SJR 19 — DIRECTING THE DEPARTMENT OF HEALTH & SOCIAL SERVICES TO EXPLORE SOLUTIONS RELATED TO THE STATE’S HIGH HEALTH CARE COSTS.

Seigfried DELAWARE& STATESen. SENATE 153rd GENERAL ASSEMBLY SENATE AMENDMENT NO.

1Pinkney TO& SENATESen. JOINT RESOLUTION NO.

19Townsend AMEND& SenateRep. Joint Resolution No.

19Chukwuocha afterReps. line 6 and before line 7 by inserting the following:

“WHEREAS,Griffith, chronicSnyder-Hall diseasesDELAWARE suchSTATE asSENATE diabetes,153rd heartGENERAL disease,ASSEMBLY cancer,SENATE andJOINT obesityRESOLUTION areNO. among the leading drivers of health care spending, and preventing, managing, and treating chronic disease more effectively can improve health outcomes while reducing long- term costs for patients, employers, and taxpayers;

and19 WHEREAS,DIRECTING prescriptionTHE drugDEPARTMENT costsOF areHEALTH a& significantSOCIAL driverSERVICES ofTO healthEXPLORE careSOLUTIONS spendingRELATED andTO anti-competitiveTHE behaviorSTATE’S relatedHIGH toHEALTH prescriptionCARE drugsCOSTS. remains a concern;

and WHEREAS, highfor healthcalendar careyear costs2023, disproportionatelythe burdenState’s low-incometotal individuals, rural communities, communities of color, and other historically underserved populations, and advancing strategies that improve affordability and access is essential to promoting health equitycare forexpenditures alltotaled Delawareans;nearly $11,000,000,000;

and”.and WHEREAS, during the same calendar year, health care expenditures totaled $10,588 per capita;

FURTHERand AMENDWHEREAS, Senateon Jointa Resolutionper No.capita basis, total health care expenditures for 2023 increased 9.1% from the previous year;

10and byWHEREAS, deletingDelaware linesmust 38explore throughall 39available intools theirto entiretylower andthe insertingcost inof lieuhealth thereofcare for families, employers, and the following:state budget;

"BEand ITWHEREAS, FURTHERMedicaid RESOLVEDhospital thatoutlier nopayments laterfor thaninpatient Januaryservices 1,are 2027, the Department shall submit a reporttool tointended the General Assembly that explores the feasibility of multiple additional strategies to lowerprotect healthboth carehospitals costsand inpatients from the Statefinancial acrossimpact all sectors of theunusually healthexpensive caretreatments; system, including insurance, long-term care, pharmacy, and hospitals.

BEand ITWHEREAS, FURTHERthe RESOLVEDDivision that, as part of itsMedicaid evaluation& ofMedical strategiesAssistance tolast lowerupdated healththeir caremethodology costs,for theoutlier reportpayments shallin also2009; evaluate strategies to prevent and better manage chronic disease, improve health outcomes, advance health equity, reduce prescription drug spending, and decrease long-term health care expenditures.

BEand ITWHEREAS, FURTHERfederal RESOLVEDand thatstate theentities Department’sare reportmoving shallaway assessfrom howfee-for-service proposed cost-containment and coveragelooking strategiestowards mayalternative affectpayment healthmodels equity,that includingreward theirhealth impact on access to affordable care providers for low-incomedelivering individuals,high-quality rural communities, communities of color, and othercoordinated historicallycare; underserved populations.".

SYNOPSISand ThisWHEREAS, Amendmentthe Centers for Medicaid and Medicare Innovation (CMMI) has created the AHEAD model to Senateallow Jointstates Resolutionto No.partner with Medicare to support multi-payer alignment on hospital global budgets, primary care investment and other tools to create accountability for the total cost of care;

19and addsWHEREAS, threeindependent "WHEREAS" clauses concerning some of the leadingAHEAD driversmodel, ofDelaware healthhas carediverse spendingopportunities andto howdrive healthgreater outcomesaccountability canfor be improved while long-term costs are reduced and the disproportionate impact of health care costsspending; on certain populations.

Inand addition,WHEREAS, thisthe AmendmentDelaware addsDepartment examples of strategiesInsurance thathas shouldan beOffice addressedof inValue-Based theHealthcare reportDelivery submitteddesigned to thereduce Generalhealth-care Assemblycosts by increasing the Departmentavailability of Healthcost-efficient, &high-quality Socialhealth SDinsurance :products;

and WHEREAS, members of the General Assembly, the Delaware Department of Insurance, the Office of the Governor, and the Department of Health and Social Services are advocating for several pieces of transformational health legislation in 2026;

and SD :

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06/11/202606/09/2026 10:1704:03 AMPM Services.WHEREAS, one such bill is Senate Bill No.

Further,1, thiswhich Amendmentpermanently requiresenhances theinvestment reportin toprimary assesscare howservices, cost-containmentencourages adoption of value-based care and coveragealternative strategiespayment maymodels, affectand brings greater accountability and transparency among some of the largest drivers of higher health equity.care costs;

and WHEREAS, Delaware’s hospitals have closely engaged with State agencies on the issue of higher health care costs in Delaware, including on efforts to address transparency and sustainability of hospital costs;

and WHEREAS, Delaware recently collaborated with Nemours to adopt the first ever pediatric global revenue budget model in the United States;

and WHEREAS, some state entities have pursued a public option or other publicly sponsored coverage strategy to reduce costs while expanding access;

and WHEREAS, it is crucial that the State look for innovative strategies and continue to collaborate with healthcare systems to lower Delaware’s exorbitant health care costs.

NOW, THEREFORE:

BE IT RESOLVED by the Senate and the House of Representatives of the 153rd General Assembly of the State of Delaware, with the approval of the Governor, that the Department of Health & Social Services is directed to explore and consider additional steps for tackling the high cost of health care in Delaware.

BE IT FURTHER RESOLVED that no later than January 1, 2027, the Department shall submit a report to the General Assembly that explores the feasibility of multiple additional strategies to lower health care costs in the State.

BE IT FURTHER RESOLVED the report issued by the Department shall consider updating the current Medicaid outlier methodology and consider ways to ensure further cost savings for the calendar year 2027 benefit year.

BE IT FURTHER RESOLVED the report issued by the Department shall also consider the feasibility of a statewide adoption of global budget or 2-sided risk models, including participation in the AHEAD model.

BE IT FURTHER RESOLVED that the Department’s report shall evaluate options for a public option or other publicly sponsored coverage strategy;

and the Department may consult with the Department of Insurance, the Department of Human Resources, and the State Employees’ Benefits Committee.

BE IT FURTHER RESOLVED that the Department shall submit the report to the members of the House Health & Human Development Committee and the Senate Health & Social Services Committee, the Chief Clerk of the House and the Secretary of the Senate, and the Director and Librarian of the Division of Legislative Services.

SYNOPSIS This Joint Resolution directs the Department of Health & Social Services to explore and consider additional solutions for tackling the State's high cost of health care and to submit a report to the General Assembly by January 1, 2027, that explores the feasibility of additional strategies to lower health care costs.

The report will explore updating the current Medicaid outlier methodology, ways to ensure further cost savings for 2027, and the feasibility of a statewide adoption of a SD :

MD :

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06/09/2026 04:03 PM global budget or 2-sided risk models, and will evaluate options for a public option or other publicly sponsored coverage strategy.

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