Health care, families, taxes & AI among key topics state legislatures likely to address in 2024, says national lawmaker group

Georgia Capitol. (Credit: Georgia Senate)

Georgia Capitol. (Credit: Georgia Senate)

Jan 05, 2024

By Krista Kano, Gongwer News Service

COLUMBUS — The National Conference of State Legislatures is anticipating lawmakers across the country will spend much of 2024 debating bills related to a host of topics like workforce, families, justice, artificial intelligence, taxes and more.

That is according to its recently issued forecast of 12 overarching issues expected to trend this year based on recent proposals considered or enacted by states in 2023, as well as new federal laws and investments, advancing technologies and the global landscape.

For example, last year, state legislators introduced more than 23,000 bills on health policy, not including resolutions and budget bills.

“Health policy will continue to be a focus in legislatures in 2024 as states grapple with health workforce shortages and increased behavioral health challenges,” NCSL wrote. “Perennial topics such as Medicaid, which takes about 30% of state budgets, will continue across the country.”

The conference expects lawmakers to take a look at a number of health-related issues including expanding behavioral health care, decriminalizing fentanyl test strips and covering community health workers and doulas under Medicaid.

States may also consider adding innovative services to Medicaid coverage such as prescription digital therapeutics and biomarker testing.

Given initial federal funding has run out for the federally mandated 988 service, states will also likely be discussing how to permanently fund the mental health help line.

In another category, NCSL projects several states will discuss workforce issues specific to the military and veteran community. This could come in the form of licensure compacts, other licensure expansion programs, support for military installations and expanded benefits for National Guard members.

Bills focusing on cleaner, on-demand energy are also on the horizon, NCSL experts said, particularly given the rise of extreme weather events that have highlighted the need for reliable and resilient grids and federal funding opportunities that can accelerate electric vehicle infrastructure programs.

Along those same lines, NCSL predicts continued discussions of gas tax alternatives.

One option is taxing electricity consumed at public EV charging stations as has been done in Georgia, Iowa, Kentucky, Montana, Oklahoma, Pennsylvania and Utah.

Another is implementing road usage charges that require drivers to pay based on miles driven instead of gallons of fuel consumed, which has been implemented in Hawaii, Oregon, Utah and Virginia.

Also trending in on-the-road topics, according to NCSL, is a crackdown on impaired driving, particularly as states continue to legalize cannabis.

NCSL noted that Alabama and Indiana have permanent oral fluid roadside screening programs while Michigan and Minnesota have authorized pilot programs.

The forecast also predicts that more states will consider legislation requiring impaired drivers convicted of vehicular homicide to pay child support for victims’ surviving children, a law that has already been enacted in Tennessee, Kentucky, Maine and Texas.

State-level changes to the justice system could be coming, NCSL said.

“From battling the fentanyl crisis to dealing with ongoing catalytic converter thefts, lawmakers continue to rethink criminal justice policy,” it wrote. “Legislatures are focusing resources on community-oriented approaches that prioritize public safety and prevent people from becoming more deeply involved with the justice system.”

NCSL said states may also consider mandating participation in the National Decertification Index, the role of money in the pretrial process, expanding deflection programs and sealing criminal records to ease reentry.

Artificial intelligence is likely to be a topic, NCSL said, given its potential implications on elections and other state operations.

Some states have already prohibited the use of AI to influence elections by generating fake content using candidates’ images and voices, while others have mandated disclosures on political communications using AI-generated content.

“In 2024, more states may enact these or other as-yet unimaginable AI policies,” NCSL wrote.

Meanwhile, 15 states and Puerto Rico have already adopted resolutions or enacted legislation creating task forces or commissions to study and inventory state government use of AI.

“The technology raises issues of accuracy and bias in generated educational content, the use of disinformation and misinformation, copyright and intellectual property infringement, and the vulnerability of employment and financial services, to name but a few,” it wrote. “Few technologies have been as widely or quickly adopted as generative AI without a full understanding of the risks.”

Some of NCSL’s other trending topics include:

  • Improvements to literacy and math.
  • Supporting educators.
  • Easing licensure requirements.
  • Requiring pay transparency.
  • Establishing portable benefit programs.
  • Ensuring consumer data privacy.
  • Lowering taxes.
  • Sorting out the tax implications of remote work.
  • Making courts more child friendly.
  • Increasing affordable housing.
  • Reducing food insecurity.
  • Increasing access to child care.
  • Regulating “forever chemicals.”
  • Protecting wetlands.

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