicaid costs. She also talked about what we know about the new rules and how they will affect the number of people who will qualify for coverage.  Resources How Medicaid Provider Taxes Work: An Explainer, National Association of Medicaid DirectorsMedicaid’s Next Chapter, National Association of Medicaid DirectorsMedicaid Road Ahead: Policy Options and Budget Impacts | Webinar Series, NCSLThe Medicaid Puzzle: Piecing Together Policies for a Balanced Budget, NCSL Medicaid Road Ahead: Policy Options and Budget Impacts, NCSL Medicaid Toolkit, NCSLNational Association of Medicaid DirectorsOBBBA Medicaid Policy Timeline, National Association of Medicaid DirectorsWhy did they do it that way? Medicaid Financing, National Association of Medicaid DirectorsMedicaid Financing 101, NCSL

    41 Min.

Info

Learn about the people, policies and politics of America's state legislatures with NCSL's three podcasts: "Our American States," "Across the Aisle" and the special limited series "Building Democracy."

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